Temazepam misuse in a group of injecting drug users

Abstract

It is well recognized that many injecting drug users are poly-drug users. The intravenous use of Temazepam has become popular recently. In response to the ease of misuse, the pharmaceutical industry produced a formulation that would be as 'resistant' as possible to injecting. The preparation is a gel-filled formulation, one proprietary name being Temazepam Gelthix. General Practitioners have been encouraged to prescribe gel-filled capsules to potential drug misusers in order to reduce the harm Temazepam can cause by its misuse. This study of 23 Temazepam injectors shows that the group still find the gel-filled preparation readily injectable. It appears to be more problematic in causing medical complications including superficial thrombophlebitis, abscesses and deep venous thrombosis. Temazepam misuse can cause drug users to become more chaotic. The study group recognize this and suggest there should be stricter control on the supply of Temazepam to drug dependents. General Practitioners, who are the main source of Temazepam prescribing, require additional training in prescribing to drug users.

Prevalence and Pattern of Benzodiazepine Abuse and Dependence Among Patients in a Methadone Detoxification Programme: A Repeated Cross-Sectional Analysis (Benzodiazepine Abuse Among Opiate Addicts)

“…Increase in the use of temazepam from 38.1% in cohort 1 to 83.6% in cohort 2 is consistent with earlier reports on temazepam as the most widely abused benzodiazepine among opiate addicts (Ruben & Morrison, 1992;Seivewright & Dougal, 1993). What the earlier studies did not mention, which our study revealed, is the more widespread use of temazepam relative to diazepam.…”

“…In cohort 2, however, this trend was reversed with 73.7% and 83.6% reporting the use of diazepam and temazepam respectively. Since temazepam use is more closely associated with injecting behaviour than other benzodiazepines (Klee et af., 1990;Ruben & Morrison, 1992;Sakol et al, 1989), the observed increase in temazepam use in cohort 2 may have accounted for the significant rise in benzodiazepines injecting from 4.8% at baseline to 24.6% at follow-up.…”

“…OYEFESO ETAL. Ruben & Morrison, 1992) seem to indicate that temazepam is now the most preferred in the UK. Of recent concern in the UK is the increasing use of temazepam by injection (Strang er al., 1994) which has been closely associated with a range of HIV risk behaviours (Klee er al., 1990).…”

Co-abuse of opiates and benzodiazepines

“…Williams et al found that diazepam and temazepam were most popular 12 , Gantry et al identified nitrazepam, chlordiazepoxide and temazepam 13 and Iguchi et al rated diazepam, lorazepam and alprazolam as the most preferred benzodiazepines used 14 . Great concerns have also been expressed towards the injection of temazepam 5,15,16 . In this study the use of temazepam is low, with only 2 in the control group having used it and no person in the benzodiazepine detoxification group using it.…”

Benzodiazepine use among injecting drug users

“…Although some studies have not found withdrawal symptoms to be a prominent feature of high dose benzodiazepine abuse (e.g. Ruben & Morrison, 1992), we found elsewhere that a proportion of such mdividuals experience the range of withdrawal symptoms which are well known from investigations of low dose users of prescribed benzodiazepines, to a more severe degree (Seivewright & Dougal, 1993). It would seem that the possibihty of fits in particular is enough to persuade many residential units or prisons to prescribe a short course of benzodiazepines if high dose benzodiazepine abuse has been in the clinical picture, probably in the latter setting more commonly than methadone would be prescribed as a detoxification from heroin.…”