Benzodiazepine usage during 19.5 years in methadone maintenance treatment patients and its relation to long-term outcome.

IF 0.5 4区医学 Q4 PSYCHIATRY

Israel Journal of Psychiatry and Related Sciences Pub Date : 2014-01-01

Einat Peles, Miriam Adelson, Shaul Schreiber

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引用次数: 0

Abstract

Background: Benzodiazepines (BDZs) abuse was found to cause diverse harmful effects among MMT patients. The current study evaluates prevalence rates of BDZ usage during 19.5 years in MMT, and its relation to patients' long-term retention in treatment.

Methods: All 787 opiate addicts who were ever admitted to the Adelson MMT clinic in Tel Aviv between 1993 and 2012 were studied. Observed and random urine results for BDZs usage were taken a few times every month. Positive for BDZ was defined in each month if at least one of the urines tested positive. Long-term retention was studied using Kaplan Meier analyses.

Results: BDZ prevalence among the MMT patients (ranged from 26 patients in 1994, and 300 to 350 since 2009) was about 35-40% in the last few years, with a "peak" of 61% followed by low rate of 25.4%. Followed up for up to 19.5 years, those who were negative to BDZ upon admission to MMT stayed longer in treatment (mean 8.5y, 95% Confidence Interval [CI] 7.6-9.4) than those who were positive to BDZ when admitted (mean 6.9y, 95% CI 6.2-7.7) (Kaplan Meier analyses p=0.01).

Conclusion: BDZs abuse is highly prevalent among MMT patients. Abuse of BDZ on entry to treatment predicts worse MMT outcome. High and low rates of BDZ abuse may also be attributed to staff tolerance of this abuse; thus, we strongly recommend a strict attitude by staff in order to reduce patients' harm.

本刊更多论文

美沙酮维持治疗患者19.5年苯二氮卓的使用及其与远期预后的关系。

背景:苯二氮卓类药物(BDZs)滥用在MMT患者中引起多种有害影响。本研究评估了MMT患者19.5年BDZ的使用率及其与患者长期坚持治疗的关系。方法:对1993年至2012年在特拉维夫Adelson MMT诊所就诊的787例阿片依赖者进行研究。每月进行几次BDZs使用的观察和随机尿液结果。如果每个月至少有一种尿液检测呈阳性，则定义为BDZ阳性。使用Kaplan Meier分析研究长期留存率。结果:MMT患者BDZ患病率(1994年为26例，2009年为300 ~ 350例)近几年约为35 ~ 40%，最高为61%，最低为25.4%。随访时间长达19.5年，入院时BDZ阴性的患者(平均8.5y, 95%可信区间[CI] 7.6-9.4)比入院时BDZ阳性的患者(平均6.9y, 95%可信区间[CI] 6.2-7.7)的治疗时间更长(Kaplan Meier分析p=0.01)。结论:BDZs滥用在MMT患者中非常普遍。在开始治疗时滥用BDZ预示着更糟糕的MMT结果。BDZ滥用率的高低也可归因于工作人员对这种滥用的容忍程度;因此，我们强烈建议工作人员采取严格的态度，以减少对患者的伤害。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Israel Journal of Psychiatry and Related Sciences PSYCHIATRY-

CiteScore

0.80

自引率

25.00%

发文量

审稿时长

>12 weeks

期刊介绍： THE ISRAEL JOURNAL OF PSYCHIATRY publishes original articles dealing with the all bio-psycho-social aspects of psychiatry. While traditionally the journal has published manuscripts relating to mobility, relocation, acculturation, ethnicity, stress situations in war and peace, victimology and mental health in developing countries, papers addressing all aspects of the psychiatry including neuroscience, biological psychiatry, psychopharmacology, psychotherapy and ethics are welcome. The Editor also welcomes pertinent book reviews and correspondence. Preference is given to research reports of no more than 5,000 words not including abstract, text, references, tables and figures. There should be no more than 40 references and 4 tables or figures. Brief reports (1,500 words, 5 references) are considered if they have heuristic value. Books to be considered for review should be sent to the editorial office. Selected book reviews are invited by the editor.