Dependence on addictive prescription and illicit drugs is very harmful which can lead to negative health and social consequences (Bonnet et al., 2020). Over the past 15 years, addiction experts investigated social and health consequences of addictive substances in Scotland, (McAuley et al., 2023) England, (Nutt, King, & Phillips, 2010) France, (Bourgain et al., 2012) and Australia (Bonomo et al., 2019). In 2021, parliament of Scotland declared the crisis of drug related deaths attributed to illicit drugs use in combination with pharmaceutical drugs as a public health emergency (McAuley et al., 2023).
The likelihood of negative health consequences, drugs use disorders and mental health issues increases with misuse of prescription drugs (McCabe, Veliz, Dickinson, Schepis, & Schulenberg, 2019; Schepis & McCabe, 2019). Prior researches had identified prescription drugs misuse associated with suicidal thoughts, emergency rooms visits with other substance use disorders (Compton, Han, Blanco, Johnson, & Jones, 2018). Previous studies reported considerable high risk of overdose and suicide associated with misuse of combined benzodiazepines with opioids than opioids alone (Schepis, West, Teter, & McCabe, 2016). In US, overdose deaths due to combined use of opioids and psycho-stimulant increased by 900% between 2009 to 2018 (Hedegaard, Miniño, & Warner, 2020). Due to lack of research on differences in health disorders related to misuse of prescription drugs combination alone or with illicit drugs limits prevention and treatment intervention efforts (McHugh, Nielsen, & Weiss, 2015).
Dependence on licit and illicit substances is a complex phenomenon that effects the various life domains including health, employment, education and social relationship (Colpaert, De Maeyer, Broekaert, & Vanderplasschen, 2013). One of the most striking finding reported recently is dependence on benzodiazepines and prescription opioids with or without illicit drugs among the subsample of addiction treatment seeking individuals (Nawaz et al., 2023). Previous studies reported that patients suffering from GAD prefer using alcohol with illicit or prescribed benzodiazepines, whereas patients having PTSD combined benzodiazepines, opioids and tobacco (Tucker, Hill, Nicholson, & Moylan, 2023).