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Reducing diazepam prescribing for illicit drug users: A randomised control study
Author(s) -
ELLIOTT LAWRIE,
GLENDAY JOHN,
FREEMAN LAURA,
AJEDA DINA,
JOHNSTON BRIAN,
CHRISTIE MORAG,
OGSTON SIMON
Publication year - 2005
Publication title -
drug and alcohol review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.018
H-Index - 74
eISSN - 1465-3362
pISSN - 0959-5236
DOI - 10.1080/09595230500125138
Subject(s) - medicine , diazepam , medical prescription , psychological intervention , anxiety , depression (economics) , intervention (counseling) , pittsburgh sleep quality index , randomized controlled trial , population , physical therapy , psychiatry , sleep quality , insomnia , pharmacology , economics , macroeconomics , environmental health
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.