From: A qualitative study of benzodiazepine/z-drug and opioid co-use patterns and overdose risk
No pattern reporteda | Co-use to aid sleep or come down | Curated co-use | Morning and evening BZ/Z doses with OP throughout the day | Co-use binges | Co-use throughout the day | BZ/Z use throughout the day, OAT only no other OP | |
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Prescribed BZ, Z and OP (including total daily doses where stated) | Methadone 70-80mgb(n = 4) Long acting injectable buprenorphine 128 mg (n = 1) Dihydrocodeine NSc (n = 1) | Methadone NSc (n = 1) Buprenorphine 14mgb (n = 2) | Buprenorphine 6-16mgb (n = 2) | Methadone 60-160mgb (n = 4) Heroin Assisted treatment 140 mg total dose taken in 2 sittings (n = 1) | Methadone 38-120mgb (n = 8) Buprenorphine 8- 16mgb (n = 1) Long acting injectable buprenorphine NSc (n = 1) Morphine (110 mg) (n = 1) | Methadone 40-160mgb (n = 7) Buprenorphine 8-16mgb (n = 2) Long acting injectable buprenorphine NSc (n = 2) | Methadone 80-90mgb (n = 3) Buprenorphine 8mgb (n = 2) Long acting injectable buprenorphine NSc (n = 2) |
Prescribed BZ and Z (including total daily doses where stated) | Diazepam 6-30 mg (n = 2) | Diazepam 30 mg (n = 1) | None reported | Nitrazepam 20mgd (n = 1) Diazepam 30mgd (n = 1) | Diazepam 25-30 mg (n = 5) Diazepam 22 mg (n = 1) this is prescribed on a weekly pick-up and this participant takes all 7 doses for the week in one day (154 mg) | Diazepam 12-35 mg (n = 6) | Diazepam 4 mg (n = 2) Diazepam 30 mg (splits the dose, spreading the 6 5 mg tablets throughout the afternoon and evening) (n = 1) |
Illicit OP (including total daily doses where stated)e | Heroin NSc (n = 1) | Heroin 3 × 0.4 g bags/day, smoked (n = 1) / a couple of lines (n = 1) Co-codamol 20/day (n = 1) | None reported | Heroin NSc (n = 2) Oxycontin NSc (n = 1) | Heroin NSc (n = 5) Oxycodone NSc (n = 1) | Heroin 0.2–1.75 g (n = 10) Morphine NSc (n = 1) | (very occasional) heroin 0.2–1.2 g (n = 4) |
Illicit BZ and Z (including total daily doses where stated)f | Zopiclone 3 a day approx. 22.5 mg (n = 1) Street diazepam 15 a day (150 mg) (n = 1) / NSc (n = 1) | Zopiclone 2 a day approx. 15 mg (n = 1) Street diazepam 1–5 tablets / day approx. 10-50 mg (n = 3) | Street BZ (clonazepam, diazepam, alprazolam or temazepam) aims to take approx. 40 mg BZ dose each day – but varies which BZ they take each day (n = 1) Zopiclone up to 10 × 7.5 mg (n = 1) | Zopiclone 10 a day approx. 75 mg (n = 1) Street diazepam approx. 40 mg (n = 1) / up to 12 tablets / day NSc (n = 1) | Zopiclone 10 approx. 75 mg (n = 3) Street diazepam (20 -75 tablets or more) NSc (n = 3) diverted diazepam 18 × 2 mg tablets (36 mg) (n = 1) alprazolam (120 mg)(n = 1) online or diverted clonazepam 200 × 2 mg tablets (0.2 g) (n = 1), NSc (n = 1) | Zopiclone, 30–40 3.75 mg blue tablets approx. 150 mg (n = 1) Street diazepam 20—500 tablets /day NSc (n = 11) Diverted/online diazepam sold as 10 mg takes approx. 40 mg in the morning and then as and when needed throughout the day (total daily dose not stated) (n = 1) Online BZ alprazolam, diazepam, nitrazepam or clonazepam 30 tablets a day day NSc (n = 1) | Zopiclone 12 tablets a day NSc (n = 1) Online BZ—takes alprazolam, diazepam, or clonazepam, 30 tablets, of one of the above BZ, each sold as 2 mg strength, approx. 60 mg total dose (n = 1) Street diazepam (yellows, sold as 5 mg) taken in handfuls (estimates up to 80 tablets) 400 mg total dose (n = 1) Diverted diazepam (20 mg) (n = 1) Diverted or street diazepam 15 (n = 1), 50 (n = 1), 100 per day (n = 1) NSc |
Other illicit /bought substances takene | Pregabalin NSc (n = 2) Cocaine (n = 1) NSc Crack cocaine NSc (n = 1) Alcohol (n = 1) approx. 18 units/week | Ketamine NSc (n = 1) Cocaine NSc (n = 2) Crack cocaine NSc (n = 1) Alcohol (n = 2, 3—12 units/day) | Occasional alcohol (a few units/week) (n = 1) Alcohol (up to 10 units, 2–3 times / week) (n = 1) | Pregabalin NSc (n = 1) Cocaine NSc (n = 1) Crack cocaine NSc (n = 1) Cannabis NSc (n = 2) Alcohol (4–6 cans cider or lager /day) (n = 1) | Pregabalin NSc (n = 2) Crack cocaine NSc (n = 1) Cocaine NSc (n = 2) Cannabis NSc (n = 3) Alcohol (up to 20 units/week) (n = 3) | Pregabalin (300-700 mg/day)(n = 6) Crack cocaine (0.2–0.8 g) (n = 4) Cocaine NSc (n = 5) Cannabis NSc (n = 4) Spice NSc (n = 1) Alcohol (n = 4) 1–12 cans cider/beer/day) | Pregabalin (300-700 mg/day)(n = 1) Crack cocaine NS (n = 3) Cocaine NSc (n = 2) Cannabis NSc (n = 4) Alcohol (n = 1) up to 4 cans beer/cider /day) |
Other prescribed drugs | Mirtazapine (45 mg, n = 2), Olanzapine (10 mg), Pregabalin (600 mg) Amitriptyline (10 mg) (n = 1) | none | Quetiapine 25 mg (n = 1) | Quetiapine NSc (n = 1) Risperidone NSc (n = 1) Sertraline NSc (n = 1) | Mirtazapine NSc (n = 2) Amitriptyline NSc (n = 1) Pregabalin NSc (n = 1) Fluoxetine NSc (N = 1) | Mirtazapine 30 mg (n = 3) Pregabalin (100-500 mg) (n = 2) Amitriptyline 25 mg (n = 1) Dosulepin (75 mg in 2 doses) (n = 1) | Mirtazapine 30 mg (n = 2) Naproxen NSc (n = 1) |