Evidence map›Paper›PMID 34098286›Full record

ArticleJournal of substance abuse treatment2021

"It could potentially be dangerous... but nothing else has seemed to help me.": Patient and clinician perspectives on benzodiazepine use in opioid agonist treatment.

Tae Woo Park, Jennifer Sikov, Vanessa dellaBitta, Richard Saitz, Alexander Y Walley, Mari-Lynn Drainoni

Open access · greenAbstract read
In one paragraph

Article in Journal of substance abuse treatment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 21% of its field
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

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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 at 2 institutions in 1 country.

Tae Woo ParkDepartment of Psychiatry, Boston University School of Medicine, Boston Medical Center, United States of America; Grayken Center for Addiction, Boston Medical Center, United States of America. Electronic address: taewoo.park@bmc.org.
Jennifer SikovDepartment of Psychiatry, Boston University School of Medicine, Boston Medical Center, United States of America.
Vanessa dellaBittaDepartment of Psychiatry, Boston University School of Medicine, Boston Medical Center, United States of America.
Richard SaitzGrayken Center for Addiction, Boston Medical Center, United States of America; Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston Medical Center, United States of America; Department of Community Health Sciences, Boston University School of Public Health, United States of America.
Alexander Y WalleyGrayken Center for Addiction, Boston Medical Center, United States of America; Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston Medical Center, United States of America.
Mari-Lynn DrainoniDepartment of Medicine, Section of Infectious Diseases, Boston University School of Medicine, United States of America; Center for Implementation and Improvement Sciences, Department of Medicine, Boston University School of Medicine, United States of America; Department of Health Law, Policy & Management, Boston University School of Public Health, United States of America.
Boston Medical Center · USBoston University · US

Funding

Oral v Injection Naltrexone in Hospital: Comparative Effectiveness for AlcoholismR01AA021335 · NIAAA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI SAITZ, RICHARD · 2014 to 2019
$4.2M
Distress Tolerance and Benzodiazepine Discontinuation in Opioid Agonist TherapyK23DA044321 · NIDA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI PARK, TAE WOO · 2017 to 2021
$927k
NIAAA NIH HHS R01 AA021335NIDA NIH HHS K23 DA044321
6 · The paper itself

Abstract

backgroundBenzodiazepine use among patients receiving opioid agonist treatment (OAT) presents a conundrum: benzodiazepines increase overdose risk, yet can treat anxiety and insomnia. How best to balance the risks and benefits of benzodiazepines among OAT patients is unclear. Using qualitative methods, we examined patient motivations for benzodiazepine use and understanding of risks, and the context in which benzodiazepine use and prescribing occurs.

methodsWe conducted semi-structured interviews with 26 OAT patients using benzodiazepines and 10 OAT clinicians. Participants were recruited from an office-based buprenorphine clinic at an academic medical center and a methadone opioid treatment program using purposive sampling. The study team reviewed transcripts and double-coded 100% of interviews. Data analysis combined both deductive and inductive methods.

resultsMajor emergent themes were: 1) patients focus on benefits over risks of benzodiazepines, 2) patients can learn to use benzodiazepines safely, 3) patients want to use benzodiazepines now but discontinue in the future, 4) clinicians and patients weigh the risks and benefits of benzodiazepine use differently, 5) clinicians and patient have differences in treatment goals, and 6) clinicians struggle with benzodiazepine discontinuation.

conclusionsOAT patients and clinicians can weigh the risks and benefits of benzodiazepines differently leading to a difference in treatment goals. The risk-benefit analysis of benzodiazepine prescribing may depend on whether the patient is engaged in opioid treatment. Future work among patients and clinicians is warranted to determine how to better balance patient and clinician priorities in order to deliver safer prescribing practices and maintain patient engagement in care.

Indexed as

BuprenorphineOpioid-Related DisordersAnalgesics, OpioidBenzodiazepinesHumansMethadoneAnalgesics, OpioidBenzodiazepinesBuprenorphineMethadoneBenzodiazepinesBuprenorphineMethadone

Identifiers

PMID34098286
PMCPMC8556389
OpenAlexW3165414887

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.