title: Abuse liability of intra-nasal midazolam in inhaled-cocaine abusers.
abstract: Intra-nasally instilled benzodiazepines have been proposed for acute anxiety episodes. However, routes with faster absorption may increase abuse liability. This study compared abuse liability of intra-nasal midazolam between subjects with a history of intra-nasal drug abuse and non-psychiatric subjects on a single-blind randomized controlled trial. Thirty-one inhaled-cocaine abusers and 34 normal volunteers received either 1 mg intra-nasal midazolam or active placebo. Visual analogue scales assessing desire to repeat the experience (ER) and Experience Liking (EL) assessed abuse liability. Profile analysis for repeated measures showed a significant effect of time over ER (F([5,57])=3.311, p=0.011) and EL (F([5,57])=3.947, p=0.004), diagnostic group (cocaine abusers scoring higher on both - F([5,57])=5.229, p=0.026; F([5,57])=4.946, p=0.030), regardless of the administered substance. It is concluded that the intra-nasal route does not seem to pose risks for non-psychiatric individuals, but it may represent a risk in itself for subjects with a history of drug abuse through this path.
authors.affiliation: Anxiety Disorders Program, Institute and Department of Psychiatry, University of São Paulo, Brazil.
authors.forename: Ivan Mario
authors.initials: IM
authors.lastname: Braun
authors.forename: Hermano
authors.initials: H
authors.lastname: Tavares
authors.forename: Gilberto
authors.initials: G
authors.lastname: de Nucci
authors.forename: Marcio
authors.initials: M
authors.lastname: Bernik
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D019540:Area Under Curve; D016022:Case-Control Studies; D019970:Cocaine-Related Disorders / Q000523:psychology*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D008297:Male; D008874:Midazolam / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D015999:Multivariate Analysis; D016037:Single-Blind Method; D013997:Time Factors
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam