Evidence map›Paper›PMID 26743909›Full record

ArticleHarm reduction journal2016

Attitudes towards a maintenance (-agonist) treatment approach in high-dose benzodiazepine-dependent patients: a qualitative study.

Michael Liebrenz, Marcel Schneider, Anna Buadze, Marie-Therese Gehring, Anish Dube, Carlo Caflisch

Abstract read
In one paragraph

Article in Harm reduction journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Benzodiazepine high-doses: The need for an accurate definition.International journal of methods in psychiatric research · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michael LiebrenzDepartment of Forensic Psychiatry, Institute of Legal Medicine, University of Bern, Bern, Switzerland. Michael.Liebrenz@fpd.unibe.ch.
Marcel SchneiderDepartment of Surgery, Division of Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland. marcelandre.schneider@gmail.com.
Anna BuadzeDepartment of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland. Anna.Buadze@puk.zh.ch.
Marie-Therese GehringUlmenhof, Sozialtherapie, Ottenbach, Switzerland. marie-therese.gehring@diealternative.ch.
Anish DubeUniversity of Pennsylvania Health System, Philadelphia, USA. Anish.Dube@gmail.com.
Carlo CaflischDepartment of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland. Carlo.Caflisch@puk.zh.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh-dose benzodiazepine dependence constitutes a major clinical concern. Although withdrawal treatment is recommended, it is unsuccessful for a significant proportion of affected patients. More recently, a benzodiazepine maintenance approach has been suggested as an alternative for patients' failing discontinuation treatment. While there is some data supporting its effectiveness, patients' perceptions of such an intervention have not been investigated.

methodsAn exploratory qualitative study was conducted among a sample of 41 high-dose benzodiazepine (BZD)-dependent patients, with long-term use defined as doses equivalent to more than 40 mg diazepam per day and/or otherwise problematic use, such as mixing substances, dose escalation, recreational use, or obtainment by illegal means. A qualitative content analysis approach was used to evaluate findings.

resultsParticipants generally favored a treatment discontinuation approach with abstinence from BZD as its ultimate aim, despite repeated failed attempts at withdrawal. A maintenance treatment approach with continued prescription of a slow-onset, long-acting agonist was viewed ambivalently, with responses ranging from positive and welcoming to rejection. Three overlapping themes of maintenance treatment were identified: "Only if I can try to discontinue…and please don't call it that," "More stability and less criminal activity…and that is why I would try it," and "No cure, no brain and no flash…and thus, just for everybody else!"

conclusionsSome patients experienced slow-onset, long-acting BZDs as having stabilized their symptoms and viewed these BZDs as having helped avoid uncontrolled withdrawal and abstain from criminal activity. We therefore encourage clinicians to consider treatment alternatives if discontinuation strategies fail.

Indexed as

AdultAgedAttitudeBenzodiazepinesCrimeDelayed-Action PreparationsDiazepamFemaleHumansIllicit DrugsInterview, PsychologicalMaleMiddle AgedQualitative ResearchSelf ReportSubstance-Related DisordersBenzodiazepinesDelayed-Action PreparationsDiazepamIllicit Drugs

Identifiers

PMID26743909
PMCPMC4705614

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.