Diazepam reinforcement in anxious patients

The reinforcing effects of diazepam were examined in 4 female patients with generalized anxiety disorder but without histories of drug abuse. Under double-blind conditions, patients were given medication capsules containing either 4 mg diazepam or placebo that they could use 'as needed' for anxiety. After a 1-week sampling period for each medication, participants repeatedly chose which medication they preferred over the next 4 weeks. Reinforcing effects of diazepam were demonstrated in 3 participants who showed exclusive diazepam preference. The results suggest procedures whereby drug self-medication behavior may be studied in an outpatient environment.