Managing Benzodiazepine Use in Medication-Assisted Treatment

The Need

Benzodiazepines (BZDs) are widely used and misused in conjunction with medication-assisted treatment (MAT).

The frequency with which MAT patients concurrently use BZDs carries major risk of harm, including mortality.

In Philadelphia, BZD abuse in MAT programs as a long term problem that seemed to be expanding in severity and scope.

There is a dearth of research about how to effectively administer MAT when a patient is using (licitly or illicitly) BZDs.

The Solution

In 2012, under contract with the Philadelphia Department of Behavioral Health and Intellectual Disability Services (DBHIDS), IRETA conducted a project to determine best practice guidelines for the management of benzodiazepines in medication-assisted treatment (MAT).

IRETA’s research team conducted a comprehensive literature review and utilized a research-based guideline development process called the RAND/UCLA Appropriateness Method to combine the best available research and clinical evidence to practical guidelines.

The Results

The guidelines have been promulgated by DBHIDS among its addiction and mental health providers. National news and advocacy organizations have shared the guidelines among their networks, including SAMHSA, AATOD, Addiction Treatment Forum and the National Addiction Technology Transfer Center network.

Epilogue

After the publication of the guideline on BZD use in MAT, IRETA utilized the RAND/UCLA Appropriateness Method a for the creation of a subsequent practice guideline. The resulting Appropriate Use of Drug Testing in Clinical Addiction Medicine was published by ASAM in 2017. The same year, IRETA began further guideline development work for ASAM, which addresses the clinical management of alcohol withdrawal.