Factors surrounding long-term benzodiazepine prescribing in methadone maintenance clients

Patterns of prescribed and non-prescribed benzodiazepine use among 100 patients in methadone maintenance treatment were tracked over a 2-year period. Ninety-one participants were re-interviewed 6 months after initial interview and 76% a further 18 months later. Approximately one-third of patients were prescribed diazepam at each time point, on stable doses. Those prescribed diazepam at initial interview were also likely to be prescribed the drug at the two subsequent data collection points. Clients prescribed diazepam reported significantly higher methadone doses, reported higher anxiety and depression levels, and used heroin less frequently at each interview. Low levels of non-prescribed diazepam use were reported over the study period while non-prescribed diazepam users were also on higher methadone doses and reported more alcohol consumption. The effects of long-term benzodiazepine prescribing on patterns of illicit drug use is a matter of considerable concern for providers of methadone maintenance treatment, and may require careful policy consideration around the impact of prescribing on use patterns.