title: Risk factors for concurrent use of benzodiazepines and opioids among individuals under community corrections supervision.
abstract: BACKGROUND
  The use of heroin and prescription opioids has increased over the past decade. The concurrent use of opioids with other depressants such as benzodiazepines increases the risk of overdose death compared with use of either drug alone. This study examined factors associated with concurrent use of opioids and benzodiazepines in a criminal justice sample in the state of Alabama.
  
  
  METHODS
  The Addiction Severity Index (ASI) and urine drug screen results from 28,570 individuals who were under community corrections supervision from 2002-2012 were examined for independent or concurrent opioid and benzodiazepine use. Multinomial logistic regression analyses were conducted to determine associations between socio-demographic characteristics and drug use.
  
  
  RESULTS
  Concurrent use was detected in 11.5% of the sample. Concurrent use of opioids and benzodiazepines or use of either drug alone was associated with being White, female, married, prescribed psychiatric medications, having seen a physician in the past two years, cannabis use, and having a drug-related offense. Concurrent users were more likely to be unemployed or disabled and have received counseling, and less likely to have completed college, live with relatives or friends, have a history of hallucinations, or have an offense against a person relative to nonusers.
  
  
  CONCLUSIONS
  While significant overlap of risk factors exists between individuals with concurrent use versus sole use of opioids or benzodiazepines, individuals with concurrent use generally have more social dysfunction than individuals who tested for either substance alone. Concurrent users may need more psychosocial resources and intensive treatments to promote recovery.
authors.affiliation: University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1720 7th Ave S., Birmingham, AL 35294-0017, United States. Electronic address: kcropsey@uab.edu.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Cropsey
authors.affiliation: University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1720 7th Ave S., Birmingham, AL 35294-0017, United States.
authors.forename: Erin N
authors.initials: EN
authors.lastname: Stevens
authors.affiliation: Columbia University, Mailman School of Public Health, 722 W. 168th St., New York, N.Y. 10032, United States.
authors.forename: Pamela
authors.initials: P
authors.lastname: Valera
authors.affiliation: University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1720 7th Ave S., Birmingham, AL 35294-0017, United States.
authors.forename: C
authors.initials: C
authors.lastname: Brendan Clark
authors.affiliation: University of Alabama at Birmingham, Department of Psychology, 1720 2nd Ave S., Birmingham AL 35233, United States.
authors.forename: Hailey W
authors.initials: HW
authors.lastname: Bulls
authors.affiliation: University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1720 7th Ave S., Birmingham, AL 35294-0017, United States.
authors.forename: Parvathy
authors.initials: P
authors.lastname: Nair
authors.affiliation: University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1720 7th Ave S., Birmingham, AL 35294-0017, United States.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Lane
mesh_terms: D000328:Adult; D000407:Alabama; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D001569:Benzodiazepines / Q000008:administration & dosage*; D057237:Criminals / Q000523:psychology*; D055030:Drug Users / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012651:Self Medication / Q000523:psychology*
chemical_list: D000701:Analgesics, Opioid; D001569:Benzodiazepines
keywords: Benzodiazepine; Community corrections; Concurrent use; Criminal justice; Opiates