Aging & Longevity

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

TL;DR

Loneliness was associated with incident use of benzodiazepines and opioids, with lonely participants having nearly twice the odds of initiating benzodiazepines and 43% higher odds of initiating opioids compared to non-lonely participants.

Key Findings

Lonely participants had a significantly higher rate of incident benzodiazepine use compared to non-lonely participants.

  • 73 lonely participants (2.8%) initiated benzodiazepines vs. 305 non-lonely participants (1.3%)
  • Adjusted odds ratio (aOR) of 1.94 (95% CI 1.47–2.57)
  • Loneliness remained significantly associated with benzodiazepine use even after adjusting for mood and anxiety disorders
  • Analysis used multivariable modified logistic regression models from the Canadian Longitudinal Study on Aging (CLSA)

Lonely participants had a significantly higher rate of incident opioid use compared to non-lonely participants.

  • 60 lonely participants (2.2%) initiated opioids vs. 283 non-lonely participants (1.2%)
  • Adjusted odds ratio (aOR) of 1.43 (95% CI 1.05–1.93)
  • The association between loneliness and opioid use was no longer statistically significant after adjusting for mood and anxiety disorders
  • Total sample included 29,976 participants with 10.8% classified as lonely at baseline

Lonely participants differed from non-lonely participants in several sociodemographic characteristics at baseline.

  • Lonely participants were older (mean age 64.4, SD 10.5) compared to non-lonely participants (mean age 62.8, SD 10.2)
  • Lonely participants were more likely to be female (57.9% vs. 50.1%)
  • Lonely participants were more likely to live alone (45.2% vs. 19.9%)
  • 10.8% of the total sample of 29,976 participants were classified as lonely (all the time or occasionally) at baseline

Among lonely participants, sex, race/ethnicity, and immigrant status were associated with differential rates of benzodiazepine initiation.

  • Lonely females were more likely to be initiated on benzodiazepines compared to lonely males
  • Lonely non-White participants were more likely to be initiated on benzodiazepines
  • Lonely immigrants were less likely to be initiated on benzodiazepines
  • These sociodemographic factors were evaluated specifically within the subgroup of lonely participants

Adjustment for mood and anxiety disorders attenuated the association between loneliness and opioid use but not benzodiazepine use.

  • After adjusting for mood and anxiety disorders, loneliness remained significantly associated with benzodiazepine use
  • After adjusting for mood and anxiety disorders, loneliness was no longer significantly associated with opioid use
  • This suggests that the pathway between loneliness and opioid use may be mediated in part by mood and anxiety disorders
  • Multivariable modified logistic regression models were used for these analyses

What This Means

This research suggests that older adults who experience loneliness are significantly more likely to start using benzodiazepines (medications typically prescribed for anxiety and sleep problems) and opioids (pain medications) compared to people who are not lonely. Using data from nearly 30,000 Canadians followed over time, researchers found that lonely individuals had almost twice the odds of starting benzodiazepines and about 43% higher odds of starting opioids. Importantly, when the researchers accounted for depression and anxiety disorders, loneliness still independently predicted starting benzodiazepines, but the link with opioids became statistically non-significant—suggesting that for opioids, mental health conditions may partly explain the connection. The study also found that not all lonely people face the same risks. Among lonely individuals, women and non-White participants were more likely to be prescribed benzodiazepines, while lonely immigrants were less likely to receive these prescriptions. This highlights that social and cultural factors shape how loneliness translates into medication use, potentially reflecting both differences in healthcare-seeking behavior and disparities in prescribing practices. This research matters because both benzodiazepines and opioids carry significant risks for older adults, including dependence, falls, cognitive impairment, and overdose. The findings suggest that loneliness may be a driver of potentially risky medication initiation in aging populations. Addressing loneliness through social and community interventions, alongside careful prescribing practices and deprescribing efforts for those already on these medications, could help reduce these risks.

Have a question about this study?

Citation

Watt J, Sharma S, Huang Y, Jones A, Nicholson K, Yu A, et al.. (2026). Association between loneliness and incident use of benzodiazepines and opioids: analyses of the Canadian Longitudinal Study on Aging.. Age and ageing. https://doi.org/10.1093/ageing/afag267