Reducing diazepam prescribing for illicit drug users: A randomised control study

Elliott, Lawrie; Glenday, John; Freeman, Laura; Ajeda, Dina; Johnston, Brian; Christie, Morag; Ogston, Simon

Abstract

Illicit drug users undergoing mandatory reductions in prescribed diazepam were randomly allocated to one of two methods of delivering psychological support to help reduce their prescription: a) an enhanced intervention consisting of skills training and reinforcement, and b) a limited intervention where patients initially received skills training and thereafter only advice. Outcome measures at baseline and six-months consisted of daily diazepam dose; reported illicit drug use; Severity of Dependence Scale;
Hospital Anxiety and Depression Scale (HADS); Pittsburgh Sleep Quality Index. Fifty-three of 119 eligible patients agreed to be randomly allocated to the interventions. Those in the enhanced intervention reduced their daily dose of prescribed diazepam from a mean of 27.8mgs to 19.9mgs at six months (5.3% per month) compared with 29.8 mgs to 17.6mgs at six months (7.5%) among those in the limited intervention group. However, there was no statistically significant difference in the reduction
rate between the intervention groups. Approximately 75% of patients in each group suspended their reduction programme. The enhanced intervention group reported a statistically and clinically greater reduction in the mean HADS depression score (10.6 at baseline and 7.7 at follow-up), compared with a rise from 8.9 to 11.2 in the limited intervention group. In conclusion, it is possible to reduce prescribed diazepam among illicit drug users but not at the rate of 10% per month set by the study. The
difficulties of working with this population necessitate a flexible and possibly long-term approach to reducing prescribed benzodiazepines.

Citation

Elliott, L., Glenday, J., Freeman, L., Ajeda, D., Johnston, B., Christie, M., & Ogston, S. (2005). Reducing diazepam prescribing for illicit drug users: A randomised control study. Drug and Alcohol Review, 24(1), 25-31. https://doi.org/10.1080/09595230500125138

• Journal Article Type: Article
• Publication Date: Jan 1, 2005
• Deposit Date: Mar 6, 2008
• Print ISSN: 0959-5236
• Electronic ISSN: 1465-3362
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 24
• Issue: 1
• Pages: 25-31
• DOI: https://doi.org/10.1080/09595230500125138
• Keywords: Benzodiazepine prescribing, Illicit drug users; Drug addicts
• Public URL: http://researchrepository.napier.ac.uk/id/eprint/1571
• Publisher URL: http://dx.doi.org/10.1080/09595230500125138