Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes

Authors

  • Catarina Oliveira Psychiatry Department. Hospital Prof. Dr. Fernando Fonseca. Amadora. https://orcid.org/0000-0003-2636-696X
  • Rita Filipe Public Health Unit. Health Group Unit of Western Lisbon and Oeiras. Oeiras.
  • João Meira Drug Addiction Treatment Centre. Agualva-Cacém. Cacém.
  • Lara Sampaio Drug Addiction Treatment Centre. Agualva-Cacém. Cacém.
  • Leonor Teixeira Drug Addiction Treatment Centre. Agualva-Cacém. Cacém.
  • Júlio Rodrigues Drug Addiction Treatment Centre. Agualva-Cacém. Cacém.
  • Inês Nunes Drug Addiction Treatment Centre. Agualva-Cacém. Cacém.
  • João Tavares Drug Addiction Treatment Centre. Agualva-Cacém. Cacém.

DOI:

https://doi.org/10.20344/amp.13181

Keywords:

Benzodiazepines, Buprenorphine, Methadone, Opiate Substitution Treatment

Abstract

Introduction: The co-association of benzodiazepines and opioids is associated with an increased risk of overdose, death, and poorer psychosocial prognosis. The aim of this study is to characterize the prevalence, pattern of use, and primary clinical outcomes in benzodiazepines users in a public opioid maintenance treatment unit.
Material and Methods: We conducted a cross-sectional study involving 236 patients treated with opioid substitutes (methadone and buprenorphine). We conducted a descriptive, bivariable, and multivariable analysis to determine clinical differences between benzodiazepines users and non-users.
Results: The prevalence of consumption of benzodiazepines was 25.4% (60). The benzodiazepines were obtained with a medical prescription (49.8%) or on the black market (42.6%). The most prescribed benzodiazepine was diazepam (29.1%), and the main reasons were to relieve insomnia (27.7%) or anxiety (26.9%) and to enhance the psychoactive effects of other drugs (19.7%). Regarding the clinical outcomes, we highlight: a very high prevalence of hepatitis C (51.7%); severe ongoing consumption of psychoactive drugs (73.7%); and a high rate of depression and anxiety (> 60%), significantly higher in the benzodiazepines-user group. In the multivariable analysis of benzodiazepine use, we found alcohol consumption (OR 0.482; IC 95% 0.247, 0.238) had a negative association and having hepatitis C (OR 2.544, IC 95% 1.273, 5.084) or anxiety symptoms (OR 5.591; IC 95% 2.345, 13.326) had positive associations.
Discussion: Our results suggest the BZD users had a complex drug addiction problem and underline the importance of adequately addressing BZD use, contemplating psychological and psychiatric approach in this particular population.
Conclusion: Past or current use of benzodiazepines is associated with poor clinical and psychiatric outcomes. A multidisciplinary approach with a focus on infectious diseases and mental health is critical in order to enhance the treatment effectiveness and overall prognosis.

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Author Biography

Catarina Oliveira, Psychiatry Department. Hospital Prof. Dr. Fernando Fonseca. Amadora.

Psychiatry Department

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Published

2021-03-01

How to Cite

1.
Oliveira C, Filipe R, Meira J, Sampaio L, Teixeira L, Rodrigues J, Nunes I, Tavares J. Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes. Acta Med Port [Internet]. 2021 Mar. 1 [cited 2024 Mar. 29];34(3):209-16. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/13181

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Original