Developing an Intervention to Manage Benzodiazepine Dependence and High Risk Use in the Context of Escalating Drug Related Deaths: A feasibility study

Scotland has the highest rate of drug related deaths in Europe. These are deaths in people who use drugs such as heroin, cocaine, benzodiazepines and gabapentin. It is a feature of deaths in Scotland that people use combinations of drugs. This is very risky and increases the chance of a drug related death. Most deaths involve illegal drugs like heroin in combination with other drugs but some deaths are of people in treatment who still use illegal drugs. A feature of deaths in recent years has been the high number involving street supplies of benzodiazepines (BZD), in particular a drug called etizolam. This is not available on prescription in the UK so is coming from illegal sources. People who use heroin (an opiate) can be treated by prescribing a safer replacement drug (e.g. methadone). However it is not currently recommended to treat people who use benzodiazepines with a similar replacement although drugs such as diazepam could be used. Clinicians find it very difficult to reduce the risk of a drug related death in people using street benzodiazepines. This study will test a new intervention, designed by consulting people who use street BZD and clinicians. The intervention involves prescribing and psychosocial support. This study will help the research team plan a big trial to test the intervention with more people. This will provide clinicians the evidence they need to reduce drug related deaths from street BZDs in Scotland.