Votaw Victoria R, Trapani Emma W, Geyer Rachel B, Sugarman Dawn E, McHugh R Kathryn
Division of Alcohol, Drugs and Addiction, McLean Hospital, Belmont, Massachusetts, USA.
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
Subst Use Misuse. 2025;60(9):1328-1338. doi: 10.1080/10826084.2025.2496936. Epub 2025 Apr 26.
Benzodiazepine misuse is common among individuals with substance use disorders (SUDs) and is associated with poorer clinical outcomes. As benzodiazepines have heterogeneous effects, standard measures of substance use motives may overlook key reasons for misuse. Understanding motives better can inform intervention development.
Our overarching objective was to characterize motives for benzodiazepine misuse among individuals with SUDs and develop a preliminary measure of these motives.
We used a two-study, mixed methods design. Participants were recruited from a continuum of SUD treatment programs at a private psychiatric hospital. Study 1 participants ( = 10, 5 women) completed a semi-structured interview regarding motives and triggers for benzodiazepine misuse, and notes from interviews underwent inductive thematic analysis. Results from Study 1 were used to develop the Benzodiazepine Use Motives Questionnaire (BUMQ), which was administered to 38 participants (13 women) in Study 2.
Qualitative analysis from Study 1 revealed six themes reflecting motives subtypes for benzodiazepine misuse, including (1) coping, (2) other substance (i.e., non-benzodiazepine) related, (3) sleep, (4) recreational, (5) benzodiazepine withdrawal and habit, and (6) social contextual. Results from Study 2 further supported the misuse of benzodiazepines to cope with negative affect, modulate the effects of non-benzodiazepine drugs, and improve sleep.
This study revealed a broad range of benzodiazepine misuse motives in adults with SUDs, spanning misuse for drug-indicated reasons (e.g., anxiety, sleep), compensatory or synergistic effects with other drugs, physiological dependence, and recreational and social reasons. Treatments for benzodiazepine misuse may need to target multiple, varied motivators for misuse.
苯二氮䓬类药物滥用在物质使用障碍（SUDs）患者中很常见，且与较差的临床结局相关。由于苯二氮䓬类药物具有多种不同的作用，物质使用动机的标准测量方法可能会忽略滥用的关键原因。更好地理解动机可为干预措施的制定提供依据。
我们的总体目标是描述SUDs患者中苯二氮䓬类药物滥用的动机，并开发一种对这些动机的初步测量方法。
我们采用了两项研究的混合方法设计。参与者从一家私立精神病医院的一系列SUD治疗项目中招募。研究1的参与者（n = 10，5名女性）完成了关于苯二氮䓬类药物滥用动机和触发因素的半结构化访谈，访谈记录进行了归纳主题分析。研究1的结果用于编制苯二氮䓬类药物使用动机问卷（BUMQ），该问卷在研究2中施测于38名参与者（13名女性）。
研究1的定性分析揭示了反映苯二氮䓬类药物滥用动机亚型的六个主题，包括（1）应对，（2）与其他物质（即非苯二氮䓬类药物）相关，（3）睡眠，（4）娱乐，（5）苯二氮䓬类药物戒断和习惯，以及（6）社会背景。研究2的结果进一步支持了滥用苯二氮䓬类药物以应对负面影响、调节非苯二氮䓬类药物的作用以及改善睡眠。
本研究揭示了患有SUDs的成年人中广泛的苯二氮䓬类药物滥用动机，包括因药物指征原因（如焦虑、睡眠）滥用、与其他药物的补偿或协同作用、生理依赖以及娱乐和社会原因。苯二氮䓬类药物滥用的治疗可能需要针对多种不同的滥用动机。
