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Heroin Addiction and Related Clinical Problems: 2014, 16, 3 (pages: 55 - 64)

Outcomes of clonazepam maintained benzodiazepine-heroin addicted patients during methadone maintenance: A descriptive case series

Maremmani A.G.I., Bacciardi S., Rugani F., Rovai L., Massimetti E., Gazzarrini D., Dell'Osso L., Pani P.P., Pacini M., and Maremmani I.

Summary: Background. The use of benzodiazepine (BDZ) by patients on methadone maintenance treatment (MMT) has the effect of complicating the clinical picture. The relative safety of BDZ use by methadone- or buprenorphine-treated patients has still not been systematically examined. It is not yet clear whether a maintenance strategy with clonazepam is a useful BZD treatment modality for BZD-dependent MMT patients with a long-term history of abuse and previous attempts at detoxification. Methods. In this study our aim has been to collect and present detailed information regarding the outcomes of a small group of our patients who were treated with clonazepam maintenance during methadone maintenance. Results. In our sample of BZD-dependent MMT patients, who were treated with a methadone-clonazepam combination, the retention rate, at 8 years, was 57.1%. Baseline-endpoint improvements were significant for clinical global impression and the level of social adjustment. Conclusions. Patients with a severe comorbid dependence, when treated with over-standard dosages of methadone and co-treated with CMT, may have outcomes that are satisfactory as long as they are maintained on their medication in the long term.