ArticleThe International journal on drug policy2017
High enhancer, downer, withdrawal helper: Multifunctional nonmedical benzodiazepine use among young adult opioid users in New York City.
Article in The International journal on drug policy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- The epidemiology of benzodiazepine misuse: A systematic review.Drug and alcohol dependence · 2019Pooled it
- Opioid withdrawal symptoms, frequency, and pain characteristics as correlates of health risk among people who inject drugs.Drug and alcohol dependence · 2020Trial
- Mind the gap! Addressing unresolved aspects of abuse potential evaluation and scheduling of classic and novel psychedelic drugs.Journal of psychopharmacology (Oxford, England) · 2026Review
- Benzodiazepines and Opioid co-use Among Rural People Who Use Drugs: Findings From the Rural Opioid Initiative.Substance use & addiction journal · 2025Article
- Profiles of polysubstance use among people reporting past 12-month sleep-motivated nonmedical use of prescription tranquilizers/sedatives.The American journal on addictions · 2025Article
- Severity of post-traumatic stress and non-medical, concomitant opioid and benzodiazepine use in a sample of women at high risk of overdose.International journal of mental health and addiction · 2025Article
- A qualitative study of benzodiazepine/z-drug and opioid co-use patterns and overdose risk.Harm reduction journal · 2025Article
- A Mixed-Methods Study of Motives for Benzodiazepine Misuse Among Adults Receiving Substance Use Disorder Treatment.Substance use & misuse · 2025Article
- Initial validation of the expectancies for Benzodiazepine Analgesia Scale.Experimental and clinical psychopharmacology · 2024Article
- Characterizing Opioid Withdrawal Experiences and Consequences Among a Community Sample of People Who Use Opioids.Substance use & misuse · 2024Article
- Severity of behavioral addiction symptoms among young adults using non-prescribed sedatives/hypnotics.Addictive behaviors reports · 2023Article
- Drug use patterns and factors related to the use and discontinuation of medications for opioid use disorder in the age of fentanyl: findings from a mixed-methods study of people who use drugs.Substance abuse treatment, prevention, and policy · 2023Article
- Methods for Assessing Spillover in Network-Based Studies of HIV/AIDS Prevention among People Who Use Drugs.Pathogens (Basel, Switzerland) · 2023Article
- Anhedonia modulates benzodiazepine and opioid demand among persons in treatment for opioid use disorder.Frontiers in psychiatry · 2023Article
- Hepatitis C virus risk among young people who inject drugs.Frontiers in public health · 2022Article
- Association Between Benzodiazepine or Z-Drug Prescriptions and Drug-Related Poisonings Among Patients Receiving Buprenorphine Maintenance: A Case-Crossover Analysis.The American journal of psychiatry · 2021Article
- Factors associated with methamphetamine withdrawal symptoms among people who inject drugs.Drug and alcohol dependence · 2021Article
- Hepatitis C testing and treatment uptake among young people who use opioids in New York City: A cross-sectional study.Journal of viral hepatitis · 2021Article
- Adverse Childhood Experiences Predict Early Initiation of Opioid Use Behaviors.Frontiers in sociology · 2021Article
- Emergency Department Visits Attributed to Adverse Events Involving Benzodiazepines, 2016-2017.American journal of preventive medicine · 2020Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundBenzodiazepines are a widely prescribed psychoactive drug; in the U.S., both medical and nonmedical use of benzodiazepines has increased markedly in the past 15 years. Long-term use can lead to tolerance and dependence, and abrupt withdrawal can cause seizures or other life-threatening symptoms. Benzodiazepines are often used nonmedically in conjunction with other drugs, and with opioids in particular-a combination that can increase the risk for fatal and non-fatal overdose. This mixed-methods study examines nonmedical use of benzodiazepines among young adults in New York City and its relationship with opioid use.
methodsFor qualitative analysis, 46 90-minute semi-structured interviews were conducted with young adult opioid users (ages 18-32). Interviews were transcribed and coded for key themes. For quantitative analysis, 464 young adult opioid users (ages 18-29) were recruited using Respondent-Driven Sampling and completed structured interviews. Benzodiazepine use was assessed via a self-report questionnaire that included measures related to nonmedical benzodiazepine and opioid use.
resultsParticipants reported using benzodiazepines nonmedically for a wide variety of reasons, including: to increase the high of other drugs; to lessen withdrawal symptoms; and to come down from other drugs. Benzodiazepines were described as readily available and cheap. There was a high prevalence (93%) of nonmedical benzodiazepine use among nonmedical opioid users, with 57% reporting regular nonmedical use. In bivariate analyses, drug-related risk behaviours such as polysubstance use, drug binging, heroin injection and overdose were strongly associated with regular nonmedical benzodiazepine use. In multivariate analysis, growing up in a middle-income household (earning between $51,000 and $100,000 annually), lifetime overdose experience, having ever used cocaine regularly, having ever been prescribed benzodiazepines, recent drug binging, and encouraging fellow drug users to use benzodiazepines to cope with opioid withdrawal were consistently strong predictors of regular nonmedical benzodiazepine use.
conclusionNonmedical benzodiazepine use may be common among nonmedical opioid users due to its drug-related multi-functionality. Harm reduction messages should account for the multiple functions benzodiazepines serve in a drug-using context, and encourage drug users to tailor their endorsement of benzodiazepines to peers to include safer alternatives.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.