Benzodiazepines, if Prescribed, May Not Affect Methadone Treatment Retention

The use of benzodiazepine, only if prescribed, may not affect retention of methadone medication-assisted treatment, according to a study published in the Journal of Addiction Medicine.

The study included patients from 52 opioid use disorder outpatient clinics who were initiating methadone medication-assisted treatment and taking prescribed benzodiazepines, nonprescribed benzodiazepines, or no benzodiazepines. Participants were followed from treatment initiation to treatment discontinuation, death, or 1-year follow-up. Urine drug screening (UDS) data and prescribing information from single-payer health records were examined. 

The study’s primary outcome was methadone treatment retention at the 1-year follow-up. A total of 3692 participants initiating methadone-assisted treatment for the first time were included in the study. Of these, 76% had no benzodiazepine prescription and <30% screening positive for benzodiazepine, 13% had a benzodiazepine prescription but had negative UDS, 6% did not have a benzodiazepine prescription but had positive UDS, and 6% had a benzodiazepine prescription and had positive UDS.

Patients using nonprescribed benzodiazepine who had positive UDS were found to be more likely to discontinue methadone treatment (adjusted odds ratio, 0.38; 95% CI, 0.27-0.53) compared with participants not using benzodiazepine or those using benzodiazepine as prescribed.

“Importantly, we urge both the physician and patient to seek alternative clinical options to [benzodiazepine] prescribing, due to the potential for developing physical dependence (and [benzodiazepine] use disorder) to [benzodiazepine] and the risks [for] negative interactions with opioids,” noted the study’s authors.

Reference

Eibl JK, Wilton AS, Franklyn AM, Kurdyak P, Marsh DC. Evaluating the impact of prescribed versus nonprescribed benzodiazepine use in methadone maintenance therapy: results from a population-based retrospective cohort study. [published online December 12, 2018]. J Addict Med. doi:10.1097/ADM.0000000000000476

This article originally appeared on Clinical Pain Advisor