Treatment of out-patients with complicated benzodiazepine dependence: comparison of two approaches

Abstract

Aims: To evaluate whether gradual benzodiazepine taper combined with cognitive-behavioural treatment is more effective than standard treatment for patients with dependence in out-patient clinics.

Design: A randomized, controlled clinical trial, using standard questionnaires and serum and urine tests.

Settings: Four public-sector out-patient clinics for alcohol and drug abusers in Helsinki.

Participants: Seventy-six patients with benzodiazepine dependence (DSM-III-R). Patients taking high doses of the drug or with alcohol use disorders were included to obtain a subject group representative of usual clinical practice.

Intervention: Subjects received gradual benzodiazepine taper combined with cognitive-behavioural therapy (experimental group) or standard withdrawal treatment not scheduled by the researchers (control group).

Measurements: The outcome was measured in terms of attaining a state of abstinence or by a decrease in the dosage during the study period of up to 12 months' duration.

Findings: No statistically significant differences in the outcomes were observed between the groups. A total of 13% of the experimental group and 27% of the control group were able to discontinue drug use. In addition 67% of the experimental group and 57% of the control group were able to decrease the dose.

Conclusions: The search continues for improved methods of helping patients with complicated benzodiazepine dependence.