Nonmedical benzodiazepine use in adults with alcohol use disorder: The role of anxiety sensitivity and polysubstance use

McHugh, R. Kathryn; Geyer, Rachel B.; Karakula, Sterling L.; Griffin, Margaret L.; Weiss, Roger D.

doi:10.1111/ajad.12765

Cited by 29 publications

(16 citation statements)

References 36 publications

(46 reference statements)

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“…Women had higher mean scores on the negative emotionality construct than men. This is consistent with previous findings that women with substance use disorders report greater negative affect than men and that negative affect might have a larger contribution to women’s drinking than to men’s drinking (Conway et al, ; McHugh et al, , ). Future efforts should examine multiple group measurement invariance of the negative emotionality domain across those with and without AUD and those with AUD who are treatment‐seeking and non–treatment‐seeking.…”

Section: Discussionsupporting

confidence: 92%

The Addictions Neuroclinical Assessment Negative Emotionality Domain Among Treatment‐Seekers with Alcohol Use Disorder: Construct Validity and Measurement Invariance

Votaw

Pearson

Stein

et al. 2020

Alcoholism Clin & Exp Res

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Background The Addictions Neuroclinical Assessment (ANA), a framework for measuring heterogeneity in alcohol use disorder (AUD), focuses on 3 domains that reflect neurobiological dysfunction in addiction and correspond to the cycles of addiction: executive function, incentive salience, and negative emotionality. Kwako and colleagues (Am J Psychiatry 176:744, 2019) validated a 3‐factor model of the ANA with neuropsychological and self‐report indicators among treatment‐seekers and non–treatment‐seekers with and without AUD. The present analysis replicated and extended these findings in a treatment‐seeking sample, focusing on the negative emotionality domain. Methods Participants (n = 563; 58.8% male; mean age = 34.3) were part of a multisite prospective study of individuals entering AUD treatment. We examined the factor structure of the negative emotionality domain at the baseline, 6‐month follow‐up, and 12‐month follow‐up assessments. The Beck Depression Inventory, Beck Anxiety Inventory, State‐Trait Anger Expression Inventory‐Trait Anger Subscale, and 3 Drinker Inventory of Consequences items assessing negative affective consequences were indicators in the model. Results Results indicated that a 1‐factor model was an excellent fit at all assessments and that the negative emotionality domain was time and gender invariant. Furthermore, negative emotionality was associated with drinking patterns and reasons for alcohol use (i.e., drinking because of negative emotions and urges/withdrawal) at all assessments. Conclusions This analysis provides evidence for the construct validity and measurement invariance of the ANA negative emotionality domain among AUD treatment‐seekers. Future studies are needed to evaluate prospective associations between negative emotionality and specific treatment modalities, and whether individuals with greater negative emotionality are more likely to respond to treatment that targets drinking to relieve negative affective states.

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Section: Discussionsupporting

confidence: 92%

The Addictions Neuroclinical Assessment Negative Emotionality Domain Among Treatment‐Seekers with Alcohol Use Disorder: Construct Validity and Measurement Invariance

Votaw

Pearson

Stein

et al. 2020

Alcoholism Clin & Exp Res

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“…Rates of misuse might be higher among those with greater AUD severity, as evidenced by an analysis of NSDUH data wherein approximately 12% of those with DSM-IV alcohol dependence reported past-year sedative/tranquilizer misuse (Hedden et al, 2010). Indeed, studies of people with AUD in treatment demonstrate even higher rates, with estimates of recent benzodiazepine misuse (self-reported past-month use or urine drug screen results) ranging from 19-40% (McHugh et al, 2018;Morel et al, 2016;Ogborne and Kapur, 1987;Ross, 1993).…”

Section: Substancementioning

confidence: 99%

“…This is consistent with data that other substance use is consistently associated with benzodiazepine misuse in numerous populations, and that benzodiazepine misuse is associated with greater substance use severity cross-sectionally and prospectively (see Supplementary Materials). In fact, benzodiazepine misuse increases with the overall level of polysubstance use (McHugh et al, 2018;Schuman-Olivier et al, 2013;Votaw et al, 2019). Benzodiazepine misuse is strongly associated with risk for other prescription drug misuse and use disorders, particularly prescription opioid misuse and OUD (Blanco et al, 2018;Boggis et al, 2019;Han et al, 2017;Han et al, 2015;Huang et al, 2006;Jones and McCance-Katz, 2019;Jones, 2017;Maust et al, 2018).…”

