Insomnia in addictive diseases and treatment of insomnia in opiate withdrawal crisis

Abstract

Introduction: The article is focused on sleep disorders in people addicted to psychoactive substances. In the extensive introductory part, the complexity of this problem is presented from etiological and pathophysiological aspects. Insomnia stands out as the most prominent problem during withdrawal crises. In the second part of the work, a pilot study of the treatment of insomnia in opiate abstinence crisis was presented. The aim of the article was to evaluate the effectiveness of midazolam in treating insomnia in opioid addicts during the abstinence crisis. Methods: The research was conducted as a retrospective study, an analysis of the medical history of opioid addicts treated at the Addictions Department of the Psychiatry Clinic of the Clinical Center of Vojvodina in Novi Sad. The analysis includes 60 medical histories of people addicted to opiates who were treated in the period 2015-2021. The experimental group consisted of 30 people addicted to opiates who received midazolam, and the control group consisted of 30 people addicted to opiates who received diazepam or lorazepam. We monitored the intensity of insomnia in patients of both groups using the clinical scale for opiate withdrawal syndrome (SOWS) - insomnia variable. The data was collected and statistically processed in the program Statistic for Windows 10. Results: Irritability (Chi-square: 13.125; df-1; p=0.002) and insomnia (Chi-square=7.423; df=1; p=0.042) were statistically significantly less frequently registered in patients prescribed midazolam for sleep. Conclusion: When administered with midazolam, lower doses of anxiolytics are needed during the day. During the abstinence crisis, midazolam shows a positive effect on insomnia and indirectly on irritability.