Page 27 - ITPS-8-3

INNOSC Theranostics

and Pharmacological Sciences

REVIEW ARTICLE
The impact of benzodiazepine use on treatment

retention in opioid agonist treatment:
A literature review

Caitlin Lawrence 1 , Rachel McLellan-Carich 1,2 , and Alasdair M. Barr *
1,2
1 Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of
British Columbia, Vancouver, BC, Canada
2 British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC,
Canada

Abstract

It is well established that there is an elevated overdose risk with benzodiazepine
(BZD) use during opioid agonist treatment (OAT). However, further studies regarding
other aspects of how BZDs influence OAT are necessary. This review summarizes the
literature on concurrent BZD use with medications for opioid use disorder (MOUD)
and how they affect treatment retention in OAT. EMBASE (Ovid), PubMed, and Google
Scholar database search tools were used to search for studies that examined the effect
*Corresponding author: of concurrent BZD and MOUD on treatment retention in OAT. Studies published up
Alasdair M. Barr
th
(al.barr@ubc.ca) to January 30 , 2024, were included with no restriction applied other than English
language. The criteria for included literature were the presence of both BZD and
Citation: Lawrence C, McLellan-
Carich R, Barr AM. The impact at least one MOUD as a variable and treatment retention or MOUD adherence as
of benzodiazepine use on an outcome. Fourteen articles met the criteria for review: eleven retrospective
treatment retention in opioid studies and three observational studies. Methadone was utilized in seven studies,
agonist treatment: A literature
review. INNOSC Theranostics buprenorphine in five, naltrexone in one, and suboxone (buprenorphine + naloxone)
and Pharmacological Sciences. in one study. The included studies indicated that when BZDs are taken as prescribed
2025;8(3):21-34. and for shorter periods in conjunction with OAT, subjects are retained in their MOUD
doi: 10.36922/itps.5151
programs just as well as patients who do not take BZDs. Any potential benefits of
Received: October 15, 2024 increased treatment retention must be balanced against potential harmful effects of
1st revised: December 30, 2024 BZD use, such as drug overdose and addiction. Further studies must be performed to
validate the results of treatment retention and to evaluate other factors that might
2nd revised: January 25, 2025
affect OAT.
Accepted: February 11, 2025
Published online: February 27, Keywords: Benzodiazepine; Opioid agonist therapy; Treatment retention
2025
Copyright: © 2025 Author(s).
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution 1. Introduction
License, permitting distribution,
1-3
and reproduction in any medium, North America and many other parts of the word are currently in an opioid crisis,
4-8
provided the original work is which is compounded by comorbid conditions for many opioid users. For patients
properly cited. with opioid use disorder (OUD), the standard of care includes opioid agonist treatment/
9
Publisher’s Note: AccScience therapy (OAT), where medications for opioid use disorder (MOUD), such as methadone,
Publishing remains neutral with buprenorphine and naltrexone are substituted in place of more potent and harmful
regard to jurisdictional claims in 10-13
published maps and institutional opioids. The use of MOUD can help alleviate withdrawal symptoms and/or cravings
affiliations that can be experienced as a result of discontinuing opioid usage. 10,14,15 Furthermore,

Volume 8 Issue 3 (2025) 21 doi: 10.36922/itps.5151