MANAGING DIAZEPAM ABUSE IN AN AIDS-RELATED PSYCHIATRIC CLINIC WITH A HIGH PERCENTAGE OF SUBSTANCE-ABUSERS

Controversy over using benzodiazepines in a human immunodeficiency vir us (HIV)-positive population to relieve sleep and anxiety has not been addressed in the literature. Serious problems with diazepam abuse eme rged in a psychiatric outpatient clinic for a predominately HIV-positi ve and illicit drug-using population, which led to a review of patient characteristics and prescribing policies and to a systematic problem- solving effort. The patients originally prescribed diazepam were signi ficantly more likely to be on methadone and have histories of intraven ous drug use compared with the patients not on benzodiazepines. Thus, the patients asking for diazepam are likely to have histories of subst ance abuse and have a high potential for abusing the medication. The a uthors found that diazepam can be discontinued without causing a signi ficantly greater drop-out rate in that group.