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ID: 212

Type of submission: Oral

Conference track: Research

Topics: Opioid Substitution Therapy Programmes

Presenting author: Alexandra Franklyn

Presenting author biography:

Alex is a Research Assistant at the Northern Ontario School of Medicine. She completed her B.Sc. from McGill University and M.Sc. from Laurentian University. Alex has also worked as an Outreach Worker where she developed a Naloxone program, which helped fuel her passion for addiction and harm reduction.

The impact of benzodiazepine use in patients enrolled in opioid agonist therapy in Northern and rural Ontario

Alexandra Franklyn, Joseph Eibl, Graham Gauthier, David Pelligrini, Nancy Lightfoot, David Marsh

Abstract: Benzodiazepine use is common among patients in opioid agonist therapy; this puts patients at an increased risk of overdose and death. In this study, we examine the impact of baseline and ongoing benzodiazepine use, and whether patients are more likely to terminate treatment with increasing proportion of benzodiazepine positive urine samples. We also study whether benzodiazepine use impacts treatment retention differentially by geographic location.

Methods: We conducted a retrospective cohort study using anonymized electronic medical records from 58 clinics offering opioid agonist therapy in Ontario between 2011 and 2012. One-year treatment retention was the primary outcome of interest and was measured for patients who did and did not have a benzodiazepine positive urine sample in their first month of treatment, and for the proportion of benzodiazepine positive urine samples throughout the course of treatment.

Results: Our cohort consisted of 3,850 patients, with an average retention rate of 43.4%. Baseline benzodiazepine users had a retention rate of 39.9% and non-users had a retention rate of 44%. Patients who were benzodiazepine negative on admission benefited from an increased median days retained of 265 vs. 215 days. Patients with more than 75% of urines positive for benzodiazepines were 175% more likely to drop out of treatment than those patients with little or no benzodiazepine use.

Conclusion: Baseline benzodiazepine use is predictive of decreased retention. Patients who have a higher proportion of benzodiazepines positive urine samples are more likely to drop out of treatment compared to those who have little or no benzodiazepine detection in their urine.