Drug Interactions with Benzodiazepines: Epidemiologic Correlates with Other CNS Depressants and In Vitro Correlates with Inhibitors and Inducers of Cytochrome P450 3A4

Moody, David E.

doi:10.1007/978-1-61779-222-9_2

Cited by 11 publications

(6 citation statements)

References 367 publications

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“…Though studies suggest that BZDs are capable of inhibiting the metabolism of some opioid drugs, BZDs are weak competitive inhibitors of CYP3A4, only one of the several hepatic enzymes that metabolize these drugs (Moody et al, 2004). Thus, this inhibition may not always be sufficient to produce clinically relevant interactions.…”

Section: Pharmacological Interactions Between Opioids and Benzodiamentioning

confidence: 99%

Polydrug abuse: A review of opioid and benzodiazepine combination use

Jones

Mogali

Comer

2012

Drug and Alcohol Dependence

593

411

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This paper reviews studies examining the pharmacological interactions and epidemiology of the combined use of opioids and benzodiazepines (BZD). A search of English language publications from 1970 - 2012 was conducted using PubMed and PsycINFO®. Our search found approximately 200 articles appropriate for inclusion in this paper. While numerous reports indicate that the co-abuse of opioids and BZDs is ubiquitous around the world, the reasons for the co-abuse of these medications are not entirely clear. Though the possibility remains that opioid (ab)users are using BZDs therapeutically to self-medicate anxiety, mania or insomnia, the data reviewed in this paper suggest that BZD use is primarily recreational. For example, co-users report seeking BZD prescriptions for the purpose of enhancing opioid intoxication or “high,” and use doses that exceed the therapeutic range. Since there are few clinical studies investigating the pharmacological interaction and abuse liability of their combined use, this hypothesis has not been extensively evaluated in clinical settings. As such, our analysis encourages further systematic investigation of BZD abuse among opioid users. The co-abuse of BZDs and opioids is substantial and has negative consequences for general health, overdose lethality, and treatment outcome. Physicians should address this important and underappreciated problem with more cautious prescribing practices, and increased vigilance for abusive patterns of use.

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Section: Pharmacological Interactions Between Opioids and Benzodiamentioning

confidence: 99%

Polydrug abuse: A review of opioid and benzodiazepine combination use

Jones

Mogali

Comer

2012

Drug and Alcohol Dependence

593

411

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“…80 While toxicity has rarely been reported with inhibition of the metabolism of benzodiazepines at therapeutic doses, it is unknown if there would be significant harm in patients who abuse benzodiazepines. 81 Benzodiazepines have been found to have both pharmacodynamic and pharmacokinetic interactions with opioids. The pharmacodynamic interaction is discussed below, but there have been several studies that have shown that benzodiazepines may alter the pharmacokinetics of opioids.…”

Section: Benzodiazepinesmentioning

confidence: 99%

“…Significant DDIs have been reported with potent CYP450 2A12, 2C19, 2D6, and 3A4 inhibitors resulting in increases in plasma concentrations 80 . While toxicity has rarely been reported with inhibition of the metabolism of benzodiazepines at therapeutic doses, it is unknown if there would be significant harm in patients who abuse benzodiazepines 81 …”

Section: Benzodiazepinesmentioning

confidence: 99%

A Review of the Metabolism and Potential Drug-drug Interactions With Addictive Drugs

Radke

Tocki

Faine

2021

Journal of Addiction Medicine

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People who use drugs (PWUD) are at increased risk for drug-related harms such as overdose. Additionally, they are also at increased risk of secondary harms from bacterial and other infections such as hepatitis B, hepatitis C, and Human Immunodeficiency Virus. These secondary harms, along with other medical conditions, typically require treatment with prescription medications. When considering treatment options, drug-drug interactions (DDIs) must be considered, unfortunately these interactions are often overlooked with addictive drugs. Although DDIs in PWUD have been reviewed for certain drug classes and specific drugs of abuse, no comprehensive list could be found. The objective of this article is to compile a list of potential DDIs between prescription drugs and addictive drugs to create a list allowing prescribers to make more informed decisions when prescribing a medication to PWUD.

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“…Benzodiazepine detection is complicated. Not due to a large number of benzodiazepines, the number of metabolites potentially present amplifies the number of reactant molecules with various levels of cross reactivity [16].…”

Section: Journal Of Drug Abuse 2471-853xmentioning

confidence: 99%

Efficiency Evaluation of Urine Collection Vessels with Impeded Urine Adulteration/Substance of Abuse (SOA) Rapid Detection Test Strips

AR¹,

R²,

FA³

et al. 2017

J Drug Abuse

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Laboratory testing for drugs of abuse has become standard practice in many settings both forensic and clinical. Sending the specimen to any laboratory is waste of time and sometimes the rapid urine testing is a target. A limitation inherent in all urine drug testing is the possibility of sample adulteration or substitution. The aim of the current study is to prove the validity by deeply investigated procedures for urine collection vessels with impeded urine adulteration/substance of abuse (SOA) Test Strips (two types of investigated kits) and evaluation of their total turnaround time and efficacy for cannabinoids, opiates, benzodiazepines, tramadol and amphetamines in-comparison with immunoassay screening and GC-MS confirmatory procedures. Both Investigated Kits have the capability of detecting variable procedures of adulteration by a high efficiency degree. Therefore, SOA tests with rapid releasing results can improve patient management protocol with few percentage of pseudo-positivity/negativity results, unfortunately the operators immediate start the clinical action and realize the limitations of the test and wait for follow-up confirmation testing as appropriate before definitive medico-legal action.

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Drug Interactions with Benzodiazepines: Epidemiologic Correlates with Other CNS Depressants and In Vitro Correlates with Inhibitors and Inducers of Cytochrome P450 3A4

Cited by 11 publications

References 367 publications

Polydrug abuse: A review of opioid and benzodiazepine combination use

Polydrug abuse: A review of opioid and benzodiazepine combination use

A Review of the Metabolism and Potential Drug-drug Interactions With Addictive Drugs

Efficiency Evaluation of Urine Collection Vessels with Impeded Urine Adulteration/Substance of Abuse (SOA) Rapid Detection Test Strips

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