Section: Substancementioning

confidence: 99%

“…Although not consistently studied, several studies examining gender as a moderator of the association between symptoms of anxiety and/or depression and benzodiazepine misuse have found a stronger association among women than men (Hearon et al, 2011;McHugh et al, 2018;McHugh et al, 2017;Zullig and Divin, 2012). Analysis of a large general population sample in the U.S. found that the association between anxiety disorders and SHA use disorder was stronger among women relative to men; however, the association between panic disorder without agoraphobia and sedative dependence was higher among men (Conway et al, 2006).…”

Section: Psychiatric Comorbidity and Affectivementioning

confidence: 99%

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The epidemiology of benzodiazepine misuse: A systematic review

Votaw

Geyer

Rieselbach

et al. 2019

Drug and Alcohol Dependence

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284

214

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Background: Benzodiazepine misuse is a growing public health problem, with increases in benzodiazepine-related overdose deaths and emergency room visits in recent years. However, relatively little attention has been paid to this emergent problem. We systematically reviewed epidemiological studies on benzodiazepine misuse to identify key findings, limitations, and future directions for research. Methods: PubMed and PsychINFO databases were searched through February 2019 for peerreviewed publications on benzodiazepine misuse (e.g., use without a prescription; at a higher frequency or dose than prescribed). Eligibility criteria included human studies that focused on the prevalence, trends, correlates, motives, patterns, sources, and consequences of benzodiazepine misuse. Results: The search identified 1,970 publications, and 351 articles were eligible for data extraction and inclusion. In 2017, benzodiazepines and other tranquilizers were the third most commonly used illicit or prescription drug in the U.S. (approximately 2.2% of the population). Worldwide rates of misuse appear to be similar to those reported in the U.S. Factors associated with misuse include other substance use, receipt of a benzodiazepine prescription, and psychiatric symptoms and disorders. Benzodiazepine misuse encompasses heterogeneous presentations of motives, patterns, and sources. Moreover, misuse is associated with myriad poor outcomes, including mortality, HIV/HCV risk behaviors, poor self-reported quality of life, criminality, and continued substance use during treatment.

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“…Todavia, o uso de BZD's pelas mulheres foi de maneira prescrita, para o tratamento de transtorno de uso de álcool, depressão e ansiedade. Sendo que os mais prescritos foram o Lorazepam e Alprazolam, entre os BZD's ansiolíticos, o Lormetazepam como hipnótico para o tratamento de ansiedade e depressão (Mchugh et al, 2018;Kroll et al, 2016).…”

Section: Resultsunclassified

Uso crônico e indiscriminado de benzodiazepínicos: uma revisão de literatura

Andrade

Cunha²,

Júnior

et al. 2020

RSD

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The chronic and indiscriminate use of benzodiazepines (BZD’s) can have many adverse effects, which can lead to tolerance, dependence and withdrawal crises. Thus, the objective is to identify which BZD’s are most used in Brazil, outlining the profile of users of this pharmacological class. A literature review was carried out with articles indexed in the scientific bases Scientific Electronic Library Online (Scielo), Virtual Health Library (VHL) and PubMed, in the time frame from 2010 to 2020, using the following descriptors: “Benzodiazepines”, “Use of medicines", "Disorder related to substance use", Abuse", "Intoxication". A total of 220 articles were found in the initial selection, with 97 articles from the Scielo database, 67 from the VHL and 56 from PubMed. Being listed 13 articles (Scielo: 05, VHL: 05, PubMed: 03) as relevant, which were selected for complete analysis and construction of this study. In the studies listed, the most consumed BZD’s was Lorazepam, however in cases of anxiety Clonazepam is the drug of first choice. Regarding the profile of users of BZD’s, the age group that most use these drugs is the elderly, concerning the use of high doses of BZD’s, it was observed that younger patients, male, single and less educated are more associated sensitive. We conclude then, a high prevalence of the use of BZD’s, mainly in developed countries, which can be characterized by stress, anxiety and insomnia experienced by people in their daily lives.

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Nonmedical benzodiazepine use in adults with alcohol use disorder: The role of anxiety sensitivity and polysubstance use

Cited by 29 publications

References 36 publications

The Addictions Neuroclinical Assessment Negative Emotionality Domain Among Treatment‐Seekers with Alcohol Use Disorder: Construct Validity and Measurement Invariance

The Addictions Neuroclinical Assessment Negative Emotionality Domain Among Treatment‐Seekers with Alcohol Use Disorder: Construct Validity and Measurement Invariance

The epidemiology of benzodiazepine misuse: A systematic review

Uso crônico e indiscriminado de benzodiazepínicos: uma revisão de literatura

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