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INNOSC Theranostics and
Pharmacological Sciences Benzodiazepine use and retention in OAT

“treatment” in “treatment retention” as two examples. As Methadone was used in seven studies, buprenorphine
such, many of the selected articles were not included after in five, naltrexone in one, and suboxone in one study.
the initial abstract reading. All studies utilized urine drug testing (UDT) to evaluate
the presence of opioids, BZDs, and other substances
2.2. Data extraction and analysis at intake and/or during OAT. Some studies performed
Information taken from the studies included: author immunoassays to distinguish between different opioids,
information, date of publication, journal of publication, including whether they were illicit or prescribed. Statistical
location of study, study design, trial duration, sample size, methods utilized to compare BZD’s effect on OAT retention
subject demographics (age, sex, polysubstance use, and included Cox regression analyses, adjusted hazard-ratios,
psychiatric comorbidities), MOUD used for treatment adjusted odds-ratios, and Z-scores.
(and dose if available), definition of treatment retention,
percentage of BZD users in each cohort, and methods for 3.2. BZD use within each study
evaluating opioid and BZD use. We followed the definition Thirteen of the included studies reported on the percentage
of treatment retention provided in each study. Due to the of BZD-positive patients within their cohort. The study by
large variability of each study’s design and OAT program, Ray-Griffith et al. was the only included study that did
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we did not perform a meta-analysis of the study results. not include this outcome. In the retrospective study by
Instead, we provided a narrative summary of the key Morford et al., 18% of patients tested positive at intake.
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findings according to similarities in study design and The retrospective cohort study by Brands et al., found that
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methodology, as previously. 35-37 70.9% of patients used BZD in the past year and 33% had
consumed BZD for 30 out of the 90 days before treatment
3. Results initiation. Similarly, the observational study by Durand
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3.1. Search results and characteristics of studies et al., found that 65.5% of patients possessed a BZD
prescription 90 days before treatment. In the retrospective
The search identified 141 publications and 136 articles cohort study by Franklyn et al., 15% of patients were
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were screened after removing duplicates (Figure 1). BZD-positive at intake. The observational cohort study by
Twenty-seven full-text articles were evaluated for Dayal et al. noted that 16% of study patients used BZD.
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eligibility. Fourteen papers were selected for analysis: In the retrospective cohort study conducted by Hallowell
eleven retrospective cohort studies and three observational et al., 18% of subjects were found to have overlapping
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studies. Table 2 outlines the main study design of each BZD and buprenorphine prescriptions during a 12-month
study, while Table 3 provides study characteristics about treatment period. In the retrospective study conducted by
the subjects and the study location. Schuman-Olivier et al., 48% of participants were found to
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Figure 1. Flow design

Volume 8 Issue 3 (2025) 23 doi: 10.36922/itps.5151