Past-year use or misuse of an opioid is associated with use of a sedative-hypnotic medication: a US National Survey on Drug Use and Health (NSDUH) study

Andrew S. Tubbs, Sadia B. Ghani, Michelle Naps, Michael A. Grandner, Michael D. Stein, Subhajit Chakravorty

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Study Objectives: Prescription use and misuse of opioids are linked to greater sleep disturbance. However, there are limited data on the prevalence of sedative-hypnotic medication use among persons who use opioids. Therefore, this study examined whether past-year sedative-hypnotic use among persons who used/misused opioids was higher than among individuals who did not use opioids. Methods: Data were acquired from the US National Survey on Drug Use and Health for 2015–2018. Use of a sedative benzodiazepine (temazepam, flurazepam, triazolam) or a Z-drug (eszopiclone, zaleplon, zolpidem) was examined in relation to use/misuse of an opioid within the past year. Logistic regression models estimated the associations between opioids and sedative-hypnotics using inverse probability of treatment weighting. A secondary machine learning analysis tested 6 binary classifiers to predict sedative-hypnotic use based on opioid use/misuse and other covariates. Results: Of 171,766 respondents, 24% used a prescription opioid whereas 3.6% misused an opioid in the past year. Among those who used a prescription opioid, 1.9% received a sedative benzodiazepine and 9% received a Z-drug during the same time frame. Use of an opioid was associated with greater odds of sedative benzodiazepine use (odds ratio, 4.4; 95% confidence interval, 3.61–5.4) and Z-drug use (odds ratio, 3.8; 95% confidence interval, 3.51–4.09), and stronger associations were noted for misuse of an opioid. Machine learning models accurately classified sedative-hypnotic medication use for > 70% of respondents based on opioid use/misuse. Conclusions: Sedative-hypnotic use is common among persons who use opioids, which is of concern given the elevated mortality risk with concurrent use of these substances.

Original languageEnglish (US)
Pages (from-to)809-816
Number of pages8
JournalJournal of Clinical Sleep Medicine
Issue number3
StatePublished - Mar 2022


  • analgesics
  • chronic pain
  • hypnotics
  • maintenance disorders
  • opioid-related disorders
  • opioids
  • sedatives
  • sleep initiation

ASJC Scopus subject areas

  • Medicine(all)


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