Prolonged use of benzodiazepines is associated with childhood trauma in opioid-maintained patients

Drug Alcohol Depend. 2011 Dec 1;119(1-2):93-8. doi: 10.1016/j.drugalcdep.2011.05.037. Epub 2011 Jun 28.

Abstract

Background: Benzodiazepine (BZD) misuse in opioid-maintained patients is widespread and has been related to poorer treatment success. Associated factors, in particular, traumatic childhood experiences, have not been investigated extensively.

Methods: Cross-sectional survey including the childhood trauma questionnaire (CTQ) and clinical data among 193 patients prescribed oral opioids or injectable diacetylmorphine for opioid dependence.

Results: BZD use was prevalent (61%) and the burden of childhood traumatic experiences was high with 67% reporting at least one trauma subscore of moderate-to-severe level. In univariate analysis, CTQ-subcategories "emotional abuse" (p<0.05), "emotional neglect" (p<0.01) and "physical neglect" (p<0.001) were significantly associated with prolonged BZD use. In multivariate analysis, prolonged BZD use was associated with categorized overall CTQ-scores (OR 1.5), HCV-seropositivity (OR 4.0), psychiatric family history (OR 2.3), and opioid dose (mg methadone equivalents, OR 1.010).

Conclusions: Childhood traumatic experiences may be associated with prolonged BZD use in opioid-maintained patients and could pose an important starting-point for prevention.

MeSH terms

  • Age Factors
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Analgesics, Opioid / urine
  • Benzodiazepines / adverse effects
  • Benzodiazepines / therapeutic use*
  • Benzodiazepines / urine
  • Child
  • Child Abuse / psychology*
  • Child Abuse / statistics & numerical data
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Methadone / therapeutic use
  • Methadone / urine
  • Opiate Substitution Treatment / methods
  • Opiate Substitution Treatment / psychology*
  • Opiate Substitution Treatment / statistics & numerical data*
  • Opioid-Related Disorders / drug therapy
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / psychology
  • Psychiatric Status Rating Scales
  • Substance-Related Disorders / drug therapy
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / psychology
  • Surveys and Questionnaires
  • Time Factors
  • Violence

Substances

  • Analgesics, Opioid
  • Benzodiazepines
  • Methadone