Illicit drug users undergoing mandatory reductions in prescribed diazepam were randomly allocated to one of two methods of delivering psychological support to help reduce their prescription: a) an enhanced intervention consisting of skills training and reinforcement, and b) a limited intervention where patients initially received skills training and thereafter only advice. Outcome measures at baseline and six-months consisted of daily diazepam dose; reported illicit drug use; Severity of Dependence Scale; Hospital Anxiety and Depression Scale (HADS); Pittsburgh Sleep Quality Index. Fifty-three of 119 eligible patients agreed to be randomly allocated to the interventions. Those in the enhanced intervention reduced their daily dose of prescribed diazepam from a mean of 27.8 mgs to 19.9 mgs at six months (5.3% per month) compared with 29.8 mgs to 17.6 mgs at six months (7.5%) among those in the limited intervention group. However, there was no statistically significant difference in the reduction rate between the intervention groups. Approximately 75% of patients in each group suspended their reduction programme. The enhanced intervention group reported a statistically and clinically greater reduction in the mean HADS depression score (10.6 at baseline and 7.7 at follow-up), compared with a rise from 8.9 to 11.2 in the limited intervention group. In conclusion, it is possible to reduce prescribed diazepam among illicit drug users but not at the rate of 10% per month set by the study. The difficulties of working with this population necessitate a flexible and possibly long-term approach to reducing prescribed benzodiazepines.

Acclaimed publisher and editor Neil Astley, founder of Bloodaxe Books, guest-edits this special transatlantic all-poetry issue, featuring poets from North America, Great Britain, and Ireland. The issue contains a stirring diversity of work, with writers who have roots everywhere from Guyana to Pakistan to Zambia, and also features poetry in Welsh, Irish, and Scottish Gaelic. Much of the work is from accomplished British poets who are still little-known in the States. As Astley writes in his introduction, the issue aims to break down “the illogical divide between readerships on either side of the Atlantic,” and spark a conversation that will enliven and invigorate both poetic traditions.

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