TRAINING

Why do people co-use benzodiazepines and opioids? Opening the question to the forum, Bristol Medical School’ s Dr Jenny Scott said it was important to try to understand motivation, particularly when looking at care of vulnerable people – and because most drug-related deaths involved polydrug use. A study involving 48 people who had overdosed in Glasgow, Bristol and Teesside had given insight.

On one hand benzo use could be called functional – to feel calm or give confidence, rather than to deliberately feel intoxicated. The other scenario was more experimental – to feel a buzz, a warm glow, a feeling of intoxication:‘ Benzos took them into oblivion, away from all their problems.’

Many people were bingeing, using handfuls of street benzos in uncontrolled quantities, and often using opioids and

benzos together, she explained. The changing patterns of co-use could be triggered by prescribing decisions or the change in availability of illicit drugs, and could veer from controlled use to a much more chaotic situation.

So what was the perception of overdose risk?‘ People were acutely aware of consumption roulette, where they’ re not sure what they’ re going to get,’ said Scott.‘ At times they were asking“ how can I keep myself safe?”.’ Attempts to try to do so included taking one dose every five minutes, then another – not failsafe as the effects could take longer to kick in – but it was at least evidence of a strategy, she said. Others experienced hopelessness and inability to change –‘ it’ ll probably kill me’ – particularly if they had been severely affected by trauma.

Lack of care could make people feel

‘ horrible’ about themselves and give them a sense of not being able to go anywhere for help. And while some people felt able to do things to keep themselves safe, others were made additionally vulnerable by their lack of stability and inability to manage triggers such as arguments with family members. The findings pointed to a‘ huge unmet need for mental health support,’ said Scott.

People’ s understanding of street benzos was found to be‘ quite limited’, especially where there was co-use with other drugs. As most overdoses were unintentional, there was a clear need for consumption rooms and drug-checking initiatives, she said. Furthermore, the different cohorts and uses relating to street benzos and prescribed benzos needed very different interventions.

22 • DRINK AND DRUGS NEWS • MAY 2025