An unusual benzodiazepine dependence in an opioid dependent patient: a case report

Abstract

Treatment of polysubstance abuse involving heroin and benzodiazepines is a challenge in clinical practice. The potential risk of additive pharmacological effects may be associated with poorer outcomes in patients who use benzodiazepines together with heroin. The index case had presented with multiple episodes of seizure with the average use of 250 mg of diazepam per day over past 1year. The patient also has dependence of heroin taking around 2 grams per day since last 12 yrs with multiple admissions in rehabilitation centres. Patient was previously tried with Opioid Substitution Therapy (OST) multiple times with unsuccessful attempts. Finally, as patient was unmanageable on OST due to severe withdrawal features, he was started on Methadone Maintenance Treatment (MMT).