Characteristics of benzodiazepine abuse in methadone maintenance treatment patients: a 1 year prospective study in an Israeli clinic

Gelkopf, Marc; Bleich, Avi; Hayward, R. Anna; Bodner, Gershon; Adelson, Miriam

doi:10.1016/s0376-8716(98)00175-6

Cited by 107 publications

(102 citation statements)

References 25 publications

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“…Greater baseline drug use has also been shown to be a robust predictor of treatment response Stitzer et al, 2007). These results extend previous findings that BZD use among injecting drug users is associated with poorer psychosocial functioning, greater levels of polydrug use, and greater likelihood of HIV risk-taking behaviors (Darke et al, 1992;Drake et al, 1993;Darke, 1994;Chutuape et al, 1997;Bleich et al, 1999;Gelkopf et al, 1999;Bleich et al, 2002). These findings also complement previous work showing that co-use of BZDs and methadone in methadone-maintained outpatients is associated with performance deficits on a variety of measures, relative to methadone alone (Preston et al, 1984;Lintzeris et al, 2006).…”

Section: Discussionsupporting

confidence: 78%

“…Co-ingestion of benzodiazepines (BZDs) and methadone augments the physiological and subjective opioid effects of methadone (Preston et al, 1984;Lintzeris et al, 2006), and methadone-maintenance patients have high rates of BZD abuse (Stitzer et al, 1981;Darke, 1994;Gossop et al, 2003). BZD use among injecting drug users has been associated with poorer psychosocial functioning, greater levels of polydrug use, and greater likelihood of HIV risk-taking behaviors (Darke et al, 1992;Drake et al, 1993;Darke, 1994;Chutuape et al, 1997;Bleich et al, 1999;Gelkopf et al, 1999;Bleich et al, 2002). However, it is not clear whether BZD use in methadone-maintenance patients affects their response to behavioral treatments designed to reduce use of other illicit drugs, such as CM for cocaine use.…”

Section: Introductionmentioning

confidence: 99%

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Self-report of illicit benzodiazepine use on the Addiction Severity Index predicts treatment outcome

Ghitza

Epstein

Preston

2008

Drug and Alcohol Dependence

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The relationship between pretreatment illicit benzodiazepine use (days of use in the last 30) assessed on the Addiction Severity Index (ASI) and treatment outcome was investigated by retrospective analysis of data from two controlled clinical trials in 361 methadone maintained cocaine/opiate users randomly assigned to 12-week voucher-or prize-based contingency management (CM) or control interventions. Based on screening ASI, participants were identified as nonusers (BZD-N; 0 days of use) or users (BZD-U; >0 days of use). Outcome measures were: urine drug screens (thrice weekly); quality of life and self-reported HIV-risk behaviors (every 2 weeks); and current DSM-IV diagnosis of cocaine and heroin dependence (study exit). In the CM group, BZD-U had significantly worse outcomes on in-treatment cocaine use, quality-of-life scores, needle-sharing behaviors, and current heroin dependence diagnoses at study exit compared to BZD-N. In the control group, BZD-U had significantly higher in-treatment cocaine use but did not differ from BZD-N on psychosocial measures. Thus, in a sample of non-dependent BZD users, self-reported illicit BZD use on the ASI, even at low levels, predicted worse outcome on cocaine use and blunted response to CM.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Self-report of illicit benzodiazepine use on the Addiction Severity Index predicts treatment outcome

Ghitza

Epstein

Preston

2008

Drug and Alcohol Dependence

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“…Also, according to numerous reports, coadministration of opioids and benzodiazepines (BZs) is ubiquitous around the world, concomitant use ranged between 51% and 70% [42][43][44]. However, if BZs used therapeutically among methadone maintained patients to anxiety, mania or insomnia, the prevalence this DDI could be overestimated.…”

Section: Icd-10-cm Code M00-m99mentioning

confidence: 99%

“…Non-prescription drugs, including over-the-counter products, herbal medicines, and dietary supplements have not been registered in the database and were not considered, thus possibly underestimating drug exposures and consequently of the risk to potential DDIs. For example, acetylsalicylic acid have not been registered in Health Center prescription database, but in other countries DDIs for this drug were reported frequently [23,43,46].…”

Section: Limitationsmentioning

confidence: 99%

Prevalence and predictors of potential drug-drug interactions

Nikolic¹,

Janković

Stojanov³

et al. 2014

Open Medicine

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“…An alternative strategy is to ask the users directly, but subjective reports can be difficult to interpret. For example, Gelkopf et al (1999) asked a group of methadone-maintained patients their reasons for cousing benzodiazepines. The responses ranged from 'to relax and induce sleep,' which is consistent with the known psychopharmacolgical action of benzodiazepines, to 'wakeup,' which is not.…”

Section: Introductionmentioning

confidence: 99%

Effects of Cocaine in Rats Exposed to Heroin

Leri

Flores

Rajabi

et al. 2003

Neuropsychopharmacol

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We investigated whether chronic exposure to heroin alters responses to cocaine in ways that might explain the use of cocaine by opioid addicts. To this end, the effects of cocaine (5 and 20 mg/kg) were assessed on locomotor activity of rats chronically exposed to heroin (0.0, 3.5, 7.0, and 14.0 mg/kg/day, over 14 days, via osmotic mini-pumps), or withdrawn from heroin (1 day, acute withdrawal, and 14 days, protracted withdrawal). Chronic heroin exposure, in itself, dose dependently increased locomotion and acute cocaine administration further elevated locomotor activity in a dose-dependent and additive manner. During acute withdrawal, there was a dosedependent decrease in locomotion that was reversed by cocaine in a dose-dependent manner. During protracted withdrawal, spontaneous locomotion normalized, but rats previously exposed to heroin displayed cross-sensitization to cocaine as indicated by small, but significant, enhanced locomotor response to 5 mg/kg of cocaine, and enhanced intravenous self-administration of low doses of cocaine (0.13 mg/kg/infusion). In a separate study, we measured extracellular dopamine (DA) in the nucleus accumbens (Acb) using in vivo microdialysis before and after acute withdrawal from heroin. During chronic exposure to heroin, basal extracellular DA was elevated dose dependently, whereas in acute withdrawal, levels were not different from those in vehicle-treated rats. In response to cocaine, however, DA activity in the Acb was significantly lower in rats withdrawn from the highest dose of heroin.

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Characteristics of benzodiazepine abuse in methadone maintenance treatment patients: a 1 year prospective study in an Israeli clinic

Cited by 107 publications

References 25 publications

Self-report of illicit benzodiazepine use on the Addiction Severity Index predicts treatment outcome

Self-report of illicit benzodiazepine use on the Addiction Severity Index predicts treatment outcome

Prevalence and predictors of potential drug-drug interactions

Effects of Cocaine in Rats Exposed to Heroin

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