Theme: Clinical Research Year: 2024
Background: Opioid agonist treatment (OAT) is effective in managing opioid dependence but combining it with benzodiazepines (BZD) may increase morbidity and mortality risk. Given the prevalent use of BZDs among individuals on OAT, evidence-based interventions to manage BZD use becomes paramount. The aim of this review was to investigate the scope of evidence for interventions to manage BZD use among people on OAT.
Methods: A scoping review following PRISMA-ScR guidelines assessed BZD management during OAT, without study date restrictions. We included all types of interventions and outcomes, reviewing English studies from MEDLINE, PsycINFO, and CINAHL until January 2024. Our search combined the terms buprenorphine, methadone, OAT, opiate, opioid* with benzodiazepine*. We extracted data on the population, outcomes, interventions, comparisons, and effects.
Results: We screened 800 studies and extracted data on 10. All studies focused on pharmacological management of BZD use, although almost every study included a psychosocial component. Most studies included only patients on methadone treatment, had a sample size <20 patients and lacked a control arm. Every study had a unique design and outcomes varied between studies, resulting in non-generalizable mixed results.
Conclusion: This scoping review highlights a dire lack of evidence-based methods for the management of BZDs among patients on OAT. Despite this, most guidelines for OAT recommend discontinuing BZD use for patients initiating OAT. In some instances, patients may even risk discontinuation from OAT if found using BZDs. This underscores the urgent need for more comprehensive and diverse studies on the management of BZDs within OAT programs with a particular emphasis on integrating psychosocial strategies. reduce medical risks and amend potentially harmful guidelines and policies.
Disclosure of Interest Statement:
This study was funded by the Local Research and Development Council Gothenburg and Södra Bohuslän (VGFOUGSB-983671).