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Inadequate Dose of Opioid-agonist Medication is Related to M… : Addictive Disorders & Their Treatment

Inadequate Dose of Opioid-agonist Medication is Related to Misuse of Benzodiazepines

Heikman, Pertti Kalevi PhD; Ojanperä, Ilkka Antero PhD

Abstract

Objectives: To evaluate whether misuse of nonprescribed substances is related to dose-adequacy of opioid-agonist medication (OAM) in opioid substitution treatment.

Methods: Opioid-dependent patients undergoing a substitution treatment program of the Helsinki University Central Hospital. Opioid-dependent patients evaluated their dose of OAM (methadone or buprenorphine combined with naloxone) as either too low (group 1) or adequate (group 2). Instead of being limited to the main drug classes detectable by standard immunoassay techniques, this study systematically investigated the incidental use of a very broad spectrum of therapeutic and illicit drugs both from blood and urine samples.

Results: Of the 65 participating patients 21 (32%) completed the study. Their doses and blood concentrations of OAM showed no differences between the 2 groups. The group 1 patients, however, showed more positive laboratory findings for nonprescribed benzodiazepines (7/10 vs. 1/11, P=0.008). Diazepam was present in all positive samples of nonprescribed benzodiazepines, alprazolam in 4, clonazepam in 3, and midazolam in 2 samples. There was no difference in misuse of opiates, amphetamine, cannabis, barbiturates, designer drugs, or psychotropic drugs between groups 1 and 2.

Conclusions: The inadequate dose of OAM in opioid substitution treatment for opioid-dependent patients seems to be related to the misuse of benzodiazepines.

via Inadequate Dose of Opioid-agonist Medication is Related to M… : Addictive Disorders & Their Treatment.

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