Taking
opioids with other central nervous system (
CNS) depressants can increase risk of oversedation and
respiratory depression. We used telephone survey and electronic health care data to assess the prevalence of, and risk factors for, concurrent use of alcohol and/or
sedatives among 1,848 integrated care plan members who were prescribed chronic
opioid therapy (COT) for chronic noncancer
pain. Concurrent
sedative use was defined by receiving
sedatives for 45+ days of the 90 days preceding the interview; concurrent alcohol use was defined by consuming 2+ drinks within 2 hours of taking an
opioid in the prior 2 weeks. Some analyses were stratified by
substance use disorder (SUD) history (alcohol or
drug). Among subjects with no SUD history, 29% concurrently used
sedatives versus 39% of those with an SUD history. Rates of concurrent alcohol use were similar (12 to 13%) in the 2
substance use disorder strata. Predictors of concurrent
sedative use included SUD history, female gender, depression, and taking
opioids at higher doses and for more than 1
pain condition. Male gender was the only predictor of concurrent alcohol use. Concurrent use of
CNS depressants was common among this sample of COT users regardless of
substance use disorder status.
PERSPECTIVE: Risks associated with concurrent use of
CNS depressants are not restricted to COT users who abuse those substances. And, the increased risk of concurrently using
CNS depressants is not restricted to
opioid users with a prior SUD history. COT requires close monitoring, regardless of
substance use disorder history.