title: Benzodiazepine use in all alcohol consumers predicts use of opioids in patients 20 years later--a follow-up study of 13,390 men and women aged 40-42 years.
abstract: OBJECTIVE
  To evaluate the effect of the consumption of benzodiazepines at age 40-42 years on prescription of opioids later in life.
  
  
  METHODS
  A cohort of 6707 men and 6683 women aged 40-42 years reported no use of analgesics in health surveys in 1985-1989. This cohort was linked to the Norwegian prescription database (NorPD) and their prescriptions of opioids during 2004-2006 were analysed. Low-high, moderate-high and high prescription frequency of opioids were defined as at least 6, 12 or 16 prescriptions during January 2004-December 2006. Non-steroid anti-inflammatory drugs (NSAIDs) were used as comparators.
  
  
  RESULTS
  The unadjusted odds ratios (ORs) for low-high prescription frequency of opioids for men and women using benzodiazepines were 3.8 (95%CI 2.5-5.7) and 3.4 (2.6-4.4), respectively, as compared with non-users. After adjustment for alcohol, smoking habits and socio-economic variables, the ORs were lowered for both sexes: 2.6 (1.7-4.0) in men and 2.5 (1.9-3.3) in women. The adjusted OR for those with high prescription of opioids was higher for both sexes: 4.5 (2.4-8.5) in men and 3.7 (2.4-5.7) in women. A stratified analysis revealed no relationship between benzodiazepine use and later low and moderate prescription frequency of opioids among teetotallers. The adjusted ORs for low-high prescription frequency NSAID use for men and women using benzodiazepines were 1.6 (1.1-2.4) and 1.6 (1.3-2.0), respectively.
  
  
  CONCLUSIONS
  In this study population, a history of benzodiazepine use raised the chance of being prescribed opioids later in life among those who also used alcohol.
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, 0403 Oslo, Norway. svetlana.skurtveit@fhi.no
authors.forename: Svetlana
authors.initials: S
authors.lastname: Skurtveit
authors.forename: Kari
authors.initials: K
authors.lastname: Furu
authors.forename: Jørgen G
authors.initials: JG
authors.lastname: Bramness
authors.forename: Aage
authors.initials: A
authors.lastname: Tverdal
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000639:trends*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D015331:Cohort Studies; D004363:Drug Utilization / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D055656:Prescriptions; D011446:Prospective Studies; D013695:Temperance / Q000639:trends
chemical_list: D000701:Analgesics, Opioid; D001569:Benzodiazepines