Benzodiazepine use, quality of life and psychiatric symptom burden in oral and injectable opioid agonist treatment: a cross-sectional study

Abstract

Background Use of benzodiazepines (BZD) in patients receiving opioid agonist treatment (OAT) is common and associated with a variety of negative health and social outcomes. This cross-sectional study investigates the impact of BZD use in OAT patients on their quality of life (QoL). Methods A convenience sample of patients receiving oral OAT or heroin-assisted treatment in two outpatient centres in Basel, Switzerland was investigated. Participants (n = 141) completed self-report questionnaires on psychiatric symptoms and psychological distress (The Symptom Checklist 27, SCL-27), depressive state (German version of the Center for Epidemiological Studies Depression Scale), quality of life (Lancashire Quality of Life Profile, LQOLP) and use of BZD and other drugs (self-report questionnaire). Substance use was assessed by urine toxicology testing. Results In bivariate analysis, total QoL scores were significantly lower for lifetime, current, and prolonged BZD users compared to participants without the respective use patterns. There was no significant relationship between BZD dose and QoL. In multivariable linear regression models controlling for psychiatric symptom load and depressive state, only lifetime use predicted lower QoL, whereas other BZD use patterns were not significantly associated. Conclusions The association of lower QoL and BZD use in OAT patients is strongly confounded by co-occurring depressive state and psychiatric symptoms. Careful diagnosis and treatment of co-occurring mental disorders in OAT is paramount to improve QoL in this patient population and may also help reduce BZD use.

The interplay between the microbiota and opioid in the treatment of neuropathic pain

“…When considering the combination of opioid drugs and sedative drugs, particularly benzodiazepines, it is imperative to exercise a high degree of vigilance due to the potential risks associated with these medications ( Liu et al, 2021 ). Previous studies have confirmed that when compared to using opioids in isolation for managing NP, the combination of opioids and sedative drugs may lead to a notable increase in the risk of drug overdose ( Meyer et al, 2023 ). Furthermore, it can escalate to a critical level, potentially culminating in fatal respiratory depression ( Liu et al, 2021 ).…”