Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-27T07:20:21.321Z Has data issue: false hasContentIssue false

Benzodiazepine misuse and dependence among opiate addicts in treatment

Published online by Cambridge University Press:  13 June 2014

Hugh Williams
Affiliation:
Division of Psychiatry of Addictive Behaviour, St George's HospitalMedical School, Cranmer Terrace, Tooting, London SW17 ORE, England
A Oyefeso
Affiliation:
Division of Psychiatry of Addictive Behaviour, St George's HospitalMedical School, London, England
AH Ghodse
Affiliation:
Division of Psychiatry of Addictive Behaviour, St George's HospitalMedical School, London, England

Abstract

Objective: Benzodiazepine misuse among opiate addicts is well described but few studies have reported on the occurrence and management of benzodiazepine dependence within this group. This study reports on the nature and extent of benzodiazepine dependence among a group of opiate addicts and describes the patients' treatment progress and requirement for substitute medication.

Method: Over a 12 month period routinely collected data on all admissions of opiate addicts to our inpatient treatment and research unit were searched. Specific details were then extracted for those 61 admissions who were opiate dependent and also currently misusing benzodiazepines.

Results: 26 (43%) of the 61 admissions were found to bephysically dependent on benzodiazepines. Temazepam and diazepam (respectively) were the most commonly misused preparations and 22% of those using temazepam were injecting it. Patients requiring detoxification were stabilised on doses of diazepam ranging from 20mg to 80mg daily (mean; 40mg). No correlation was found between reported use of benzodiazepines and the dose of diazepam required for stabilisation. Users found to be physically dependent on benzodiazepines more commonly reported daily use and use of two or more benzodiazepines concurrently.

Conclusions: Our findings suggest: 1) that benzodiazepine dependence occurs in opiate addicts with a frequency similar to that reported previously for other groups of benzodiazepine users; 2) that individuals using benzodiazepines on a daily basis may be more at risk of developing physical dependence; and 3) that clinically it is difficult to accurately predict requirements for substitute medication solely from patient's reported daily use prior to admission.

Type
Brief Report
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Beary, M, Christofides, J, Fry, D, Ghodse, AH, Smith, E & Smith, V. The benzodiazepines as substances of abuse. The Practitioner 1987; 231:1920.Google ScholarPubMed
2.Busto, U, Sellers, EM, Naranjo, CA, Cappell, HD, Sanchez-Craig, M, Skipkins, J. Patterns of benzodiazepine abuse and dependence. Br J of Addiction 1986;81: 8794.CrossRefGoogle ScholarPubMed
3.Perera, K, Tulley, M, Jenner, F. The use of benzodiazepines among drug addicts. Br J of Addiction 1987;82:511–5.CrossRefGoogle ScholarPubMed
4.Seivewright, N, Dougal, W. Benzodiazepine misuse. Current Opinion in Psychiatry 1992;5:408–11.CrossRefGoogle Scholar
5.Stitzer, M, Griffiths, R, McLellan, A. Diazepam use among methadone maintenance patients, patterns and dosage. Drug and Alcohol Dependence 1981; 8: 189–9.CrossRefGoogle Scholar
6.Ruben, S, Morrison, C. Temazepam misuse in a group of injecting drug users. Br J of Addiction 1992; 87: 1387–92.CrossRefGoogle Scholar
7.Sakol, M, Stark, C, Sykes, R. Buprenorphine and temazepam abuse by drug takers in Glasgow – an increase. Br J of Addiction 1989; 84: 439–41.CrossRefGoogle ScholarPubMed
8.Ashton, H. Benzodiazepine withdrawal: an unfinished story. BMJ 1984; 288: 1135–40.CrossRefGoogle ScholarPubMed
9.Lader, M. Benzodiazepine dependence. Int Rev of Psychiat 1989; 1: 149–56.CrossRefGoogle Scholar
10.Higgitt, A, Lader, M, Fonagy, P. Clinical management of benzodiazepine dependence. BMJ 1985; 21: 688–90.CrossRefGoogle Scholar
11.Lader, M, Morton, S. Benzodiazepine problems. Br J of Addiction 1991; 86: 823–8.CrossRefGoogle ScholarPubMed
12.Harrison, M, Busto, U, Naranjo, CA, Kaplan, H, Sellers, EM. Diazepam tapering in detoxification for high-dose benzodiazepine abuse. Clin Pharm and Therap 1984; 36: 527–33.CrossRefGoogle ScholarPubMed
13.Smith, D, Landry, M. Benzodiazepines dependency discontinuation; focus on the chemical dependency detoxification setting and benzodiazepine-polydrug abuse. J of Psychiat Res 1990; 24: 145–56.CrossRefGoogle ScholarPubMed
14.Seivewright, N, Dougal, W. Withdrawal symptoms from high dose benzodiazepines in poly drug users. Drug and Alcohol Dependence 1993; 32: 1523.CrossRefGoogle ScholarPubMed
15.Ghodse, AH. Drugs and addictive behaviour; a guide to treatment. London: Blackwell, 1989: 175–82.Google Scholar
16.Darke, S. Benzodiazepine use among injecting drug users: problems and implications. Addiction; 89: 379–82.CrossRefGoogle Scholar