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Benzodiazepine use during buprenorphine treatment for opioid dependence: clinical and safety outcomes.
- Source :
-
Drug and alcohol dependence [Drug Alcohol Depend] 2013 Oct 01; Vol. 132 (3), pp. 580-6. Date of Electronic Publication: 2013 May 18. - Publication Year :
- 2013
-
Abstract
- Background: Prescribing benzodiazepines during buprenorphine treatment is a topic of active discussion. Clinical benefit is unclear. Overdose, accidental injury, and benzodiazepine misuse remain concerns. We examine the relationship between benzodiazepine misuse history, benzodiazepine prescription, and both clinical and safety outcomes during buprenorphine treatment.<br />Methods: We retrospectively examined outpatient buprenorphine treatment records, classifying patients by past-year benzodiazepine misuse history and approved benzodiazepine prescription at intake. Primary clinical outcomes included 12-month treatment retention and urine toxicology for illicit opioids. Primary safety outcomes included total emergency department (ED) visits and odds of an ED visit related to overdose or accidental injury during treatment.<br />Results: The 12-month treatment retention rate for the sample (N=328) was 40%. Neither benzodiazepine misuse history nor benzodiazepine prescription was associated with treatment retention or illicit opioid use. Poisson regressions of ED visits during buprenorphine treatment revealed more ED visits among those with a benzodiazepine prescription versus those without (p<0.001); benzodiazepine misuse history had no effect. The odds of an accidental injury-related ED visit during treatment were greater among those with a benzodiazepine prescription (OR: 3.7, p<0.01), with an enhanced effect among females (OR: 4.7, p<0.01). Overdose was not associated with benzodiazepine misuse history or prescription.<br />Conclusions: We found no effect of benzodiazepine prescriptions on opioid treatment outcomes; however, benzodiazepine prescription was associated with more frequent ED visits and accidental injuries, especially among females. When prescribing benzodiazepines during buprenorphine treatment, patients need more education about accidental injury risk. Alternative treatments for anxiety should be considered when possible, especially among females.<br /> (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Accidents trends
Adult
Benzodiazepines adverse effects
Emergency Medical Services trends
Female
Humans
Male
Middle Aged
Opiate Substitution Treatment trends
Retrospective Studies
Treatment Outcome
Analgesics, Opioid therapeutic use
Benzodiazepines therapeutic use
Buprenorphine therapeutic use
Opiate Substitution Treatment methods
Opioid-Related Disorders drug therapy
Opioid-Related Disorders epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0046
- Volume :
- 132
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Drug and alcohol dependence
- Publication Type :
- Academic Journal
- Accession number :
- 23688843
- Full Text :
- https://doi.org/10.1016/j.drugalcdep.2013.04.006