Benzodiazepine & Alcohol Co-Ingestion: Implications for Collegiate-Based Emergency Medical Services

Excessive alcohol misuse and abuse in the college population has been discussed in both the popular media and scientific literature.In 2016, an annual nationwide survey found that 38.4% of college-aged Americans engage in binge alcohol use, and 10.1% engage in heavy alcohol use. 1 The rate of benzodiazepine use, though significantly lower than alcohol use, is still significant, as approximately 2.6% of the college-aged population is legally prescribed a benzodiazepine. 2Through national epidemiological studies, surveillance reports, and various studies on college populations, abuse and misuse of benzodiazepines appear to be on the rise.[3][4][5] The 2013 Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) organization defines abuse and misuse of medications as "any intentional, non-therapeutic use of a drug product or substance, even once, for the purpose of achieving a desirable psychological or physiological effect" and "any intentional therapeutic use of a drug product in an inappropriate way," respectively.6 There is limited data pertaining to the incidence of misuse and abuse of benzodiazepines in regards to alcohol co-ingestion, specifically.In a 2001 study, 4.5% of college students reported that they had ingested or con-C ollegiate-based emergency medical services (EMS) providers at both the basic life support (BLS) and advanced life support (ALS) levels may treat a higher incidence of alcohol and substance abuse related patients than providers working with traditional community EMS populations.Among the most complex of these patients are those that have ingested alcohol as well as an illicit substance and/or prescription medication.When ingested with alcohol, benzodiazepines in particular present a unique challenge to collegiate EMS providers.