Correlates of benzodiazepine abuse in methadone maintenance treatment. A 1 year prospective study in an Israeli clinic

Abstract

We suggest that this group of patients is in need of more intensive pharmacological and psychological treatment.

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

“…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).…”

“…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.…”

Benzodiazepine use among patients in heroin-assisted vs. methadone maintenance treatment: Findings of the German randomized controlled trial

“…Previous research shows that injecting drug users (IDUs) using benzodiazepines (BZDs) are more likely to show risk behaviors such as sharing injecting equipment, therefore having a higher rate of hepatitis C and polydrug use, and to have more psychosocial problems and higher levels of psychopathology (Darke, 1994). When entering methadone maintenance treatment (MMT), clients using benzodiazepines are more likely to have a higher severity of addiction, more polydrug use and risk behavior, greater number of previous nonfatal overdoses, and more mental health and social problems (Bleich et al, 1999;Brands et al, 2008;Darke et al, 1993;Meiler et al, 2005).…”

Office-Based Treatment in Opioid Dependence: A Critical Survey of Prescription Practices for Opioid Maintenance Medications and Concomitant Benzodiazepines in Vienna, Austria

“…anxiety) for which they may receive prescribed benzodiazepines or 'selfmedicate' with illicit medications. Benzodiazepine use is strongly linked to a range of negative consequences, including poorer adherence to maintenance programs [24,25] , greater psychological distress, more HIV risk-taking behaviors, poorer health and social functioning, and an increased incidence of overdosing and mortality [26,27] . Several studies have highlighted the potential for these drugs to have additive effects when taken together, including increased sedation and respiratory depression, even at therapeutic doses of each drug [28][29][30] .…”