Page 31 - ITPS-8-3

INNOSC Theranostics and
Pharmacological Sciences Benzodiazepine use and retention in OAT

Table 2. (Continued)
Study Publication Journal Study Design and Methodology
Year
Montalvo et al. 51 2019 The American The primary outcome of the study was adherence to buprenorphine treatment≥1 year.
Journal of Secondary outcomes included 2-year buprenorphine treatment retention. Among patients
Addictions kept on continuous buprenorphine treatment, Bivariate analysis was performed to see if there
was a significant difference in buprenorphine adherence between those who were and weren't
co-prescribed BZDs.
Park et al. 46 2020 Addiction Authors compared characteristics between individuals with at least one BZD prescription
filled during the study to those with no BZD prescription. They performed outcome event
rates and Kaplan-Meier curves for four outcomes: Fatal opioid overdose, non-fatal overdose,
all-cause mortality, and buprenorphine discontinuation.
The primary outcome was time for fatal opioid overdose. Secondary outcomes included: time
to non-fatal overdose, all-cause mortality, and buprenorphine discontinuation. Buprenorphine
discontinuation was defined as a patient going more than 30 consecutive days without a
prescription filled.
Durand et al. 41 2021 Drug Alcohol By following methadone prescription records, authors were able to follow a patient's
Dependence engagement in the MMT program. A patient was considered to be retained in treatment
in their methadone prescriptions coverage was maintained with no interruptions longer
than 7 days.
The primary outcome was the time of dropout of MMT at 3 months and 1 year. Determinants
include sex, age, median methadone dose, history of co-prescription (BZDs, antidepressants,
antipsychotics), and incarceration. The author examined prescription records for BZDs during
MMT and up to 90 days before initiating treatment,
Ray-Griffith et al. 38 2021 The American Participants were split into two groups: postpartum treatment retention and postpartum
Journal on treatment dropout. A bivariate analysis was performed on both groups to identify factors
Addictions affecting treatment retention at 12 weeks postpartum. Treatment retention was defined as
attending an appointment 10 – 14 weeks postpartum. In this article, treatment retention
was not dependent on a prescription for buprenorphine. The presence of other substances
(including BZD) was evaluated using urine drug toxicology results.
Morford et al. 39 2022 Drug Alcohol Based on a urine toxicology screening at intake, they separated patients into BZD and no-BZD
Dependence groups for comparison. Kaplan-Meyer analysis was used to characterize treatment retention.
The primary outcome of methadone discontinuation was defined as a patient going more than
30 consecutive days without a methadone dose shown in their electronic medical records.
Hallowell et al. 44 2022 Drug Alcohol The primary outcome was buprenorphine retention over a 12-month OAT period. Treatment
Dependence retention was defined as having a medication possession ratio (total days supply of a
medication/number of days in the period) during the patient's follow-up period. Multivariable
logistic regression models were used to characterize treatment retention and buprenorphine
prescription.

have a history of BZD misuse, with 17% of the BZD misuse had no BZD prescription and tested above the 30% BZD
group possessing a BZD prescription and 83% not having a urine screen threshold. Thirteen percent of subjects had
prescription. Conversely, 52% had no BZD misuse history, no BZD prescription and tested below the 30% BZD urine
with 19% of the no BZD misuse group possessing a BZD screen threshold. Finally, 6% of subjects had no BZD
prescription and 83% not having a prescription. prescription and tested above the 30% BZD urine screen
50
In the retrospective cohort study conducted by Park threshold. In the study conducted by Peles et al., BZD
et al., 24% of participants filled at least one prescription prevalence fluctuated from year to year, with a peak of 61%
46
for BZDs while receiving buprenorphine therapy. In the and a low of 25.4%.
study by Raffa et al., 61.7% of participants tested positive 3.3. Studies that distinguish between BZD-positive
47
for BZDs. In the retrospective cohort study conducted by and BZD-negative at treatment intake
48
White et al., 20% of participants were found to have illicit
baseline BZD use. From the BZD-positive group, 62% had Three retrospective and one observational cohort studies
prescriptions. In the retrospective study by Eibl et al., 75% were conducted on treatment retention in OAT where the
49
of subjects had no BZD prescription and tested below the authors separated subjects into BZD-positive and BZD-
30% BZD urine screen threshold. Six percent of subjects negative groups based on UDT during treatment intake.

Volume 8 Issue 3 (2025) 25 doi: 10.36922/itps.5151