Self-reported benzodiazepine use among adults with chronic spinal cord injury in the southeastern USA: associations with demographic, injury, and opioid use characteristics

Study design: Cross-sectional cohort study. Objectives: To examine: (1) the self-reported frequency of specific prescription benzodiazepine use, (2) concurrent benzodiazepine and opioid use, and (3) sociodemographic, SCI, and opioid use factors associated with frequent benzodiazepine use. Setting: Community. Methods: Participants included 918 community dwelling adults with chronic ( > 1 year) traumatic SCI originally identified from a specialty hospital or a state-based surveillance system. Self-reported frequency of specific prescription benzodiazepines and opioids used, concurrent use, and factors associated with use were assessed. Results: Twenty percent reported any benzodiazepine use in the past year and 13% reported at least weekly use. Concurrent daily or weekly use of benzodiazepines and opioids was reported by 6.5%, with those individuals taking an average of 1.1 (0.4) benzodiazepines and 1.4 (0.6) opioids. Compared to younger adults, those 50-65 years old had lower odds of at least weekly benzodiazepine use (OR = 0.50, 95% CI, 0.29-0.89, p-value = 0.02). Non-Hispanic Blacks reported lower use of benzodiazepines compared to non-Hispanic whites (OR = 0.32, 95% CI, 0.15-0.68, p-value = <0.01). Weekly opioid use was associated with higher odds of using benzodiazepines (OR = 3.10, 95%CI, 1.95-4.95, p-value = <0.01). Conclusions: Benzodiazepine use was commonly reported among those with SCI. Despite the potential risks, a high portion of those who reported benzodiazepine use also reported prescription opioid use. The findings highlight the need for monitoring of prescription medication use to avoid potentially risky concurrent use and adverse outcomes.