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Combination of two drugs a risk for substance abuse

Thursday December 13, 2012
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Substance abuse treatment admissions for addiction involving combined use of benzodiazepine and narcotic pain relievers rose a total of 569.7%, to 33,701, from 2000 to 2010, according to a report by the Substance Abuse and Mental Health Services Administration.

By comparison, overall substance abuse treatment admissions of people ages 12 and older in the same period rose 4%, to 1.82 million, the agency said.

"Clearly, the rise in this form of substance abuse is a public health problem that all parts of the treatment community need to be aware of," SAMHSA Administrator Pamela S. Hyde said in a news release. "When patients are battling severe withdrawal effects from two addictive drugs, new treatment strategies may be needed to meet this challenge. These findings will help us better understand the nature and scope of this problem and to develop better approaches to address it."

According to the report, 38.7% of those with this combined addiction began use of both drugs in the same year, 34.1% first used narcotic pain relievers and the remaining 27.1% started with benzodiazepines.

Almost half the patients admitted for combined use also had a co-occurring psychiatric disorder. They largely were self-referred and were less likely to receive regular outpatient treatment than other admissions.

Specific demographic groups have higher rates of admission for combination benzodiazepine/NPR treatment when compared with admissions for other treatment. Non-Hispanic whites account for 91.4% of combination admissions versus only 55.8% of other admissions. Females make up 49.2% of combined admissions versus 30.2% of other admissions, and people ages 18 to 34 account for 66.9% of combined admissions versus 43.7% of other admissions.

"The public health and safety threat we face from the abuse of prescription drugs is indisputable, and these data show the increasing need for treatment for those suffering from addiction to prescription drugs," said Office of National Drug Control Policy Director Gil Kerlikowske. "While prevention is a critically important pillar of our prescription drug prevention plan, equally important is ensuring that treatment is available to those in need."

SAMHSA recognizes the importance of providing education to medical professionals about the appropriate prescribing of opioids and benzodiazepines, according to the news release. SAMHSA’s Prescribers’ Clinical Support System for Opioid Therapies (PCSS-O) is a national training and mentoring program addressing safe use of opioid medications and treatment of opioid dependence.

The program is undertaken by a consortium of national clinical specialty organizations, including the American Society for Pain Management Nursing, International Nurses Society on Addictions, American Academy of Addiction Psychiatry, American Psychiatric Association, American Osteopathic Academy of Addiction Medicine, American Medical Association and American Dental Association.

The PCSS-O (www.pcss-o.org) offers webinars and educational modules on various topics related to opioid use and mentoring and a list-serve addressing current questions related to opioid use, opioid use disorders and the confounding effects of benzodiazepines.

The survey report, "Admissions Reporting Benzodiazepine and Narcotic Pain Reliever Abuse at Treatment Entry," is available at www.samhsa.gov/data/2k12/TEDS-064/TEDS-Short-Report-064-Benzodiazepines-2012.htm.


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