Sharp Rise in Admissions From Benzo/Pain Med Combinations

Admissions to substance abuse treatment programs by patients using a combination of benzodiazepines (benzos) and pain relievers have risen drastically over the past decade, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA).

The Treatment Episode Data Set (TEDS) Report for December 13 examined national records on annual admissions for substance use treatment. It showed that between the years 2000 and 2010, admissions for those abusing both benzos and narcotic pain relievers increased more than 500% — whereas admissions for all other substances decreased by almost 10%.

"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," said Gil Kerlikowske, director of the Office of National Drug Control Policy, in a release.

Of the patients seeking treatment for this combination of drugs, 46% had a comorbid psychiatric disorder compared with 28% of patients admitted for abusing other substances.

"The high rate of co-occurring mental health disorders...may reflect in part that benzodiazepines are used to treat some mental health problems, such as anxiety," write the report authors.

"Substance abuse treatment may provide a unique opportunity to facilitate access to both substance abuse treatment and mental health services for people who co-abuse these drugs," they add.

The TEDS Report is posted on SAMHSA's Web site.

High-Need Population

Benzos are often prescribed to treat sleep disorders and drug and alcohol withdrawal symptoms. However, the drug class can also "enhance or boost the effects of...narcotic pain relievers, including oxycodone," write the investigators.

They note that people who co-abuse these drugs should be considered a "high-need, treatment-resistant population."

The TEDS Report found that there were 33,701 treatment admissions in 2010 for these co-abusers compared with 5032 admissions in 2000 (an increase of 569.7%).

A total of 57.1% of the combo users reported daily use of narcotic pain relievers during the month just prior to treatment admission, and 45.5% reported using benzos daily.

The annual number of admissions for other types of substance abuse decreased from 1,675,736 in 2000 to 1,514,940 in 2010.

"While the volume of benzodiazepine and narcotic pain reliever combination admissions is comparatively small relative to the annual number of treatment admissions, substance abuse treatment programs are treating an increasing number of patients who co-abuse these drugs," write the report authors.

Serious Withdrawal Effects

Other findings from the report include the following:

43.1% of the combination admissions in 2010 occurred in the southern part of the United States, whereas only 5.3% of these admissions occurred in the western part;
91.4% of all benzo plus narcotic pain reliever admissions were for non-Hispanic whites;
The number of female abusers of the combination was almost equal to male abusers (49.2% vs 50.8%, respectively); and
The average age of all combination users was 31.2 years.

"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," said Pamela S. Hyde, SAMSHA administrator, in a release.

"When patients are battling severe withdrawal effects from 2 addictive drugs, new treatment strategies may be needed to meet this challenge. These findings will help us to better understand the nature and scope of this problem and to develop better approaches."

Kerlikowske added that "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."

The full TEDS Report was published online December 13, 2012, on SAMHSA's Web site.