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Benzodiazepines and Opioid co-use Among Rural People Who Use Drugs: Findings From the Rural Opioid Initiative.

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Benzodiazepine and opioid co-use in rural areas is linked to increased heavy drinking and gabapentin use. This pattern also shows less criminal legal system involvement compared to stimulant-opioid users.

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Area of Science:

  • Public Health
  • Substance Use Research
  • Rural Health Disparities

Background:

  • Benzodiazepine and opioid misuse are prevalent, yet co-use patterns in rural settings remain understudied.
  • Limited resources in rural areas necessitate a clear understanding of polysubstance use for effective intervention strategies.

Purpose of the Study:

  • To investigate the distinct patterns and outcomes of benzodiazepine+opioid co-use compared to stimulant+opioid co-use in rural populations.
  • To inform targeted interventions for substance use in underserved rural communities.

Main Methods:

  • Analysis of data from the Rural Opioid Initiative, including 1107 participants with past 30-day opioid use.
  • Comparison of participants reporting benzodiazepine+opioid use versus stimulant+opioid use.
  • Assessment of substance use behaviors, health outcomes, and criminal legal system involvement.

Main Results:

  • Benzodiazepine+opioid users (10%) reported higher use of opioid pain medication, gabapentin, and clonidine compared to stimulant+opioid users (90%).
  • Increased frequency of heavy episodic drinking was observed in the benzodiazepine+opioid group.
  • Lower prevalence of law enforcement encounters, arrests, and incarceration was reported by the benzodiazepine+opioid group.

Conclusions:

  • Benzodiazepine+opioid co-use is associated with specific behavioral patterns, including increased heavy episodic drinking and gabapentin use.
  • Distinct outcomes, such as reduced criminal legal system involvement, characterize this co-use group.
  • Targeted interventions are crucial for addressing the unique needs of rural populations engaging in benzodiazepine and opioid co-use.