PMID: 16614601Apr 15, 2006Paper

Benzodiazepine withdrawal in subjects on opiate substitution treatment

La Presse médicale
Mélina FatséasMarc Auriacombe

Abstract

Benzodiazepines are the most widely used psychotropic agents in the world. Abuse and dependence are reported in the general population and among drug misusers, including those dependent on heroine. Benzodiazepine use by heroine users increases their risk of overdose, not only from heroin but also substitution drugs such as methadone and more recently buprenorphine. Hence, detoxification from benzodiazepines is desirable. The objective of this paper was to review the literature and determine the best benzodiazepine detoxification procedure for opiate-dependent individuals receiving substitution treatment. Relevant studies were sought through systematic searches of Medline and Toxibase (a database focusing on substance abuse). There were fewer controlled studies than expected about benzodiazepine detoxification, and all of them excluded subjects who misused opiates or were in opiate substitution treatment. The best evidence supports a procedure where the patient is switched to a long-lasting benzodiazepine and the dose then tapered by 25% of the initial dose each week. Diazepam is the drug most often used in the framework. In opiate users, diazepam may raise special problems of misuse, as suggested by clinical and epidemiologic s...Continue Reading

Citations

May 15, 2010·Substance Use & Misuse·Morgane Guillou LandreatPascale Jolliet

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