Diazepam use among methadone maintenance patients: patterns and dosages

Area of Science:

• Addiction Medicine
• Pharmacology
• Clinical Psychology

Background:

• Benzodiazepine co-use is common in methadone maintenance treatment.
• Understanding patient motivations and usage patterns is crucial for effective treatment.

Purpose of the Study:

• To investigate the dosage, patterns, frequency, and motives of benzodiazepine use among methadone maintenance patients.
• To differentiate between therapeutic and abusive benzodiazepine use in this population.

Main Methods:

• Survey interviews with methadone maintenance patients at two clinics (Baltimore and Philadelphia).
• Analysis of urinalysis test results for benzodiazepine use.
• Comparison of diazepam's effects versus barbiturates on methadone effects.

Main Results:

• Benzodiazepine use was prevalent (65-70% positive urinalysis).
• Diazepam was the most frequently used benzodiazepine (93%).
• High daily diazepam doses (median 40-45 mg, with 31% at 70-300 mg) and timing (with methadone) suggest abuse.
• 72% reported diazepam boosts methadone effects; barbiturates did not.

Conclusions:

• Diazepam use patterns and dosages among methadone patients are predominantly abusive, not therapeutic.
• Diazepam's perceived effect-boosting properties may drive its misuse in this population.
• Further research and clinical strategies are needed to address benzodiazepine misuse in opioid maintenance therapy.