Benzodiazepine and sedative use/abuse by methadone maintenance clients

https://doi.org/10.1016/0376-8716(93)90090-DGet rights and content

Abstract

Clients at three geographically separate methadone maintenance clinics were surveyed regarding their lifetime use of ten commonly used benzodiazepines and barbiturates. In Baltimore (n = 50), 94% reported use of one or more of these drugs in their lifetime, with 66% reporting use in the last 6 months. In Philadelphia (n = 218), 78% reported use in their lifetime, with 53% reporting use in the last 6 months. In New York City (The Bronx) (n = 279), 86% reported use in their lifetime, with 44% reporting use in the last 6 months. Subjects reporting a history of use of at least 7 of 10 of the named sedatives were recruited for a more detailed interview. They reported that, among the benzodiazepines, diazepam, lorazepam, and alprazolam were frequently used for their ‘high’ producing effects, and for selling to produce income. In contrast, chlordiazepoxide, oxazepam, and phenobarbital, had much lower ratings of ‘high’ and were much less likely to be obtained for getting ‘high’ or for resale.

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    Other studies carried out among drug using populations other than PWUC have found similar patterns of prescription drug misuse: benzodiazepines, PO and quetiapine were used as downers from stimulant use (Fountain et al., 1999; Inciardi et al., 2007; Rigg et al., 2010; Roy, Arruda, Vaillancourt et al., 2012; Silva et al., 2013); benzodiazepines and/or PO as enhancers of opioid-based drugs, including methadone (Fountain et al., 1999; Iguchi et al., 1993; Lankenau et al., 2007, 2012b) and/or to curb heroin use (Lankenau et al., 2012b); prescribed stimulants to increase the effects of crystal meth (Kecojevic et al., 2015); benzodiazepines to reduce or suppress withdrawal symptoms from opioid-based drugs (Fountain et al., 1999; Gelkopf et al., 1993; Lankenau et al., 2012b; Rigg et al., 2010); and benzodiazepines, PO and/or quetiapine to medicate sleep, emotional problems (Gelkopf et al., 1993; Iguchi et al., 1993; Lankenau et al., 2007, 2012b; Rigg et al., 2010) and/or stress related to harsh life conditions (Kecojevic et al., 2015) as well as physical pain (Lankenau et al., 2007, 2012b). In addition, some studies have suggested that drug users took benzodiazepines and other tranquilizers exclusively as low-cost alternatives to getting “high” (Iguchi et al., 1993; Rigg et al., 2010), which is comparable to our finding about “rivotrips”. Nonetheless, the motives for taking benzodiazepines in controlled ways, as our participants identified, seem to point to a different practice, where the aim is mainly to “take a break” or “detox” from street drugs.

  • Reasons for Benzodiazepine use Among Persons Seeking Opioid Detoxification

    2016, Journal of Substance Abuse Treatment
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    Several studies have found that patients receiving chronic opioid agonist treatment (OAT) often use BZDs to help with anxiety and sleep (Gelkopf, Bleich, Hayward, Bodner, & Adelson, 1999; Posternak & Mueller, 2001; Vogel et al., 2013). Other work in OAT populations has suggested patients in methadone maintenance treatment take BZDs to get high (Chen et al., 2011; Fatseas, Lavie, Denis, & Auriacombe, 2009; Gelkopf et al., 1999; Iguchi, Handelsman, Bickel, & Griffiths, 1993). Fewer studies exploring reasons for use have focused on treatment-seeking opioid users.

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A preliminary version of this paper was presented at the Committee on Problems of Drug Dependence Meeting, 1989.

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