Treatment of out-patients with complicated benzodiazepine dependence: comparison of two approaches.
OBJECTIVE
To evaluate whether gradual benzodiazepine taper combined with cognitive-behavioural treatment is more effective than standard treatment for patients with dependence in out-patient clinics.


METHODS
A randomized, controlled clinical trial, using standard questionnaires and serum and urine tests.


METHODS
Four public-sector out-patient clinics for alcohol and drug abusers in Helsinki.


METHODS
Seventy-six patients with benzodiazepine dependence (DSM-III-R). Patients taking high doses of the drug or with alcohol use disorders were included to obtain a subject group representative of usual clinical practice.


METHODS
Subjects received gradual benzodiazepine taper combined with cognitive-behavioural therapy (experimental group) or standard withdrawal treatment not scheduled by the researchers (control group).


METHODS
The outcome was measured in terms of attaining a state of abstinence or by a decrease in the dosage during the study period of up to 12 months' duration.


RESULTS
No statistically significant differences in the outcomes were observed between the groups. A total of 13% of the experimental group and 27% of the control group were able to discontinue drug use. In addition 67% of the experimental group and 57% of the control group were able to decrease the dose.


CONCLUSIONS
The search continues for improved methods of helping patients with complicated benzodiazepine dependence.
Vorma
Helena
H
A-Clinic Foundation, Helsinki, Finland. helena.vorma@ktl.fi
Naukkarinen
Hannu
H
Sarna
Seppo
S
Kuoppasalmi
Kimmo
K
D000328:Adult; D000553:Ambulatory Care; D014151:Anti-Anxiety Agents; D001521:Behavior Therapy / Q000379:methods*; D001569:Benzodiazepines; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D018709:Statistics, Nonparametric; D019966:Substance-Related Disorders / Q000628:therapy*; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D001569:Benzodiazepines