Methadone Cohort Found More Benzodiazepine Prescribing in Patients With PTSD

A cohort of people receiving opioid-use-disorder treatment found clinically different groups that require caution in medication-outcome comparisons.

What the source reports

The study assessed trauma and PTSD among 674 patients receiving methadone in Ontario community clinics and followed drug-testing outcomes. Benzodiazepine prescriptions were more frequent in the PTSD group, which also had different psychiatric and psychosocial characteristics. Trauma and treatment outcomes were examined separately.

Limits and uncertainty

The study did not randomize benzodiazepines or establish that prescribing caused PTSD, suicidal thoughts, or a treatment outcome. Participants already receiving methadone may differ from people outside treatment. Self-reported trauma and diagnostic assessment also have limitations.

Implications for forensic review

For an opioid-benzodiazepine opinion, underlying trauma and psychiatric burden may confound simple comparisons. Establish the reason for treatment and actual exposure rather than assigning outcomes to co-prescribing alone. This study supports integrated assessment without proving benefit or harm from a particular prescription.

Source and related reading

Source reviewed: Trauma and post traumatic stress disorder in patients treated for opioid use disorder findings from (PMC8329768). Forensic applications above are interpretive analysis of the supplied paper.

Related reading: Dominant Midazolam Sedation Was Associated With ICU Delirium in a Matched Cohort; Replacing a Benzodiazepine With Another Sedative Does Not Automatically Remove Opioid Interaction Risk.