Treatment of out-patients with complicated benzodiazepine dependence: comparison of two approaches

ABSTRACT Aims To evaluate whether gradual benzodiazepine taper combined with cognitive‐behavioural treatment is more effective than standard treatment for patients with dependence in out‐patient clinics. Design A randomized, controlled clinical trial, using standard questionnaires and serum and urine tests. Settings Four public‐sector out‐patient clinics for alcohol and drug abusers in Helsinki. Participants Seventy‐six patients with benzodiazepine dependence (DSM‐III‐R). Patients taking high doses of the drug or with alcohol use disorders were included to obtain a subject group representative of usual clinical practice. Intervention Subjects received gradual benzodiazepine taper combined with cognitive‐behavioural therapy (experimental group) or standard withdrawal treatment not scheduled by the researchers (control group). Measurements The outcome was measured in terms of attaining a state of abstinence or by a decrease in the dosage during the study period of up to 12 months’ duration. Findings No statistically significant differences in the outcomes were observed between the groups. A total of 13% of the experimental group and 27% of the control group were able to discontinue drug use. In addition 67% of the experimental group and 57% of the control group were able to decrease the dose. Conclusions The search continues for improved methods of helping patients with complicated benzodiazepine dependence.