October 2022 

The number of people dying because of drugs has been rising since 2013 in England and Scotland. Many of these deaths involve a combination of opioids (such as heroin) and benzodiazepines (sedatives often used to treat anxiety and insomnia), which are either prescribed or obtained illegally.

Tablets drugs

Scotland has been especially affected by an increase in the number of opioid-related deaths. This has happened at the same time as more people started using illegal or ‘street’ benzodiazepines together with opioids.

We don’t fully understand why using opioids and benzodiazepines together is so dangerous. We also don’t understand why using them together increases someone’s risk of dying from an overdose.

Project aims

We want to understand how benzodiazepines and opioids work together and why this makes a fatal overdose more likely.

We hope to achieve this by talking to people using benzodiazepines and opioids together in Bristol Teesside and Scotland. We will ask them:

  • How and why, they use the two types of drug together
  • What effects the two types of drug have on them
  • What role both types of drugs have played in their overdose experiences

What we hope to achieve

We hope to learn what people who use drugs understand about the risk of an overdose when they use benzodiazepines together with opioids. Understanding this will help us design strategies to reduce the negative consequences of drug use and the number of deaths by overdose.

We will also use the information we gather to design laboratory experiments that help us understand how benzodiazepines work. Especially, how they interact with opioids to slow someone’s breathing down.

Our results will be used to inform guidelines, policy and practice. This will help local and national policymakers in the UK develop strategies for people using benzodiazepines and opioids together.

Lead collaborators

  • Hannah Family, Health Protection Research Unit in Behavioural Science and Evaluation
  • Hannah Poulter, Health Protection Research Unit in Behavioural Science and Evaluation
  • Gaby Vojt, Health Protection Research Unit in Behavioural Science and Evaluation
  • Graeme Henderson, University of Bristol
  • Matt Hickman, University of Bristol
  • Ana Paula Abdala Sheikh, University of Bristol
  • Chris Bailey, University of Bath

Further information 

About the NIHR Health Protection Research Unit [HPRU] in Behavioural Science and Evaluation at the University of Bristol

The NIHR HPRU in Behavioural Science and Evaluation at University of Bristol is one of 14 HPRUs across England, part of a £58.7 million investment by the NIHR to protect the health of the nation.

The NIHR HPRU in Behavioural Science and Evaluation is a partnership between the UK Health Security Agency (UKHSA) and University of Bristol, in collaboration with MRC Biostatistics Research Unit at the University of Cambridge and University of the West of England.

Each NIHR HPRU undertakes high quality research that is used by UKHSA to keep the public safe from current and emerging public health threats.

About the NIHR

The National Institute for Health and Care Research (NIHR) is the nation’s largest funder of health and care research. The NIHR:

  • funds, supports and delivers high quality research that benefits the NHS, public health and social care
  • engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
  • attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
  • invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
  • partners with other public funders, charities and industry to maximise the value of research to patients and the economy.

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government.

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