Abuse liability of flunitrazepam among methadone-maintained patients

Psychopharmacology (Berl). 1998 Dec;140(4):486-95. doi: 10.1007/s002130050793.

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 4mg 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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Anxiety Agents*
  • Blood Pressure / drug effects
  • Body Temperature / drug effects
  • Cross-Over Studies
  • Double-Blind Method
  • Electrocardiography / drug effects
  • Flunitrazepam*
  • Heart Rate / drug effects
  • Humans
  • Male
  • Methadone / therapeutic use*
  • Narcotics / therapeutic use*
  • Opioid-Related Disorders / psychology*
  • Opioid-Related Disorders / rehabilitation*
  • Psychomotor Performance / drug effects
  • Substance-Related Disorders / psychology*
  • Surveys and Questionnaires

Substances

  • Anti-Anxiety Agents
  • Narcotics
  • Flunitrazepam
  • Methadone