Mixing opioids with anti-anxiety drugs linked to greater risk of overdose

Taking opioids together with benzodiazepines is associated with greater risk of opioid overdose, according to a U.S. study of privately insured patients.The researchers, led by Dr. Eric Sun of Stanford University in California, said opioids should be prescribed cautiously among patients who are also taking benzodiazepines, and they called for education programs that warn prescribers and patients about the risks of taking both medications concurrently.They noted that nearly 30% of fatal opioid overdoses in the U.S. also involve benzodiazepines.In their study, they reviewed claims data from 2001 to 2013 for 315,428 privately insured people ages 18 to 64 who filled at least one prescription for an opioid.Concurrent benzodiazepine/opioid use was defined as an overlap of at least one day in the time periods covered by prescriptions for each drug.During the study period, there was an 80% relative increase in the percentage of opioid users who were also prescribed a benzodiazepine: from 9% in 2001 to 17% in 2013. "This increase was driven mainly by increases among intermittent, as opposed to chronic, opioid users," the researchers noted.Compared with opioid users who did not use benzodiazepines, concurrent use of both drugs was associated with more than double the risk of an emergency room visit or inpatient admission for opioid overdose."If this association is causal, elimination of concurrent benzodiazepine/opioid use could reduce the risk of emergency room visits related to opioid use and inpatient admissions for opioid overdose by an estimated 15%," the researchers estimated.An accompanying editorial called opioid-benzodiazepine co-treatment "a powerful example of potentially dangerous low-value care."The editorialists noted this "unsound and growing clinical practice" is occurring despite the risks having long been understood. "(B)oth drug classes can be sedating, suppress respiratory efforts, impair thought, slow response time and increase falls."

Mixing opioids with anti-anxiety drugs linked to greater risk of overdose

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