Benzodiazepinicos

G Model DAD-4746; No. of Pages 7

ARTICLE IN PRESS
Drug and Alcohol Dependence xxx (2013) xxx–xxx

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Benzodiazepine use during buprenorphine treatment for opioid dependence: Clinical and safety outcomes
Zev Schuman-Olivier a,b,∗ , Bettina B. Hoeppner a,b , Roger D. Weiss a,d , Jacob Borodovsky c,e , Howard J. Shaffer a,e , Mark J. Albanese a,e
Harvard Medical School, United States Massachussets General Hospital, United States Tufts University, United States d McLean Hospital, United States e Cambridge Health Alliance, United States b c a

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Background: Prescribing benzodiazepines during buprenorphine treatment is a topic of active discussion. Clinical benefit is unclear. Overdose, accidental injury, and benzodiazepine misuse remain concerns. We examine the relationship between benzodiazepine misuse history, benzodiazepine prescription, and both clinical and safety outcomes during buprenorphine treatment. Methods: We retrospectively examined outpatient buprenorphine treatment records, classifying patients by past-year benzodiazepine misuse history and approved benzodiazepine prescription at intake. Primary clinical outcomes included 12-month treatment retention and urine toxicology for illicit opioids. Primary safety outcomes included total emergency department (ED) visits and odds of an ED visit related to overdose or accidental injury during treatment. Results: The 12-month treatment retention rate for the sample (N = 328) was 40%. Neither benzodiazepine misuse history nor benzodiazepine prescription was associated with treatment retention or illicit opioid use. Poisson regressions of ED visits during buprenorphine treatment revealed more ED visits among those with a benzodiazepine prescription versus those without (p < 0.001); benzodiazepine misuse history had no effect. The