Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 1:241:109707.
doi: 10.1016/j.drugalcdep.2022.109707. Epub 2022 Nov 19.

The impact of benzodiazepine exposure on treatment retention in an open-access methadone program: A retrospective cohort study

Kenneth L Morford  1   2   3 , Jeanette M Tetrault  1   2   3 , Bin Zhou  4 , Fangyong Li  4 , Brynna Gleeson  1   2   3   4   5   6   7 , E Jennifer Edelman  1   2 , Michael D Stein  1   2   3   4   5   6   7 , Declan T Barry  1   3   7 , Lynn Madden  1   2   3
Affiliations

The impact of benzodiazepine exposure on treatment retention in an open-access methadone program: A retrospective cohort study

Kenneth L Morford et al. Drug Alcohol Depend. .

Abstract

Background: Open-access opioid treatment programs (OTP) offer same-day access to methadone without an appointment and aim to minimize treatment barriers that often reduce admission and/or retention. We explored whether patients with benzodiazepine exposure at treatment entry would have similar 12-month retention compared to those without benzodiazepine exposure.

Methods: We conducted a retrospective cohort study of 2968 patients consecutively initiated on methadone between January 2015 and February 2017 at an open-access OTP. The sample was stratified into benzodiazepine-exposed and nonexposed groups based on intake urine toxicology. Group comparison of 12-month retention was conducted. Kaplan Meier analysis compared time to methadone treatment discontinuation between groups with a log-rank test. Multivariable Cox regression was performed to compare retention by baseline benzodiazepine exposure with adjustment for confounders.

Results: Overall, 31% of patients with benzodiazepine exposure (n = 171) and 31% without exposure (n = 2423) were retained at 12 months (p = 0.95). Median treatment duration was 182 days (95% CI, 152-239) and 175 days (95% CI, 156-196) for patients with and without benzodiazepine exposure, respectively. Kaplan-Meier analysis showed no significant difference in treatment duration between groups (log-rank test p = 0.73). Cox regression found no difference in treatment retention between groups (adjusted Hazard Ratio= 1.03, 95% CI, 0.91-1.16).

Conclusions: In this cohort of patients receiving methadone at an open-access OTP, benzodiazepine exposure at intake was not observed to impact 12-month treatment retention or duration. These findings support U.S. Food and Drug Administration (FDA) recommendations to not withhold medications for opioid use disorder from patients taking benzodiazepines.

Keywords: Benzodiazepine; Methadone; Opioid use disorder; Treatment retention.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest All authors have no declarations or conflicts of interest to report.

Figures

Figure 1.
Figure 1.
Kaplan-Meier curve of treatment duration (length of stay) between groups.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Brands B, Blake J, Marsh DC, Sproule B, Jeyapalan R, & Li S (2008). The impact of benzodiazepine use on methadone maintenance treatment outcomes. J Addict Dis, 27(3), 37–48. 10.1080/10550880802122620 - DOI - PubMed
    1. Chen KW, Berger CC, Forde DP, D’Adamo C, Weintraub E, & Gandhi D (2011, May 19). Benzodiazepine use and misuse among patients in a methadone program. BMC Psychiatry, 11, 90. 10.1186/1471-244x-11-90 - DOI - PMC - PubMed
    1. Dasgupta N, Funk MJ, Proescholdbell S, Hirsch A, Ribisl KM, & Marshall S (2016, Jan). Cohort Study of the Impact of High-Dose Opioid Analgesics on Overdose Mortality. Pain Med, 17(1), 85–98. 10.1111/pme.12907 - DOI - PubMed
    1. Eibl JK, Wilton AS, Franklyn AM, Kurdyak P, & Marsh DC (2019, May/Jun). Evaluating the Impact of Prescribed Versus Nonprescribed Benzodiazepine Use in Methadone Maintenance Therapy: Results From a Population-based Retrospective Cohort Study. J Addict Med, 13(3), 182–187. 10.1097/adm.0000000000000476 - DOI - PMC - PubMed
    1. Eisen SV, Gerena M, Ranganathan G, Esch D, & Idiculla T (2006, Jul). Reliability and validity of the BASIS-24 Mental Health Survey for Whites, African-Americans, and Latinos. J Behav Health Serv Res, 33(3), 304–323. 10.1007/s11414-006-9025-3 - DOI - PubMed

MeSH terms