Benzo Overdoses Explode in the U.S.

Plus: The ADHD-SUD connection; out-of-line opioid prescribing to youths; and the scourge of fentanyl

By William Wagner

Another front seems to have opened up in America’s battle against drug overdoses. OD deaths related to illicit benzodiazepines, sedatives also known as “benzos,” rocketed some 500% from 2019 to 2020.

This week in “From the Journals,” we also probe the ties between attention deficit hyperactivity disorder (ADHD) and substance use disorder (SUD), troubling opioid prescribing practices for young people, and how fentanyl is spilling into virtually every corner of the illicit drug supply.

From Morbidity and Mortality Weekly Report:
A Spreading Benzodiazepine Epidemic

New, more powerful street versions of benzos like Valium and Xanax are wreaking havoc, reports Morbidity and Mortality Weekly Report, a publication from the Centers for Disease Control and Prevention (CDC). “This is the first multistate report to examine recent trends in both nonfatal and fatal benzodiazepine overdoses,” the publication writes of its study. Nevertheless, a shortage of data indicates that the numbers might be far worse than the 316 illicit benzodiazepine overdose deaths cited by Morbidity and Mortality Weekly Report.

In most of the OD cases, benzos were mixed with opioids, leading the article’s authors to determine that there is a “need to enhance efforts to mitigate harm from simultaneously using benzodiazepines and opioids and monitor the magnitude and persistence of increases in illicit benzodiazepine deaths.” wrote about the emergence of benzodiazepine-opioid combinations, often called “benzo-dope,” in the Aug. 17 edition of “From the Journals.” Given the OD statistics reported by Morbidity and Mortality Weekly Report, we’ll likely hear a lot more about benzos in the future.

According to a study out of the University of Toronto, the connection between ADHD and SUD couldn’t be more apparent. After analyzing data from the Canadian Community Health Survey-Mental Health—a sample that included 6,872 people—the researchers found that about half of adults ages 20 to 39 with ADHD have suffered from SUD. Based on their conclusions, the research team writes in Alcohol and Alcoholism, “Targeted outreach and interventions for this extremely vulnerable population are warranted.”

From Pediatrics:
Risky Opioid Prescribing to Young People

Researchers from the University of Michigan write in Pediatrics that nearly 50% of opioids prescribed to young adults and children (21 years old and younger) following various medical procedures can be classified as “high risk,” meaning that the drugs and/or dosages are not in line with Food and Drug Administration (FDA) recommendations. The researchers gathered their information by combing through the IQVIA Longitudinal Prescription Database from 2019, which captures, according to the study, “92% of U.S. pharmacies.”

In the long-term, this exposure [to opioids] is associated with increased lifetime risk of substance use disorders in adolescents and young adults.”—study in “Pediatrics”

The dangers of these prescribing practices are clear, as the study’s authors write: “In the long-term, this exposure is associated with increased lifetime risk of substance use disorders in adolescents and young adults. Pediatric opioid prescribing also has spillover effects because opioids prescribed to children and young adults can be misused by relatives and friends.”

From Vice:
Fentanyl Casts a Long Shadow

More reason to steer clear of illicit drugs: You have no idea what might be in them. Vice reports that many types of drugs increasingly have been tainted by fentanyl, a synthetic opioid that’s highly lethal. As the Vice article states, “[E]xperts in harm reduction, clinical researchers, and public health professionals who spoke to VICE News agreed that the drug market is absolutely flooded with fentanyl—which means a constant, impossible-to-quantify risk of fentanyl contaminating cocaine, meth, ecstasy, and other drugs.”

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