de Wet Cornelis, Reed Laurence, Glasper Anthony, Moran Paul, Bearn Jennifer, Gossop Michael
Wickham Park House, South London & Maudsley NHS Trust Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK.
Drug Alcohol Depend. 2004 Oct 5;76(1):31-5. doi: 10.1016/j.drugalcdep.2004.04.002.
Patients seeking treatment for opiate withdrawal are commonly also dependent on benzodiazepines, although the interactions between benzodiazepine and opiate dependence and withdrawal syndromes have been subject to little systematic investigation. This is the first study comparing type, severity and course of opiate withdrawal symptoms between opiate dependent patients with, and without, concurrent benzodiazepine dependence. Patients dependent only on opiates (n = 39), and patients dependent on both opiates and benzodiazepines (n = 22), were recruited from consecutive admissions to an in-patient drug treatment unit. Quantity and duration of prior opiate use was similar for both groups. Patients completed daily self-ratings of opiate withdrawal (SOWS) for the duration of a standard in-patient detoxification treatment. Co-dependent patients were detoxified from benzodiazepines and opiates concurrently. Co-dependent patients reported a more severe withdrawal symptoms than patients withdrawing from opiates alone. Co-dependent patients had significantly more severe opiate withdrawal symptoms. Concurrent benzodiazepine withdrawal exacerbates opiate specific withdrawal symptoms. Possible psychological and neurophysiological mechanisms for the observed sensitisation are discussed.
寻求阿片类药物戒断治疗的患者通常也依赖苯二氮䓬类药物，尽管苯二氮䓬类药物与阿片类药物依赖及戒断综合征之间的相互作用很少受到系统研究。这是第一项比较有和没有并发苯二氮䓬类药物依赖的阿片类药物依赖患者之间阿片类药物戒断症状的类型、严重程度和病程的研究。仅依赖阿片类药物的患者（n = 39）和同时依赖阿片类药物和苯二氮䓬类药物的患者（n = 22），是从一家住院药物治疗单位的连续入院患者中招募的。两组患者先前使用阿片类药物的数量和持续时间相似。患者在标准住院戒毒治疗期间每天完成阿片类药物戒断自我评分（SOWS）。同时依赖两种药物的患者同时进行苯二氮䓬类药物和阿片类药物的戒毒。同时依赖两种药物的患者报告的戒断症状比仅戒断阿片类药物的患者更严重。同时依赖两种药物的患者有明显更严重的阿片类药物戒断症状。并发苯二氮䓬类药物戒断会加剧阿片类药物特异性戒断症状。文中讨论了观察到的敏化现象可能的心理和神经生理机制。
