Psychiatry Department. Hospital Prof. Dr. Fernando Fonseca. Amadora. Portugal.
Unidade de Saúde Pública. Agrupamento de Centros de Saúde Lisboa Ocidental e Oeiras. Oeiras. Portugal.
Acta Med Port. 2021 Mar 1;34(3):209-216. doi: 10.20344/amp.13181.
The co-association of benzodiazepines and opioids is associated with an increased risk of overdose, death, and poorer psychosocial prognosis. The aim of this study is to characterize the prevalence, pattern of use, and primary clinical outcomes in benzodiazepines users in a public opioid maintenance treatment unit.
We conducted a cross-sectional study involving 236 patients treated with opioid substitutes (methadone and buprenorphine). We conducted a descriptive, bivariable, and multivariable analysis to determine clinical differences between benzodiazepines users and non-users.
The prevalence of consumption of benzodiazepines was 25.4% (60). The benzodiazepines were obtained with a medical prescription (49.8%) or on the black market (42.6%). The most prescribed benzodiazepine was diazepam (29.1%), and the main reasons were to relieve insomnia (27.7%) or anxiety (26.9%) and to enhance the psychoactive effects of other drugs (19.7%). Regarding the clinical outcomes, we highlight: a very high prevalence of hepatitis C (51.7%); severe ongoing consumption of psychoactive drugs (73.7%); and a high rate of depression and anxiety (> 60%), significantly higher in the benzodiazepines-user group. In the multivariable analysis of benzodiazepine use, we found alcohol consumption (OR 0.482; IC 95% 0.247, 0.238) had a negative association and having hepatitis C (OR 2.544, IC 95% 1.273, 5.084) or anxiety symptoms (OR 5.591; IC 95% 2.345, 13.326) had positive associations.
Our results suggest the BZD users had a complex drug addiction problem and underline the importance of adequately addressing BZD use, contemplating psychological and psychiatric approach in this particular population.
Past or current use of benzodiazepines is associated with poor clinical and psychiatric outcomes. A multidisciplinary approach with a focus on infectious diseases and mental health is critical in order to enhance the treatment effectiveness and overall prognosis.
苯二氮䓬类药物和阿片类药物的联合使用与过量、死亡风险增加以及较差的社会心理预后相关。本研究旨在描述公共阿片类药物维持治疗单位中苯二氮䓬类药物使用者的流行率、使用模式和主要临床结局。
我们进行了一项横断面研究，纳入了 236 名接受阿片类药物替代物（美沙酮和丁丙诺啡）治疗的患者。我们进行了描述性、双变量和多变量分析，以确定苯二氮䓬类药物使用者和非使用者之间的临床差异。
苯二氮䓬类药物的使用率为 25.4%（60 例）。苯二氮䓬类药物的获取途径包括凭处方（49.8%）或黑市购买（42.6%）。最常开的苯二氮䓬类药物是地西泮（29.1%），主要原因是缓解失眠（27.7%）或焦虑（26.9%）以及增强其他药物的精神活性（19.7%）。关于临床结局，我们需要强调的是：丙型肝炎的患病率非常高（51.7%）；严重的持续使用精神活性药物（73.7%）；以及高比例的抑郁和焦虑症（>60%），在苯二氮䓬类药物使用者中更为显著。在苯二氮䓬类药物使用的多变量分析中，我们发现饮酒（OR 0.482；95%CI 0.247，0.238）呈负相关，丙型肝炎（OR 2.544，95%CI 0.127，5.084）或焦虑症状（OR 5.591；95%CI 0.234，13.326）呈正相关。
我们的结果表明，BZD 使用者存在复杂的药物成瘾问题，并强调在该特定人群中充分解决 BZD 使用问题的重要性，考虑到心理和精神病学方法。
过去或当前使用苯二氮䓬类药物与不良的临床和精神预后相关。多学科方法侧重于传染病和心理健康至关重要，以提高治疗效果和整体预后。
