Andrew has worked locally and nationally in the addictions field since 2005. He is currently Consultant Scientist at Public Health Scotland where he has a lead role for infections involving people who inject drugs (PWID). At Glasgow Caledonian University, Andrew works between the blood-borne virus and substance use research teams. His main interests are harms related to injecting drug use and evaluation of interventions aimed at reducing risk. In recognition of his contribution to the field, Andrew was awarded the Fred Yates prize in 2018 by the Society for the Study of Addiction.
Prevalence and determinants of non-prescribed benzodiazepine use and related harms among a national sample of people who inject drugs
Benzodiazepines are amongst the most widely prescribed psychotropic drugs in the world. Over the last 40 years, Scotland has had a strong relationship with the misuse of benzodiazepines, from temazepam, diazepam, and triazolam in the mid-1980s to the ‘New’ or ‘Novel’ Psychoactive Substances (NPS) such as etizolam and phenazepam in the 2010s. This is within an environment where benzodiazepine prescribing has steadily reduced over the last 20 years. Increasingly, the illicit market supply of benzodiazepines in Scotland has replaced and superseded the availability of benzodiazepines on prescription.
In contrast to the decrease in benzodiazepine prescribing over the past 10 years, benzodiazepine-related mortality has been increasing, especially in recent years. In 2019, benzodiazepines were implicated in, or potentially contributed to, 888/1264 deaths (70%). The majority of the recent rise in the figure for benzodiazepines was due to NPS-type drugs, particularly etizolam. The latest data shows NPS-type benzodiazepines implicated in, or potentially contributing to, 814/1264 deaths in 2019. Put another way, almost two in every three drug-related deaths in Scotland in 2019 involved an illicit NPS-type ‘street benzo’.
Despite this phenomenon playing such a key role in Scotland’s drug-death epidemic, little is known about the profile of users, their behaviours and their risk of harms. This presentation will provide one of the first epidemiological analyses of illicit NPS-type ‘street benzo’ use among a group at highest risk of overdose; people who inject drugs.