Benzodiazepine use among opiate-dependent subjects in buprenorphine maintenance treatment: correlates of use, abuse and dependence.
BACKGROUND
Previous studies from North America, Europe and Australia have reported high levels of benzodiazepine use among opiate-dependent patients in opiate maintenance treatment. However, to date, there are no available data on patterns of abuse and dependence on benzodiazepines according to DSM criteria among these patients.


OBJECTIVE
To describe the independent correlates of use, abuse and dependence on benzodiazepines among buprenorphine patients selected from standard treatment settings.


METHODS
Cross-sectional study in France between June 2001 and June 2004. Buprenorphine patients treated for over 3 months were recruited via physicians prescribing buprenorphine. Patients answered a self-administered questionnaire, the DSM-IV criteria for benzodiazepine abuse and dependence, the Beck Anxiety and Depression Inventories (BAI, BDI) and the Nottingham Health Profile (NHP). Main outcome was modalities of benzodiazepine use: no use vs. simple use vs. problematic use (abuse or dependence according to DSM-IV).


RESULTS
170 patients were recruited. 54% did not use benzodiazepines during the previous month, 15% were simple users and 31% were problematic users. Benzodiazepine use (all modalities) was associated with poly-use of psychotropics. Simple users of benzodiazepines were not statistically different from non-users for the other factors explored. Problematic users of benzodiazepines had higher depression and anxiety levels, correlated with quality of life impairment and precariousness. They used higher dosages of benzodiazepines than simple users.


CONCLUSIONS
Characteristics of simple benzodiazepine users were distinct from problematic users but not from non-users in this sample of buprenorphine patients. This should be taken into account in the clinical management of benzodiazepine use among buprenorphine patients.
Lavie
Estelle
E
Laboratoire de Psychiatrie/EA 4139, Université Victor Segalen Bordeaux 2, INSERM-IFR n degrees 99, 146 rue Léo Saignat, Bordeaux, France.
Fatséas
Mélina
M
Denis
Cécile
C
Auriacombe
Marc
M
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001569:Benzodiazepines; D002047:Buprenorphine / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
D009294:Narcotics; D001569:Benzodiazepines; D002047:Buprenorphine