Benzodiazepine (BZD)/opioid polysubstance abuse (PSA) dramatically increases risks of overdose, disability and death; however, little is known about phenotypes that could be targeted to decrease this use and these associated risks. The opioid abuse epidemic is generating unprecedented numbers of overdoses (OD) and deaths from prescribed and illegal sources (e.g. fentanyl combined with, or sold as, heroin). Yet, medical and epidemiological data suggest these adverse outcomes are not solely due to over-consumption of opioids.The FDA recognizes the health danger of BZD/opioid PSA, and issued labeling changes for prescribing BZDs and opioids. Impact of these changes is unclear and could be minimal if people obtain these substances illegally. BZD abuse can be harmful alone or combined with opioids, as BZDs: (a) contribute to OD/death e.g. 31% of opioid OD-related deaths from 1999 to 2011 were related to coincident BZD use, BZD co-use is dose-dependently related to mortality and rates of BZD OD deaths have sharply increased. (b) exacerbate progression and adverse outcomes of opioid abuse. and (c) worsen behavioral impairment from opioids, increase rates of falls and fractures, motor vehicle accidents, and sleep-disordered breathing. There has been limited systematic research of BZD/opioid PSA. This is a major gap because BZD are often co-prescribed with opioids (in 33 to 50% of cases) and are easily obtained illegally. In response to these problems, there is an urgent need to obtain population-level, clinical pharmacology, and mechanistic data to test our unified hypothesis of dual-deficit in affective/hedonic regulation.
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Psychopathology
Timeframe: Administered once during the baseline clinical assessment.
Beck Depression Inventory-II
Timeframe: Administered during the baseline clinical assessment, and at the 3-month follow-up visit.
Snaith-Hamilton Pleasure Scale
Timeframe: Administered during the baseline clinical assessment, and at the 3-month follow-up visit.
Perceived Stress Scale
Timeframe: Administered during the baseline clinical assessment, and at the 3-month follow-up visit.
State-Trait Anxiety Inventory
Timeframe: Administered during the baseline clinical assessment, and at the 3-month follow-up visit.
Difficulties with Emotion Regulation Scale
Timeframe: Administered during the baseline clinical assessment, and at the 3-month follow-up visit.
Alcohol and Drug Use Self-Efficacy Scale
Timeframe: Administered during the baseline clinical assessment, and at the 3-month follow-up visit.
Distress Tolerance Scale
Timeframe: Administered once during the clinical assessment.
Positive and Negative Affect Schedule-Short Form: Positive Affect
Timeframe: Administered once during the baseline clinical assessment.
Positive and Negative Affect Schedule-Short Form: Negative Affect
Timeframe: Administered once during the baseline clinical assessment.
Paced Auditory Serial Addition Task
Timeframe: Administered once during the baseline clinical assessment.
Brief Pain Inventory-Short Form
Timeframe: Administered during the baseline clinical assessment, and at the 3-month follow-up visit.
Current Opioid Misuse Measure
Timeframe: Administered during the baseline clinical assessment, and at the 3-month follow-up visit.
Insomnia Severity Index
Timeframe: Administered during the baseline clinical assessment, and at the 3-month follow-up visit.
Epworth Sleepiness Scale
Timeframe: Administered once during the baseline clinical assessment.
Psychomotor Vigilance Task
Timeframe: Administered once during the baseline clinical assessment.
Go/No-Go Task
Timeframe: Administered once during the baseline clinical assessment.
California Verbal Learning Test-Revised
Timeframe: Administered once during the baseline clinical assessment.
Emotional Stroop Task
Timeframe: Administered once during the baseline clinical assessment.
Wisconsin Card Sort Test
Timeframe: Administered once during the baseline clinical assessment.
Digit Symbol Substitution Test
Timeframe: Administered once during the baseline clinical assessment.
Drug History Questionnaire
Timeframe: Administered once during the baseline clinical assessment.
Timeline Followback interview
Timeframe: Administered during the baseline clinical assessment, and at the 3-month follow-up visit
Opioid /Benzodiazepine Purchasing Task
Timeframe: Administered once during the baseline clinical assessment.
Urinalysis
Timeframe: At baseline clinical assessment, and at the 3-month follow-up visit