BENZODIAZEPINE MISUSE AND DEPENDENCE AMONG OPIATE ADDICTS IN TREATMENT

Objective: Benzodiazepine misuse among opiate addicts is well describe d but few studies have reported on the occurrence and management of be nzodiazepine dependence within this group. This study reports on the n ature 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 c ollected data on all admissions of opiate addicts to our inpatient tre atment and research unit were searched. Specific details were then ext racted for those 61 admissions who were opiate dependent and also curr ently misusing benzodiazepines. Results: 26 (43%) of the 61 admissions were found to be physically dependent on benzodiazepines. Temazepam a nd diazepam (respectively) were the most commonly misused preparations and 22% of those using temazepam were injecting it. Patients requirin g detoxification were stabilised on doses of diazepam ranging from 20m g to 80mg daily (mean; 40mg). No correlation was found between reporte d use of benzodiazepines and the dose of diazepam required for stabili sation. Users found to be physically dependent on benzodiazepines more commonly reported daily use and use of two or more benzodiazepines co ncurrently. Conclusions: Our findings suggest: 1) that benzodiazepine dependence occurs in opiate addicts with a frequency similar to that r eported previously for other groups of benzodiazepine users; 2) that i ndividuals using benzodiazepines on a daily basis may be more at risk of developing physical dependence; and 3) that clinically it is diffic ult to accurately predict requirements for substitute medication solel y from patient's reported daily use prior to admission.