Shifting characteristics of nonmedical prescription tranquilizer users in the United States, 2005–2014

Abstract

BackgroundBenzodiazepine overdose rates have increased in the US, largely from concomitant use of other drugs such as opioids. Studies are needed to examine trends in prescription tranquilizer (e.g., benzodiazepine) use—with a particular focus on use of other drugs such as opioids—to continue to inform prevention efforts. MethodsWe conducted a secondary analysis of the 2005–2014 National Survey on Drug Use and Health, a repeated cross-sectional, nationally representative probability sample. Trends in past-year nonmedical tranquilizer use and trends in demographic and other past-year substance use characteristics among nonmedical users were examined (N = 560,099). ResultsPrevalence of nonmedical tranquilizer use remained stable from 2005/06 through 2013/14 at 2%. Prevalence of past-year heroin use and heroin use disorder both more than doubled among nonmedical tranquilizer users between 2005/06 and 2013/14 (Ps<.001). Nonmedical opioid use decreased between 2005/06 and 2013/14 (P < .001); however, opioid use disorder increased from 13.4% to 16.7% (P = .019). Prevalence doubled among those age >50 between 2005/06 and 2013/14 from 7.9% to 16.5% (P < .001), and nonmedical tranquilizer use among racial minorities also increased (Ps<.01). Prevalence of nonmedical use also increased among those with health insurance (P = .031), and this increase appeared to be driven by a 190.6% increase in nonmedical use among those with Medicare (from 2.6% to 7.4%; P = .002). ConclusionsCharacteristics of nonmedical tranquilizer users are shifting, and many shifts are related to past-year nonmedical prescription opioid use and heroin use. Prevention needs to be geared in particular towards older individuals and to those who use opioids nonmedically.