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Introduction: The co-association of benzodiazepines and opioids is associated with an increased risk of overdose, death, and poorer psychosocial prognosis. The aim of this study is to characterize the prevalence, pattern of use, and primary clinical outcomes in benzodiazepines users in a public opioid maintenance treatment unit.Material and Methods: We conducted a cross-sectional study involving 236 patients treated with opioid substitutes (methadone and buprenorphine). We conducted a descriptive, bivariable, and multivariable analysis to determine clinical differences between benzodiazepines users and non-users.Results: The prevalence of consumption of benzodiazepines was 25.4% (60). The benzodiazepines were obtained with a medical prescription (49.8%) or on the black market (42.6%). The most prescribed benzodiazepine was diazepam (29.1%), and the main reasons were to relieve insomnia (27.7%) or anxiety (26.9%) and to enhance the psychoactive effects of other drugs (19.7%). Regarding the clinical outcomes, we highlight: a very high prevalence of hepatitis C (51.7%); severe ongoing consumption of psychoactive drugs (73.7%); and a high rate of depression and anxiety (> 60%), significantly higher in the benzodiazepines-user group. In the multivariable analysis of benzodiazepine use, we found alcohol consumption (OR 0.482; IC 95% 0.247, 0.238) had a negative association and having hepatitis C (OR 2.544, IC 95% 1.273, 5.084) or anxiety symptoms (OR 5.591; IC 95% 2.345, 13.326) had positive associations.Discussion: Our results suggest the BZD users had a complex drug addiction problem and underline the importance of adequately addressing BZD use, contemplating psychological and psychiatric approach in this particular population.Conclusion: Past or current use of benzodiazepines is associated with poor clinical and psychiatric outcomes. A multidisciplinary approach with a focus on infectious diseases and mental health is critical in order to enhance the treatment effectiveness and overall prognosis.

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0 soro anti-tetânico, empregado como medida curativa, tem-se mostrado ineficiente em quase 50% dos casos de tétano. Vários fatores são analisados como justificativa de tal fato, principalmente o grande neurotropismo e a possibilidade de transformação da toxina tetànica no sistema nervoso central em nova substância não neutralizada pela antitoxina tetànica. Contudo, recomendamos o seu emprego, em todos os casos, pois não existem meios para avaliar, rotineiramente, se ainda está presente o agente etiológico, e os vários fatores que regulam sua toxinogênese, assim como o quanto de toxina já foi fixada. Fizemos referência às doses de soro anti-tetânico, demonstrando a ineficiência do emprego de altas doses. Damos importância grande, apoiados em fatos experimentais e clínicos, ao tratamento não específico com referência especial à sedação (depressores do centro respiratório). Fizemos ensaio com nova droga músculo-relaxadora, de ação central (Tolserol), em 40 casos e apresentamos os resultados obtidos, sendo que a mortalidade verificada foi de apenas 7,5%, a menor na bibliografia por nós consultada.

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