Characterising benzodiazepine use and the association with non-fatal overdose among people who inject opioids in England, Wales and Northern Ireland
Bibliographic record
Abstract
INTRODUCTION: In Scotland, co-use of opioids and benzodiazepines has been strongly linked to rising drug-related deaths, but little similar information is available for the rest of the UK. We compared characteristics of people who inject opioids (PWIO) by benzodiazepine use and examined its association with non-fatal overdose in England, Wales and Northern Ireland. METHODS: PWIO in England, Wales and Northern Ireland were recruited through specialist drug services in 2022 as part of the Unlinked Anonymous Monitoring Survey. Participants self-reported socio-demographic, behavioural, and health-related information. PWIO with and without past-month benzodiazepine use were compared on sociodemographic characteristics, drug use patterns, use of harm-reduction services, markers of vulnerability, quality of life and mental health. Poisson regression was used to estimate bivariable and multivariable associations between past-month benzodiazepine use and non-fatal overdose in the past year. RESULTS: Of 1333 PWIO included, 29.3 % reported past-month benzodiazepine use, and 21.8 % reported past-year non-fatal overdose. PWIO who used benzodiazepines were more likely to report using other drugs-both injected and non-injected-greater social vulnerabilities such as homelessness, incarceration, and engagement in sex work, and poorer mental health. For example, they more frequently injected speed (19.0 % vs. 9.5 %) and cocaine (46.4 % vs. 29.2 %), smoked cannabis (62.3 % vs. 31.7 %) and used pregabalin/gabapentin (60.8% vs. 10.1 %). Differences in sociodemographic characteristics, use of harm-reduction services and most quality-of-life domains were minimal. After adjusting for potential confounders, benzodiazepine use remained associated with higher prevalence of non-fatal overdose (adjusted prevalence ratio: 1.43; 95 %CI: 1.13-1.82). DISCUSSION: Benzodiazepine use is common among PWIO in England, Wales, and Northern Ireland, and is associated with higher prevalence of non-fatal overdose. These findings underscore the need to strengthen overdose prevention and harm reduction efforts addressing benzodiazepine use across the UK.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".