Association between loneliness and incident use of benzodiazepines and opioids: analyses of the Canadian Longitudinal Study on Aging

BACKGROUND: The association between loneliness and incident use of benzodiazepines and opioids, and sociodemographic factors associated with their use, is unknown. METHODS: Using the Canadian Longitudinal Study on Aging's comprehensive cohort, we conducted a longitudinal study to understand how loneliness was associated with incident use of benzodiazepines and opioids, separately, using multivariable modified logistic regression models. We evaluated sociodemographic factors associated with benzodiazepine and opioid use among lonely participants. RESULTS: We included 29 976 participants, of whom 10.8% were lonely (all the time or occasionally) at baseline. Lonely participants were older [mean age 64.4, standard deviation (SD) 10.5 vs. mean age 62.8, SD 10.2] and more likely to be female (57.9% vs. 50.1%) and live alone (45.2% vs. 19.9%) than participants who were not lonely. Lonely participants had a higher rate of incident use of benzodiazepines [73 (2.8%) vs. 305 (1.3%); adjusted odds ratio (aOR) 1.94, 95% confidence interval (95% CI) 1.47-2.57] and opioids [60 (2.2%) vs. 283 (1.2%); aOR 1.43, 95% CI 1.05-1.93] compared to those who were not lonely. Loneliness remained significantly associated with use of benzodiazepines, but not opioids, after adjusting for mood and anxiety disorders. Lonely females and non-Whites were more likely to be initiated on benzodiazepines, whereas lonely immigrants were less likely to be initiated on benzodiazepines. CONCLUSIONS: Loneliness was associated with incident use of benzodiazepines and opioids. Multimodal interventions to deprescribe these medications in lonely individuals and decrease symptoms of loneliness could mitigate their attendant health effects.