Benzodiazepines, such as alprazolam (Xanax ®), diazepam (Valium ®), clonazepam (Klonopin ®), and lorazepam (Ativan ®), depress central nerve system (CNS) activity and are utilized to ease signs of stress and anxiety, anxiety attack, and seizures.1,2 They have been considered safe and efficient when taken as recommended and directed. However, when integrated with other drugs that depress CNS activity, such as alcohol or opioid pain relievers like oxycodone (OxyContin ®), hydrocodone (Vicodin ®), hydromorphone (Dilaudid ®), or morphine, benzodiazepines may present severe or even deadly problems. Concerns exist about the increasing number of patients recommended both benzodiazepines and opioids and about severe complications occurring from using benzodiazepines with alcohol.3,4 This report quantifies the increased danger of more serious results such as hospitalization or, rarely, death in the emergency department (ED), when benzodiazepines are combined with alcohol or opioid painkiller.
The Substance abuse Caution Network (DAWN) was a public health security system that kept track of drug-related ED visits in the United States. To be a DAWN case, an ED go to should have included a drug, either as the direct reason for the see or as a contributing factor. This report thinks about four drug combinations: benzodiazepines alone, benzodiazepines and opioids, benzodiazepines and alcohol, and benzodiazepines, opioids, and alcohol. Sees involving any compound other than these 3 drugs were omitted. Visits involving suicide attempts or malicious poisonings were likewise omitted as the intent in these sees is to do damage– an objective that would bias such check outs toward more severe outcomes. Sees including clients seeking drug cleansing were also excluded, as admissions arising from these sees may not reflect the severity of a client’s condition at the time of his/her ED see.
Logistic regression is an analytical method utilized to identify if there is a relationship (that is, an association) between a result with 2 possibilities and a known characteristic, such as gender. All ED go to outcomes were organized into two categories for this report: (1) “less serious outcomes” showed that the client was dealt with and launched to home, to cops custody, or with a referral to another provider, and (2) “more serious results” indicated admission to the very same healthcare facility where the ED was located (any department), transfer to another medical facility, or death.5,6,7.
This report uses logistic regression to examine the association between ED check out result and the 4 drug mixes discussed above, patient age, gender, and the year where the go to occurred. Data from 2005 to 2011 were combined to ensure appropriate sample size; however, there were two concerns. Initially, there has been an increasing preference for prescribing alprazolam in time, which might bring a greater danger of problems than other benzodiazepines and which might have altered the association of benzodiazepines with ED go to result.8 Second, the intro in 2010 of a tamper-resistant formulation for the extended-release formulas of the commonly recommended opioid painkiller oxycodone may have lowered the occurrence of this drug’s abuse.9.
Figure 1 shows trends from 2005 to 2011 for each drug combination. Year of collection was consisted of in the initial logistic regression designs in order to check out the possibility that combining data from various years may have obscured the results of changes over time. Year of collection did not have a statistically considerable association with predicted ED check out result; for that reason, it seemed unlikely that combining data from 2005 to 2011 triggered associations of the drug mixes with check out outcome to go undiscovered over that time period.