University:
Boston University
Course:
SAR HP 151 | Introduction to Health Professions
Academic year:

2023
Views:

397

Pages:

14
Author:

eishuma5iuk

Analysis All transcriptions were reviewed by the PI and entered into Nvivo Data analysis was largely guided by thematic analysis Open coding by the PI and one research assistant to develop a codebook After coding, identified major themes and relationships between them Study sample N=18 Median age: 41 years old 11 females, 7 males 11 receiving methadone, 7 receiving buprenorphine Median length of time on opioid agonist therapy: 5 years Motivations: to feel calmer “Without the benzos, I feel like I had a lot more panic attacks. I had a lot more going on in my head and I felt like I couldn’t get my head to stop racing, so I would say that I was a lot more pent up and fearful I guess, when I wasn’t on the benzos.” Motivations: to get high “When I got on methadone, yes. Definitely because I didn’t know that when you take a benzo on methadone, you get this high feeling because they say it’s like twice as much as you take. So if you take 1 Klonopin, it has the effect of two. So yeah, in the beginning definitely. I definitely took them to get that high feeling and get a head change.” Consequences: oversedation “When I overdo ‘em, I’m falling asleep on the train, getting woken up. There’s been periods where I get on the train at 3 o clock in the afternoon and I get woken up at 1 in the morning, trying to get off the train. So it’s no fun, you know what I mean? It’s just not the high that I like.” Consequences: loss of memory “Yes. Forgetting stuff. Forgetting where I put things. Losing time and not knowing what happened during that time. Which is really scary.” Consequences: helps to feel normal “Just simple little things like walking down the street would really bother my anxiety and now I don’t have that feeling anymore. I feel like I’m able to do normal things.” Consequences: helps with drug cravings “Well you want to look out a little bit more for people that are on Suboxone or methadone because they’re addicts. And if they have too many panic attacks, the first thing they’re going to think about, like I do, is using.” Learning to use benzodiazepines appropriately Misuse of benzodiazepines during illicit opioid use: ◦ ◦ ◦ ◦ Interviewer: “Did it boost the high? Of the opioids?” Participant: “Of the opiates? Of course, of course.” I: “It did. So when you used them both at the same time…” P: “One of the main reasons was to, when mixing the two… if you take the benzo before the opiate it puts you into an instant nod…” Learning to use benzodiazepines appropriately Misuse of benzodiazepines when taking methadone: ◦ “I was taking them all at once, whenever I was prescribed, you know? And for the day, which I don’t remember at the time when it was, but I would take them all at once. I was mixing them with the methadone. I wasn’t taking them correctly. And now, you know, I span them out throughout the day.” Learning to use benzodiazepines appropriately A benzodiazepine prescription is a privilege: ◦ “When I finally earned my prescription for Klonopin, I took it as prescribed. I’ve always taken it as prescribed because there is no point. And yet, I mean I’m not gonna lie, when I first got it, I’m sure I screwed around at the very beginning but the way I look at it now is, so many people would kill to just be able to have this (prescription).” Preliminary conceptual framework MOTIVATION Inappropriate RECOVERY PROCESS Active illicit opioid use CONSEQUENCES Worse Appropriate Initial treatment phase Later treatment phase Better Capacity to take benzodiazepines responsibly Benzodiazepine prescribing attitudes Geppert, 2007 Conclusions Prescribing benzodiazepines has both risks and benefits in patients receiving opioid agonist therapy Benzodiazepines should be considered as a potential treatment It may be safer to treat patients with benzodiazepines when they are more stable in opioid agonist therapy