title: Prolonged use of benzodiazepines is associated with childhood trauma in opioid-maintained patients.
abstract: BACKGROUND
  Benzodiazepine (BZD) misuse in opioid-maintained patients is widespread and has been related to poorer treatment success. Associated factors, in particular, traumatic childhood experiences, have not been investigated extensively.
  
  
  METHODS
  Cross-sectional survey including the childhood trauma questionnaire (CTQ) and clinical data among 193 patients prescribed oral opioids or injectable diacetylmorphine for opioid dependence.
  
  
  RESULTS
  BZD use was prevalent (61%) and the burden of childhood traumatic experiences was high with 67% reporting at least one trauma subscore of moderate-to-severe level. In univariate analysis, CTQ-subcategories "emotional abuse" (p<0.05), "emotional neglect" (p<0.01) and "physical neglect" (p<0.001) were significantly associated with prolonged BZD use. In multivariate analysis, prolonged BZD use was associated with categorized overall CTQ-scores (OR 1.5), HCV-seropositivity (OR 4.0), psychiatric family history (OR 2.3), and opioid dose (mg methadone equivalents, OR 1.010).
  
  
  CONCLUSIONS
  Childhood traumatic experiences may be associated with prolonged BZD use in opioid-maintained patients and could pose an important starting-point for prevention.
authors.affiliation: Division of Substance Use Disorders, Psychiatric Hospital of the University of Basel, Basel, Switzerland. Marc.Vogel@upkbs.ch
authors.forename: Marc
authors.initials: M
authors.lastname: Vogel
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Dürsteler-Macfarland
authors.forename: Marc
authors.initials: M
authors.lastname: Walter
authors.forename: Johannes
authors.initials: J
authors.lastname: Strasser
authors.forename: Stephanie
authors.initials: S
authors.lastname: Fehr
authors.forename: Luis
authors.initials: L
authors.lastname: Prieto
authors.forename: Gerhard A
authors.initials: GA
authors.lastname: Wiesbeck
mesh_terms: D000367:Age Factors; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use / Q000652:urine; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use* / Q000652:urine; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008691:Methadone / Q000627:therapeutic use / Q000652:urine; D058850:Opiate Substitution Treatment / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014754:Violence
chemical_list: D000701:Analgesics, Opioid; D001569:Benzodiazepines; D008691:Methadone