Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes
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 opi...
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| Format: | Article |
| Language: | English |
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Ordem dos Médicos
2021-03-01
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| Series: | Acta Médica Portuguesa |
| Subjects: | |
| Online Access: | https://actamedicaportuguesa.com/revista/index.php/amp/article/view/13181 |
| _version_ | 1817968626397872128 |
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| author | Catarina Oliveira Rita Filipe João Meira Lara Sampaio Leonor Teixeira Júlio Rodrigues Inês Nunes João Tavares |
| author_facet | Catarina Oliveira Rita Filipe João Meira Lara Sampaio Leonor Teixeira Júlio Rodrigues Inês Nunes João Tavares |
| author_sort | Catarina Oliveira |
| collection | DOAJ |
| description |
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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| first_indexed | 2024-04-13T20:11:16Z |
| format | Article |
| id | doaj.art-e34c9ed5d09c4d66884b6a9c70cb130e |
| institution | Directory Open Access Journal |
| issn | 0870-399X 1646-0758 |
| language | English |
| last_indexed | 2024-04-13T20:11:16Z |
| publishDate | 2021-03-01 |
| publisher | Ordem dos Médicos |
| record_format | Article |
| series | Acta Médica Portuguesa |
| spelling | doaj.art-e34c9ed5d09c4d66884b6a9c70cb130e2022-12-22T02:31:50ZengOrdem dos MédicosActa Médica Portuguesa0870-399X1646-07582021-03-0134310.20344/amp.131815154Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical OutcomesCatarina Oliveira0Rita Filipe1João Meira2Lara Sampaio3Leonor Teixeira4Júlio Rodrigues5Inês Nunes6João Tavares7Psychiatry Department. Hospital Prof. Dr. Fernando Fonseca. Amadora.Public Health Unit. Health Group Unit of Western Lisbon and Oeiras. Oeiras.Drug Addiction Treatment Centre. Agualva-Cacém. Cacém.Drug Addiction Treatment Centre. Agualva-Cacém. Cacém.Drug Addiction Treatment Centre. Agualva-Cacém. Cacém.Drug Addiction Treatment Centre. Agualva-Cacém. Cacém.Drug Addiction Treatment Centre. Agualva-Cacém. Cacém.Drug Addiction Treatment Centre. Agualva-Cacém. Cacém. 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. https://actamedicaportuguesa.com/revista/index.php/amp/article/view/13181BenzodiazepinesBuprenorphineMethadoneOpiate Substitution Treatment |
| spellingShingle | Catarina Oliveira Rita Filipe João Meira Lara Sampaio Leonor Teixeira Júlio Rodrigues Inês Nunes João Tavares Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes Acta Médica Portuguesa Benzodiazepines Buprenorphine Methadone Opiate Substitution Treatment |
| title | Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes |
| title_full | Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes |
| title_fullStr | Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes |
| title_full_unstemmed | Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes |
| title_short | Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes |
| title_sort | benzodiazepine use in opioid maintenance treatment programme risks and clinical outcomes |
| topic | Benzodiazepines Buprenorphine Methadone Opiate Substitution Treatment |
| url | https://actamedicaportuguesa.com/revista/index.php/amp/article/view/13181 |
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