Reducing Problematic Benzodiazepine Use Among Individuals Enrolled in Methadone Treatment Programs

Schuster, James M.; Loveland, David; Parthasarathy, Meghna; Maiolo, Nicole; Cilia, Alyssa; Castelnovo, Kim

doi:10.1097/adm.0000000000000216

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Polysubstance use, especially involving benzodiazepines, was a frequent contributor to overdose in our study, and is widely acknowledged as a major overdose risk factor 42 – 47 . Benzodiazepines are the second most common drug class implicated in overdose deaths, frequently in combination with opioids 45 , 47 – 50 . The presence of benzodiazepines, combined with opioids, doubles the risk of overdose 51 .…”

Section: Discussionmentioning

confidence: 51%

“…[42][43][44][45][46][47] Benzodiazepines are the second most common drug class implicated in overdose deaths, frequently in combination with opioids. 45,[47][48][49][50] The presence of benzodiazepines, combined with opioids, doubles the risk of overdose. 51 Nonmedical uses for benzodiazepines to augment the euphoric effects of opioids or mitigate withdrawal have also been reported in other studies.…”

Section: Public Health Implicationsmentioning

confidence: 99%

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“Narcan Encounters:” Overdose and Naloxone Rescue Experiences among People who use Opioids

et al. 2022

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Background Communities across the United States are confronting the precipitous rise in opioid overdose fatalities that has occurred over the past decade. Naloxone, an opioid antagonist, is a safe rescue medication that laypeople can administer to reverse an overdose. Community naloxone training programs have been well-documented. Less is known about overdose survivors’ subjective experiences with naloxone reversal and its impacts on drug use behavior. Methods Semi-structured interviews were conducted with 35 community-dwelling adults who had been reversed at least once with naloxone. Inductive thematic content analysis incorporating Atlas.ti software was used to identify themes. Results Four broad thematic categories were identified. (1) Overdose experience and memory: Most participants remembered taking the drugs one minute and waking up the next—sometimes in different surroundings; (2) Naloxone rescue—waking up: Participants described acute withdrawal symptoms, disorientation, and volatile emotions; (3) Reasons for overdose: Polypharmacy; changes in opioid tolerance, or presence of fentanyl were the most common explanations. (4) Impacts of naloxone rescue: A variety of contextual factors influenced participants’ responses to naloxone rescue, especially acute withdrawal symptoms. While some participants altered or tempered their opioid use, others resumed opioid use—especially to mitigate withdrawal. Participants overwhelmingly emphasized that naloxone saved their lives. Conclusion Results suggest that a naloxone rescue may not be a wake-up call for many people who use opioids, but access to naloxone is an effective overdose harm reduction option, supporting its widespread implementation. The study findings underscore the importance of ongoing community overdose prevention and harm reduction initiatives, including take-home naloxone (THN) and medication assisted treatment in the Emergency Department.

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Section: Discussionmentioning

confidence: 51%

Section: Public Health Implicationsmentioning

confidence: 99%

“Narcan Encounters:” Overdose and Naloxone Rescue Experiences among People who use Opioids

et al. 2022

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Cardiovascular effects of methadone and concomitant use of diazepam during methadone maintenance treatment induction: low concentration risk

Mijatović

Samojlik

Petković

et al. 2017

Expert Opinion on Drug Safety

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Human Services and Behavioral Health Integration: A Model for Whole-Person Medicaid Managed Care

Herschell

Schuster

Keyser

et al. 2023

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Reducing Problematic Benzodiazepine Use Among Individuals Enrolled in Methadone Treatment Programs

Abstract: The 4 MMT providers involved in the study found the ongoing feedback loops valuable in the process of managing the health risks of their MMT patients.

Cited by 3 publications

References 23 publications

“Narcan Encounters:” Overdose and Naloxone Rescue Experiences among People who use Opioids

“Narcan Encounters:” Overdose and Naloxone Rescue Experiences among People who use Opioids

Cardiovascular effects of methadone and concomitant use of diazepam during methadone maintenance treatment induction: low concentration risk

Human Services and Behavioral Health Integration: A Model for Whole-Person Medicaid Managed Care

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