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Abuse liability of flunitrazepam among methadone-maintained patients
Authors:Magí Farré  María-Teresa Terán  Pere N Roset  Marta Mas  Marta Torrens  J Camí
Institution:(1) Pharmacology Research Unit, Institut Municipal d’Investigació Mèdica (IMIM) and Universitat Autònoma de Barcelona, Doctor Aiguader 80, E–08003 Barcelona, Spain, ES;(2) Psychiatry and Drug Dependence Unit, Hospital del Mar, Paseo Marítimo 25, E–08003 Barcelona, Spain, ES;(3) Pharmacology Research Unit, Institut Municipal d’Investigació Mèdica (IMIM) and Universitat Pompeu Fabra, Doctor Aiguader 80, E–08003 Barcelona, Spain e–mail: jcami@imim.es, Fax: +34-93-2213237, ES
Abstract:Abuse liability and acute subjective and psychomotor effects of flunitrazepam were assessed in ten methadone-maintained males with history of benzodiazepine and alcohol use, who voluntarily participated in a double-blind, controlled, cross-over, randomized clinical trial. There were six experimental sessions in which a single oral dose of flunitrazepam 1, 2, and 4 mg; triazolam 0.5 and 0.75 mg; and placebo was given. Evaluations included physiological measures; psychomotor performance tasks (simple reaction time, Digit Symbol Substitution Test, balance task, Maddox-wing device); and self-administered subjective effects questionnaires Addiction Research Center Inventory (ARCI), Profile of Mood States (POMS), a series of visual analog scales (VAS)]. All drugs but flunitrazepam 1 mg caused an impairment of psychomotor tasks. Effects were more evident with the highest doses of both drugs. Only flunitrazepam 4 mg produced a significant decrease in balance time. Triazolam 0.75 mg induced increases in sedation measured by ARCI-PCAG, depression in POMS, and VAS-drowsiness scores. Flunitrazepam 4 mg caused euphoria-related effects as measured by increases in ARCI-MBG and “high” scores in the VAS. Our findings of flunitrazepam-induced euphoria in methadone-maintained subjects together with epidemiological evidence of flunitrazepam abuse by opioid dependents, suggest that it may be included in the group of benzodiazepines with a relatively high abuse potential. Received: 13 February 1998/Final version: 1 May 1998
Keywords:Flunitrazepam  Benzodiazepine  Methadone  Abuse liability  Opioid abuse
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