Correlates of benzodiazepine abuse in methadone maintenance treatment. A 1 year prospective study in an Israeli clinic.

Dr Miriam & Sheldon G. Adelson Clinic for Drug Abuse Treatment and Research, Tel-Aviv Elias Sourasky Medical Center, Israel.
Addiction (Impact Factor: 4.6). 11/1999; 94(10):1533-40.
Source: PubMed

ABSTRACT This study addressed the following questions for patients after 1 year of methadone maintenance treatment (MMT); (1) What are the demographic features and past history of drug use of benzodiazepine (BZD) abusers? (2) Do BZD abusers abuse more heroin, cocaine and/or cannabis and do they receive a higher methadone dosage level? (3) Do BZD abusers suffer more from hepatitis C (HCV) and do they have more HIV/HCV risk-taking behaviors than non-abusers? (4) Do BZD abusers have more psychopathology and more emotional distress than non-abusers?
All 148 patients who completed 1 year of MMT underwent random and twice-weekly observed urine analysis for various drugs of abuse, responded to self-report questionnaires (SCL-90-R; POMS; HIV/HCV risk-taking behaviors), interviews (ASI) and underwent testing for hepatitis C. Abuse in this study is defined as any use during the 12th month of treatment.
After 1 year of MMT, more BZD abusers (n = 63) were single, had spent time in prison, were unemployed and had at least one parent with an addiction problem or mental illness in comparison to non-abusers (n = 85). They had started using heroin and cocaine earlier and currently abused more cocaine, heroin and cannabis. They had significantly more psychopathology and negative mood. They had significantly more HCV and reported more HIV/HCV risk-taking behavior.
We suggest that this group of patients is in need of more intensive pharmacological and psychological treatment.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: 130 patients from a methadone maintenance treatment program agreed to complete Symptoms Checklist 90-Revised (SCL-90R) and Alcohol Use Disorders Identification Test (AUDIT) self-report scales. Scores higher than the proposed cut-score on SCL-90R scale were observed on depression, obsessions-compulsions, paranoid ideation, anxiety, anger-hostility, somatization, interpersonal sensitivity, and psychoticism subscales. In sum, 42.9% of our sample exhibited depressive symptomatology, 34.9% obsessive-compulsive symptoms, 29.1% somatization, 27.2% anxiety symptoms, 22.2% paranoid ideation, 19% phobic anxiety, 15.1% psychoticism, and 15.1% hostility and 11.9% presented with symptoms of interpersonal sensitivity. Mean score on AUDIT scale was 6.9 ± 7.9. 63.0% of our participants scored below cutoff and were classified as having a low level of alcohol-related problems; 24.4% scored in the range of 8–15 which is an indication of alcohol abuse whereas 12.6% scored 16 and above indicative of serious abuse/addiction. Scores on AUDIT scale were positively correlated with length of time on methadone treatment, but not with length of time on drug use or age of our participants. Positive correlations were observed among AUDIT and SCL-90R scores, namely, with global severity index score, positive symptom distress index, positive symptom total, and all primary symptom dimensions subscales except phobic anxiety.
    03/2015; 2015. DOI:10.1155/2015/197652
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Concerns about prescribed methadone diversion are ongoing. This research investigated motivations for methadone diversion and continued use of street-sourced substances. Methods: Questionnaires completed with 886 past year users of methadone recruited in and out of prescribing agencies. Topics covered included current prescribing, obtaining/providing methadone, reasons for using illicit methadone and other substance use. Results: Missing appointments (prescription pick-up or reviews) were the most common reasons for use of diverted methadone but the most common course of action in these circumstances was to use other street-sourced substances. Topping up dosage levels was also a common reason for obtaining illicit methadone. The most common reason diverting methadone was to “help another substance user out”. Concurrent and simultaneous use of a variety of substances whilst prescribed methadone was common. Conclusion: Reasons for using diverted methadone are primarily related to service use and provision. Treatment services will need to consider their role in reducing demand for diverted methadone. Unlike previous work the diversion of prescribed methadone appears to be most often motivated by altruism. Simultaneous and concurrent polysubstance use increases health risks, and with the extent of these risks not fully understood, individuals are “gambling” with their usage patterns.
    Journal of Substance Use 02/2014; 19(1-2). DOI:10.3109/14659891.2012.734539 · 0.48 Impact Factor
  • Source