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Reducing diazepam prescribing for illicit drug users: a randomised control study.

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Summary

Reducing prescribed diazepam for illicit drug users is possible with enhanced psychological support. While not all patients completed the reduction, the enhanced intervention group showed greater improvements in depression scores.

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Area of Science:

  • Clinical Psychology
  • Addiction Medicine
  • Psychopharmacology

Background:

  • Illicit drug users often have co-occurring prescribed benzodiazepine use.
  • Mandatory reductions in prescribed diazepam require effective psychological support strategies.
  • Understanding patient adherence and intervention effectiveness is crucial for managing benzodiazepine dependence.

Purpose of the Study:

  • To compare an enhanced psychological intervention with a limited one for reducing prescribed diazepam in illicit drug users.
  • To assess the impact of these interventions on diazepam dosage, illicit drug use, and psychological well-being.
  • To identify factors influencing the success of prescribed diazepam reduction programs.

Main Methods:

  • Randomized controlled trial involving 53 illicit drug users undergoing diazepam reduction.
  • Two groups: enhanced intervention (skills training and reinforcement) vs. limited intervention (skills training and advice).
  • Outcome measures included daily diazepam dose, illicit drug use, dependence severity, anxiety/depression (HADS), and sleep quality.

Main Results:

  • No statistically significant difference in the rate of diazepam dose reduction between groups (enhanced: 5.3%/month, limited: 7.5%/month).
  • Approximately 75% of patients in both groups suspended their reduction program.
  • The enhanced intervention group showed a statistically and clinically significant reduction in Hospital Anxiety and Depression Scale (HADS) depression scores.

Conclusions:

  • Reducing prescribed diazepam in illicit drug users is feasible but challenging, with lower adherence than targeted.
  • An enhanced psychological intervention may offer greater benefits for depression symptoms compared to limited support.
  • A flexible, long-term approach is recommended for managing prescribed benzodiazepine reduction in this population.