Correlates of benzodiazepine abuse in methadone maintenance treatment. A 1year prospective study in an Israeli clinic

Aims. This study addressed the following questions for patients after I yea r of methadone maintenance treatment (MMT); (I) What are the demographic fe atures and past history of drug use of benzodiazepine (BZD) abusers? (2) Do BZD abusers abuse more heroin, cocaine and/or cannabis and do they receive a higher methadone dosage level? (3) Do BZD abusers suffer more from hepat itis C (HCV) and do they have more HIV/HCV risk-taking behaviors than non-a busers? (4) Do BZD abusers have more psychopathology and more emotional dis tress than non-abusers? Design. All 148 patients who completed I year of MM T underwent random and twice-weekly observed urine analysis for various dru gs of abuse, responded to self-report questionnaires (SCL-90-R; POMS; HIV/H CV risk-taking behaviors), interviews (ASI) and underwent testing for hepat itis C. Abuse in this study is defined as any use during the 12th month of treatment. Findings. After I year of MMT, more BZD abusers (n = 63) were si ngle, had spent time in prison, were unemployed and had at least one parent with an addiction problem or mental illness in comparison to non-abusers ( n = 85). They had started using heroin and cocaine earlier and currently ab used more cocaine, heroin and cannabis. They had significantly more psychop athology and negative mood. They had significantly more HCV and reported mo re HIV/HCV risk-taking behavior. Implications. We suggest that this group o f patients is in need of more intensive pharmacological and psychological t reatment.