Abstract
BackgroundReports from Thailand suggest that a growing number of people who inject drugs (IDU) are now injecting midazolam, a legal benzodiazepine with potent amnestic and ventilatory depressant effects. We therefore sought to examine midazolam injection among a community-recruited sample of Thai IDU.MethodsWe examined the prevalence and correlates of midazolam injection among 252 IDU participating in the Mitsampan Community Research Project, Bangkok, using multivariate logistic regression. We also examined the use of midazolam in combination with other drugs.Results252 IDU participated in this study, including 66 (26.2%) women. In total, 170 (67.5%) participants reported ever having injected midazolam, and 144 (57.1%) reported daily midazolam injection in the past six months. In multivariate analyses, a history of midazolam injection was independently associated with using drugs in combination (adjusted odds ratio [AOR] = 5.86; 95% confidence interval [CI]: 2.96-11.60), younger age (AOR = 0.43; 95%CI: 0.22-0.83), having a history of methadone treatment (AOR = 3.12, 95%CI: 1.55-6.90), and binge drug use (AOR = 2.25, 95%CI: 1.09-4.63). The drugs most commonly used in combination with midazolam were heroin (72.3%) and yaba (methamphetamine) (30.5%).ConclusionWe observed a high rate of midazolam injection among Thai IDU. Midazolam injection was strongly associated with polysubstance use and binge drug use, and was most commonly used in combination with both opiates and methamphetamines. Our findings suggest that midazolam injection has become increasingly common within Thailand. Evidence-based approaches for reducing harms associated with midazolam injection are needed.
Highlights
Reports from Thailand suggest that a growing number of people who inject drugs (IDU) are injecting midazolam, a legal benzodiazepine with potent amnestic and ventilatory depressant effects
Studies undertaken during the past decade suggest a number of Thai people who inject drugs (IDU) are injecting midazolam (Thai trade name: Dormicum®), a legal, rapid onset, short duration benzodiazepine with potent sedative, amnestic and ventilatory depressant effects [8,9,10]
We considered experiences of drug planting by police given that this type of contact with police could potentially prompt some IDU to obtain midazolam, given that the drug can be obtained “over-the-counter” in selected pharmacies and acquiring it may involve little or no contact with the illicit drug market
Summary
Reports from Thailand suggest that a growing number of people who inject drugs (IDU) are injecting midazolam, a legal benzodiazepine with potent amnestic and ventilatory depressant effects. Studies undertaken during the past decade suggest a number of Thai people who inject drugs (IDU) are injecting midazolam (Thai trade name: Dormicum®), a legal, rapid onset, short duration benzodiazepine with potent sedative, amnestic and ventilatory depressant effects [8,9,10]. It has been suggested that midazolam injection, partly because of the associated amnestic effects, can result in elevated rates of risk behaviour, including syringe sharing [9]. The ongoing “drug war” in Thailand, and the paucity of research on midazolam use, we sought to examine the prevalence and correlates of midazolam injection, as well as patterns of midazolam-related polysubstance use, among a communityrecruited sample of IDU in Bangkok, Thailand
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
