25 Jun Concurrent Opioids and Benzodiazepines Raise Risk of Overdose, esp. Early On
MedicalResearch.com Interview with:
Inmaculada Hernandez, PharmD, PhD
Assistant Professor of Pharmacy and Therapeutics
University of Pittsburgh School of Pharmacy
Pittsburgh, PA 15261
MedicalResearch.com: What is the background for this study?
Response: Prior research has found that taking opioids and benzodiazepines simultaneously increases the risk of overdose by 2 to 3 fold, when compared to opioid-use only.
However, prior to our study, it was unclear how the risk of overdose changes over time with the concurrent use of opioids and benzodiazepines.
MedicalResearch.com: What are the main findings?
Response: We found that, on the first 90 days that opioid users take benzodiazepines concurrently, the risk of overdose is 5 times higher, compared to opioid-use only. On the 90-180 days of concurrent opioid and benzodiazepine use, the risk of overdose is double.
After 180 days of concurrent use, the risk of overdose was no higher than the risk for opioid-only use. In addition, we noted that the number of opioid and benzodiazepine providers increased the probability of concurrent use of both medications as well as the risk of overdose.
MedicalResearch.com: What should readers take away from your report?
Response: Our findings had 3 main take-away points.
First, because the risk of overdose is highest on the first days with concurrent benzodiazepine use, clinicians should avoid prescribing benzodiazepines to patients taking opioids.
Second, in those cases where the concurrent use of both medications is medically necessary, patients should be closely monitored for signs of overdose, particularly on the first 3 months of concurrent use.
Third, rather than penalizing the long-term concurrent use of both medications, policy interventions should try to prevent the concurrent use of opioids and benzodiazepines in the first place.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future research should further assess how the risk of overdose in patients taking opioids and benzodiazepines concurrently differs depending on the specific drugs used and their strength. Additionally, future studies should evaluate the effectiveness of policy interventions designed to reduce high-risk use in the prevention of concurrent opioid and benzodiazepine use.
Any disclosures? None of the authors of the paper have any conflict of interest.
Hernandez I, He M, Brooks MM, Zhang Y. Exposure-Response Association Between Concurrent Opioid and Benzodiazepine Use and Risk of Opioid-Related Overdose in Medicare Part D Beneficiaries. JAMA Network Open. 2018;1(2):e180919. doi:10.1001/jamanetworkopen.2018.0919
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