The use of alprazolam by people who inject drugs in Melbourne, Australia

Horyniak, Danielle; Reddel, Siobhan; Quinn, Brendan; Dietze, Paul

doi:10.1111/j.1465-3362.2011.00381.x

Cited by 17 publications

(10 citation statements)

References 28 publications

(28 reference statements)

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“…This was done with specific consideration of two commonly used benzodiazepines, diazepam and alprazolam. Notably, our findings suggest that alprazolam poses a greater risk than diazepam for subsequent aggressive behaviour, supporting prior discussions which have described alprazolam as one of the most problematic benzodiazepines (Horyniak et al, 2012;Rintoul et al, 2013), and its recent up-scheduling to a controlled substance within Australia. However, as alluded to above, consideration of alprazolam use in isolation of other contributing factors fails to adequately account for the processes underlying aggressive behaviour.…”

Section: Role Of Benzodiazepine Type In Benzodiazepine-related Aggressupporting

confidence: 86%

Motivational drive and alprazolam misuse: A recipe for aggression?

Albrecht

Staiger

Hall

et al. 2016

Psychiatry Research

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Benzodiazepine-related aggression is understudied in the literature, in particular little is known about the motivational factors which may contribute to the development of this paradoxical response. The revised Reinforcement Sensitivity Theory provides a theoretical framework from which to understand the relevant underlying motivational processes. The current study aimed to identify the role of approach and avoidance motivational tendencies in the occurrence of benzodiazepine-related aggression. Data regarding benzodiazepine and other substance use, approach and avoidance motivation, and general and physical aggressive behaviour were collected via self-report questionnaires. Participants were a convenience sample (n = 204) who reported using benzodiazepines in the previous year. Participants were primarily male (62.7%), aged 18-51 years old. Hierarchical multiple regressions indicated that general and physical aggression were predicted by alprazolam use and Drive, a facet of approach motivation. Overall, lower diazepam use significantly predicted higher levels of general aggression. However, when diazepam-preferring participants were examined in isolation of the larger sample (23.5% of sample), problematic (dependent) diazepam use was associated with greater aggression scores, as was dependence risk for alprazolam-preferring participants (39.7% of sample). The findings highlight the importance of motivational factors and benzodiazepine use patterns in understanding benzodiazepine-related aggression, with implications for violent offender rehabilitation.

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Section: Role Of Benzodiazepine Type In Benzodiazepine-related Aggressupporting

confidence: 86%

Motivational drive and alprazolam misuse: A recipe for aggression?

Albrecht

Staiger

Hall

et al. 2016

Psychiatry Research

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“…This finding adds to the growing body of evidence suggesting that alprazolam in particular may play a significant role in violent criminal behavior. Alprazolam is arguably the most concerning benzodiazepine due to its short-acting nature and potential for harm (Nicholas et al, 2011;Rintoul et al, 2013), and is frequently abused in clinical and forensic populations (Horyniak et al, 2012;Sweeney & Payne, 2012). Notably, widespread evidence of alprazolam's harm potential has led to its recent rescheduling to a controlled substance (Schedule 8) in Australia.…”

Section: Discussionmentioning

confidence: 99%

Benzodiazepine use of community-based violent offenders: a preliminary investigation

Albrecht

Staiger

Best

et al. 2016

Journal of Substance Use

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Declarations of interestWe declare that none of the authors are in receipt of financial support, or have any relationship that may pose a conflict in relation to the content presented in the submitted manuscript. Dan Lubman has received speaking honorarium from AstraZeneca and Janssen, as well as provided consultancy advice to Lundbeck. Suzanne Nielsen is an investigator on untied educational grants from Reckitt Benckiser.BENZODIAZEPINES AND VIOLENT CRIME 3 Benzodiazepine use of community-based violent offenders: A preliminary investigation. Abstract Objective:To explore the relationship between benzodiazepine use and violent crime in a sample of community-based offenders. Methods:Participants were recruited via drug diversion and treatment programs in Melbourne, Australia. Data regarding benzodiazepine and other substance use, mental health, personality characteristics, and crime involvement was collected through semi-structured interviews conducted in 2011. Participants (n = 82, 79.3% male) were 21-56 years old, predominantly Australian-born (89%), with 14.6% identifying as Aboriginal or Torres Strait Islanders.Eligibility criteria were having been charged with a criminal offence in the previous six months and at least monthly benzodiazepine use. Group differences between violent (n = 11) and non-violent offenders were assessed via independent samples t-tests (two-tailed) and non-parametric tests. Results:Individuals charged with violent index offences were significantly more likely to use higher average doses of alprazolam (p = .040), and exhibit benzodiazepine dependence (p = .037) as well as report high levels of sensation seeking, prior violence, and the diagnoses of depression and personality disorder, than individuals charged with non-violent index offences. Conclusions:The findings suggest the existence of a complex dynamic between mental health and violent offending that may be influenced by benzodiazepine use, in particular alprazolam. A core BENZODIAZEPINES AND VIOLENT CRIME 4 implication of these preliminary findings includes attending to the interpersonal skills and adaptive coping resources of violent offenders.

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“…First, it is important to note that an outright prohibition of midazolam prescription to injecting drug users may have low potential to reduce the harms associated with midazolam injection. Previous studies from Australia have suggested that restrictions on BZDs prescribing did not reduce the use of diverted BZDs among injecting drug users , and may have stimulated the illicit BZD market . Moreover, many injecting drug users who use BZDs contend with concurrent psychological disorders .…”

Section: Discussionmentioning

confidence: 99%