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      Polysubstance Abuse: Alcohol, Opioids and Benzodiazepines Require Coordinated Engagement by Society, Patients, and Physicians

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          Abstract

          The Centers for Disease Control and Prevention (CDC) has published significant data trends related to substance abuse involving opioid pain relievers (OPR), benzodiazepines and alcohol in the United States. The CDC describes opioid misuse and abuse as an epidemic, with the use of OPR surpassing that of illicit drugs. Alcohol has also been a persistent problem and is associated with a number of emergency department visits and deaths independent of other substances. The use of these drugs in combination creates an additive effect with increased central nervous system suppression and a heightened risk of an overdose. We present a summary of the findings from the Morbidity and Mortality Weekly Report (MMWR) with commentary on strategies to combat prescription drug and alcohol abuse.

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          The promotion and marketing of oxycontin: commercial triumph, public health tragedy.

          Art Van Zee (2009)
          I focus on issues surrounding the promotion and marketing of controlled drugs and their regulatory oversight. Compared with noncontrolled drugs, controlled drugs, with their potential for abuse and diversion, pose different public health risks when they are overpromoted and highly prescribed. An in-depth analysis of the promotion and marketing of OxyContin illustrates some of the associated issues. Modifications of the promotion and marketing of controlled drugs by the pharmaceutical industry and an enhanced capacity of the Food and Drug Administration to regulate and monitor such promotion can have a positive impact on the public health.
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            Polydrug abuse: a review of opioid and benzodiazepine combination use.

            Jermaine D Jones, Shanthi Mogali, Sandra Comer (2012)
            This paper reviews studies examining the pharmacological interactions and epidemiology of the combined use of opioids and benzodiazepines (BZDs). A search of English language publications from 1970 to 2012 was conducted using PubMed and PsycINFO(®). Our search found approximately 200 articles appropriate for inclusion in this paper. While numerous reports indicate that the co-abuse of opioids and BZDs is ubiquitous around the world, the reasons for the co-abuse of these medications are not entirely clear. Though the possibility remains that opioid abusers are using BZDs therapeutically to self-medicate anxiety, mania or insomnia, the data reviewed in this paper suggest that BZD use is primarily recreational. For example, co-users report seeking BZD prescriptions for the purpose of enhancing opioid intoxication or "high," and use doses that exceed the therapeutic range. Since there are few clinical studies investigating the pharmacological interaction and abuse liability of their combined use, this hypothesis has not been extensively evaluated in clinical settings. As such, our analysis encourages further systematic investigation of BZD abuse among opioid abusers. The co-abuse of BZDs and opioids is substantial and has negative consequences for general health, overdose lethality, and treatment outcome. Physicians should address this important and underappreciated problem with more cautious prescribing practices, and increased vigilance for abusive patterns of use.
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              Overprescription of postoperative narcotics: a look at postoperative pain medication delivery, consumption and disposal in urological practice.

              Cory Bates, Robert J Laciak, Andrew Southwick … (2011)
              Prescription narcotic abuse is a significant social problem. Surplus medication following surgery is 1 source of prescription diversion. We assessed prescribing practices, consumption and disposal of prescribed narcotics after urological surgery.
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                Author and article information

                Journal
                Journal ID (nlm-ta): West J Emerg Med
                Journal ID (iso-abbrev): West J Emerg Med
                Journal ID (publisher-id): WestJEM
                Title: Western Journal of Emergency Medicine
                Publisher: Department of Emergency Medicine, University of California, Irvine School of Medicine
                ISSN (Print): 1936-900X
                ISSN (Electronic): 1936-9018
                Publication date (Print): January 2015
                Publication date (Electronic): 15 December 2014
                Volume: 16
                Issue: 1
                Pages: 76-79
                Affiliations
                University of California, Irvine, Department of Emergency Medicine, Orange, California
                Author notes
                Address for Correspondence: Bharath Chakravarthy, MD, MPH, Department of Emergency Medicine, 101 The City Drive South, Rte 128-01. Email: bchakrav@ 123456uci.edu .
                Article
                Publisher ID: wjem-16-76
                DOI: 10.5811/westjem.2014.11.24720
                PMC ID: 4307731
                PubMed ID: 25671013
                SO-VID: af345a2f-b5bd-4dc1-8146-dfd3a2288ae4
                Copyright © Copyright © 2015 the authors.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Non-Commercial Attribution License, which permits its use in any digital medium, provided the original work is properly cited and not altered. For details, please refer to http://creativecommons.org/licenses/by-nc-nd/3.0/. Authors grant Western Journal of Emergency Medicine a nonexclusive license to publish the manuscript.

                History
                Date received : 19 November 2014
                Date accepted : 25 November 2014
                Categories
                Subject: Behavioral Health

                ScienceOpen disciplines: Emergency medicine & Trauma
                Data availability:
                ScienceOpen disciplines: Emergency medicine & Trauma

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