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

Abstract

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.

High enhancer, downer, withdrawal helper: Multifunctional nonmedical benzodiazepine use among young adult opioid users in New York City

“…There is a need for treatment efforts to carefully screen for and address dual dependence and concomitant use of benzodiazepines and opioids (Ghitza, Epstein & Preston, 2008; Toblin et al, 2010; White & Irvine, 1999; Wolf, Lavezzi, Sullivan, & Flannagan, 2005). Benzodiazepines, when used alone, rarely lead to death, and it is perhaps this lack of overdose-associated mortality that allows users to view concurrent use of benzodiazepines with other drugs as safe (Mcgregor et al, 1998; Neira-León et al, 2006; Rowe, Santos, Behar & Coffin, 2016).…”

Health Service Utilization Among Heroin Users

“…The extensive use and abuse of anxiolytics/hypnosedatives by heroin users has been documented repeatedly, and heroin users frequently seek prescriptions for them. 1,2,4,[15][16][17][18][19] This is of importance, as such use is consistently associated with a poorer clinical profile. 12 There has also been considerable concern in recent years about the abuse of narcotic analgesics such as codeine and oxycodone, with substantial increases in sales, abuse, and deaths attributed to these drugs.…”

Effects of Acute and Chronic Flunitrazepam on Delay Discounting in Pigeons

“…Other effects of benzodiazepines could impact results of delay‐discounting procedures, independent of their effects on discounting. For example, benzodiazepines can impair working memory (Dåderman, Frederiksson, Kristiansson, Nilsson, & Lidberg, 2002; Lane, Cherek, & Nouvion, 2008), although an impairment in working memory might be expected to result in an equal distribution of responses across the two keys rather than responding predominantly on one key throughout the entire session. Another effect of benzodiazepines that might impact results in the delay‐discounting procedure is their effect on punished responding.…”

“…Although the incidence of exclusive benzodiazepine abuse is low, they are often abused with other drugs, such as opioids (Gelkopf, Bleich, Hayward, Bodner, & Adelson, 1999; Lavie, Fatséas, Denis, & Auriacombe, 2009; Peles, Schreiber, & Adelson, 2006; San, Tato, Torrens, Castillo, Farré, & Camí, 1993). Use of benzodiazepines by patients in methadone‐maintenance programs predicts poorer treatment outcomes and those patients are also more likely to engage in risky behaviors (Bleich, Gelkopf, Schmidt, Hayward, Bodner, & Adelson, 1999; Ghitza, Epstein, & Preston, 2008), perhaps indicating that these patients are more impulsive. In the current study, the effects of the benzodiazepine flunitrazepam were examined on one aspect of impulsivity.…”