title: The use of alprazolam by people who inject drugs in Melbourne, Australia.
abstract: OBJECTIVE
  In Australia, people who inject drugs (PWID) commonly report the use of benzodiazepines (BZDs). This paper explores the emerging use of alprazolam among PWID in Melbourne, Australia.
  
  
  METHODS
  This study reports on 3 years of data collected through the Victorian Illicit Drug Reporting System (2008-2010). Structured interviews were conducted with 451 PWID and analysed using odds ratios and χ(2)-tests for trends over time.
  
  
  RESULTS
  While the proportion of PWID reporting recent BZD use remained stable over time, the proportion reporting alprazolam to be their most commonly used BZD fluctuated, peaking in 2009. Alprazolam users were significantly more likely to report using illicit BZDs and to report recent BZD injection compared with users of other BZDs. Alprazolam use was associated with the sale of drugs for cash, but not with other criminal activities.
  
  
  CONCLUSIONS
  The fluctuations in alprazolam use over time may be reflective of medical practitioners ceasing to prescribe alprazolam in response to reports of associated harms; however, this may in turn be driving the illicit alprazolam market. While the data do not indicate a clear association between alprazolam use and harms, considering the potential severity of associated harms and the association between alprazolam use and anterograde amnesia, patterns of alprazolam use among PWID should be closely monitored. Potential changes to prescribing practice should consider unintended consequences, such as replacement with other BZD types, or illicitly obtained BZDs.
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, Australia. danielle@burnet.edu.au
authors.forename: Danielle
authors.initials: D
authors.lastname: Horyniak
authors.forename: Siobhan
authors.initials: S
authors.lastname: Reddel
authors.forename: Brendan
authors.initials: B
authors.lastname: Quinn
authors.forename: Paul
authors.initials: P
authors.lastname: Dietze
mesh_terms: D000328:Adult; D000525:Alprazolam; D001569:Benzodiazepines; D055030:Drug Users / Q000523:psychology*; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D014739:Victoria
chemical_list: D013287:Illicit Drugs; D001569:Benzodiazepines; D000525:Alprazolam