Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-26T15:22:55.124Z Has data issue: false hasContentIssue false
  • English
  • Français

Service response to benzodiazepine use in opiate addicts: a national postal survey

Published online by Cambridge University Press:  13 June 2014

Hugh Williams ,
Doug Handyside ,
Kirsty Bashford  and
Adenekan Oyefeso
Hugh Williams
Affiliation:
Substance Misuse Service, South Downs Health NHS Trust, 26 Ditching Road, Brighton BN1 4SF and Department of Addictive Behaviour and Psychological Medicine, St George's HospitalMedical School, London SW17 ORE, England
Kirsty Bashford
Affiliation:
Substance Misuse Service, South Downs Health NHS Trust, 26 Ditchling Road, Brighton, BN1 4SF, England
Adenekan Oyefeso
Affiliation:
Department of Addictive Behaviour and Psychological Medicine, St George's HospitalMedical School, London SW17 ORE, England
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The study reports on benzodiazepine use among opiate dependent patients attending National Health Service community prescribing services and examines current practice in the clinical management of benzodiazepine dependence.

Method: A postal questionnaire survey of 174 NHS substance misuse services in England and Wales.

Results: A 71% response rate was achieved. Services estimated the prevalence of benzodiazepine use to be 40% and the prevalence of benzodiazepine dependence to be less than 25% among opiate dependent patients in treatment. Illicit supplies (street) and general practitioners were regarded as the most common source of benzodiazepines. The most commonly reported reasons for benzodiazepine use were for the direct intoxicating effects and for the treatment of anxiety/insomnia. The majority of services (93,75%) reported prescribing benzodiazepines to patients for benzodiazepine detoxification while 43 (35%) reported prescribing for benzodiazepine maintenance treatment. The variations in benzodiazepine prescribing practices across services are described.

Conclusions: Benzodiazepine use remains common among opiate addicts in contact with treatment services. The majority of services surveyed reported prescribing benzodiazepines but there was much variation in clinical practice nationally. There is need for further research to identify effective treatment approaches for comorbid benzodiazepine dependence in opiate misusers.

Keywords

Drug dependenceOpioidsBenzodiazepinesTreatmentDetoxificationMaintenanceNational Health ServiceNational postal survey
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 22 , Issue 1 , March 2005 , pp. 15 - 18
Copyright
Copyright © Cambridge University Press 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Oyefeso, A, Ghodse, AH, Williams, H. Prevalence and pattern of benzodiazepine abuse and dependence among patients in a methadone detoxification programme: a repeated cross-sectional analysis. Addiction Res 1995; 4: 7–64.Google Scholar
2.Strang, J, Griffiths, P, Abbey, A, Gossop, M. Survey of use of injected benzodiazepines among drug users in Britain. BMJ 1994; 308: 1082.CrossRefGoogle ScholarPubMed
3.Williams, H, Oyefeso, A, Ghodse, AH. Benzodiazepine misuse and dependence among opiate addicts in treatment. Ir J Psychol Med 1996; 13: 62–64.Google Scholar
4.Darke, S, Swift, W, Hall, W, Ross, M. Drug, use, HIV risk-taking and psychosocial correlatives of benzodiazepine use among methadone maintenance clients. Drug Alcohol Depend 1993; 34: 67–70.Google Scholar
5.Darke, S. Benzodiazepine use among injecting drug users: problems and implications. Addiction 1994; 89: 397–82.Google Scholar
6.Ghodse, AH, Clancey, C, Goldfinch, R, Oyefeso, A, Pollard, M, Corkery, J. Drug related deaths as reported to the coroners in England and Wales, January-June 1998. National Programme on Substance Abuse Deaths np-SAD Surveillance report No. 2, 1999.Google Scholar
7.Advisory Council on the Misuse of Drugs. Reducing Drug Related Deaths. London: HMSO, 2000.Google Scholar
8.Gossop, M, Stewart, D, Treacy, S, Marsden, J. A prospective study of mortality among drug misusers during a 4-year period after seeking treatment. Addict 2002; 97: 39–47.Google Scholar
9.Seivewright, S. The case for other substitute drugs. In: Seivewright, S. Community treatment of drug misuse: more than methadone. Cambridge: Cambridge University Press, 1999: 70–81.CrossRefGoogle Scholar
10.Rosenberg, H, Melville, J, McLean, PC. Acceptability and availability of pharmacological interventions for substance misuse by British NHS treatment services. Addiction 2002; 97: 59–65.Google Scholar
11.Greenwood, J. Six years of sharing the care for drug users in Edinburgh. Psychiatr Bull 1996; 20: 8–11.Google Scholar
12.McDuff, DR, Schwartz, RP, Tommasello, A, Tiegel, S, Donovan, T, Johnson, JL. Outpatient benzodiazepine detoxification procedure for methadone patients. J Subst Abuse Treat 1993; 10: 297–302.Google Scholar
13.Department of Health. Drug misuse and dependence: guidelines on clinical management. London: HMSO, 1999.Google Scholar
14.National Treatment Agency for Substance Misuse. Models of Care for the treatment of adult drug misusers. London: NTA, 2002.Google Scholar
15.Strang, J, Sheridan, J, Barber, N. Prescribing injectable and oral methadone to opiate addicts: results from the 1995 national postal survey of community pharmacies in England and Wales. BMJ 1996; 313: 270–2.CrossRefGoogle ScholarPubMed
16.Dinwiddie, S, Cottier, L, Compton, W, Abdallah, A. Psychopathology and HIV risk behaviours among injecting drug users in and out of treatment. Drug Alcohol Depend 1996; 43: 1–11.Google Scholar
17.Ross, J, Darke, S. The nature of benzodiazepine dependence among heroin users in Sydney, Australia. Addiction 2000; 95: 1785–93.Google Scholar
18.Ross, J, Darke, S. Hall, W. Benzodiazepine use among heroin users in Sydney: patterns of use, availability and procurement. Drug Alcohol Review 1996; 15: 237–43.Google Scholar
19.Regier, DA, Farmer, M E, Rae, DSet al.Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiological Catchment Area (ECA) Study. JAMA 1990; 264: 2511–8.Google Scholar
20.Hall, W, Farrell, M. Comorbidity of mental disorders with substance misuse Br J Psychiatry 1997; 171: 4–5.Google Scholar
21.Seivewright, N, Donmall, M, Daly, C. Benzodiazepines in the illicit drug scene -the UK picture and some treatment dilemmas Int J Drug Policy 1993; 4: 42–8.Google Scholar
22.Task Force to Review Services for Drug Misusers. Report of an independent review of drug treatment services in England. London: Department of Health, 1995.Google Scholar
23.Harrison, M, Busto, U, Naranjo, C, Kaplan, H, Sellers, EM. Diazepam tapering in detoxification for high-dose benzodiazepine abuse. Clin Pharmacol Ther 1984; 36: 527–33.CrossRefGoogle ScholarPubMed
24.Scott, RT. The prevention of convulsions during benzodiazepine withdrawals. Br J Gen Pract 1990; 40: 261.Google Scholar