TY - JOUR
T1 - Past-year use or misuse of an opioid is associated with use of a sedative-hypnotic medication
T2 - a US National Survey on Drug Use and Health (NSDUH) study
AU - Tubbs, Andrew S.
AU - Ghani, Sadia B.
AU - Naps, Michelle
AU - Grandner, Michael A.
AU - Stein, Michael D.
AU - Chakravorty, Subhajit
N1 - Publisher Copyright: Copyright 2022 American Academy of Sleep Medicine. All rights reserved.
PY - 2022/3
Y1 - 2022/3
N2 - Study Objectives: Prescription use and misuse of opioids are linked to greater sleep disturbance. However, there are limited data on the prevalence of sedative-hypnotic medication use among persons who use opioids. Therefore, this study examined whether past-year sedative-hypnotic use among persons who used/misused opioids was higher than among individuals who did not use opioids. Methods: Data were acquired from the US National Survey on Drug Use and Health for 2015–2018. Use of a sedative benzodiazepine (temazepam, flurazepam, triazolam) or a Z-drug (eszopiclone, zaleplon, zolpidem) was examined in relation to use/misuse of an opioid within the past year. Logistic regression models estimated the associations between opioids and sedative-hypnotics using inverse probability of treatment weighting. A secondary machine learning analysis tested 6 binary classifiers to predict sedative-hypnotic use based on opioid use/misuse and other covariates. Results: Of 171,766 respondents, 24% used a prescription opioid whereas 3.6% misused an opioid in the past year. Among those who used a prescription opioid, 1.9% received a sedative benzodiazepine and 9% received a Z-drug during the same time frame. Use of an opioid was associated with greater odds of sedative benzodiazepine use (odds ratio, 4.4; 95% confidence interval, 3.61–5.4) and Z-drug use (odds ratio, 3.8; 95% confidence interval, 3.51–4.09), and stronger associations were noted for misuse of an opioid. Machine learning models accurately classified sedative-hypnotic medication use for > 70% of respondents based on opioid use/misuse. Conclusions: Sedative-hypnotic use is common among persons who use opioids, which is of concern given the elevated mortality risk with concurrent use of these substances.
AB - Study Objectives: Prescription use and misuse of opioids are linked to greater sleep disturbance. However, there are limited data on the prevalence of sedative-hypnotic medication use among persons who use opioids. Therefore, this study examined whether past-year sedative-hypnotic use among persons who used/misused opioids was higher than among individuals who did not use opioids. Methods: Data were acquired from the US National Survey on Drug Use and Health for 2015–2018. Use of a sedative benzodiazepine (temazepam, flurazepam, triazolam) or a Z-drug (eszopiclone, zaleplon, zolpidem) was examined in relation to use/misuse of an opioid within the past year. Logistic regression models estimated the associations between opioids and sedative-hypnotics using inverse probability of treatment weighting. A secondary machine learning analysis tested 6 binary classifiers to predict sedative-hypnotic use based on opioid use/misuse and other covariates. Results: Of 171,766 respondents, 24% used a prescription opioid whereas 3.6% misused an opioid in the past year. Among those who used a prescription opioid, 1.9% received a sedative benzodiazepine and 9% received a Z-drug during the same time frame. Use of an opioid was associated with greater odds of sedative benzodiazepine use (odds ratio, 4.4; 95% confidence interval, 3.61–5.4) and Z-drug use (odds ratio, 3.8; 95% confidence interval, 3.51–4.09), and stronger associations were noted for misuse of an opioid. Machine learning models accurately classified sedative-hypnotic medication use for > 70% of respondents based on opioid use/misuse. Conclusions: Sedative-hypnotic use is common among persons who use opioids, which is of concern given the elevated mortality risk with concurrent use of these substances.
KW - analgesics
KW - chronic pain
KW - hypnotics
KW - maintenance disorders
KW - opioid-related disorders
KW - opioids
KW - sedatives
KW - sleep initiation
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U2 - 10.5664/jcsm.9724
DO - 10.5664/jcsm.9724
M3 - Article
C2 - 34666879
SN - 1550-9389
VL - 18
SP - 809
EP - 816
JO - Journal of Clinical Sleep Medicine
JF - Journal of Clinical Sleep Medicine
IS - 3
ER -