Concurrent Opioids and Benzodiazepines Raise Risk of Overdose, esp. Early On

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MedicalResearch.com Interview with:

Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh, PA 15261

Dr. Hernandez

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.

Citation:

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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One thought on “Concurrent Opioids and Benzodiazepines Raise Risk of Overdose, esp. Early On

  1. World Benzodiazepine Awareness Day (W-BAD) is held annually on July 11 to help raise awareness about the dangers of these drugs (Xanax, Klonopin, Valium etc).

    The official website contains a wealth of information for victims, medical workers, caregivers and the general public…

    Join us on July 11 to help raise much needed awareness

    Official Website
    http://w-bad.org/

    Press Packet
    http://w-bad.org/wp-content/uploads/2017/04/FINAL-PRESS-PACKET.pdf

    Official W-BAD Video
    https://www.youtube.com/watch?v=ZJZE6_z3-Tw

    Facebook Page
    https://www.facebook.com/WorldBenzoDay/

    YouTube library
    https://www.youtube.com/watch?v=y1FrgpK7qUI&t=16s
    https://www.youtube.com/watch?v=XXSx1ggH4W8&t=656s
    https://www.youtube.com/channel/UCNEGYpppRPuaKg1uuSJHAbg/playlists
    https://www.youtube.com/channel/UCNEGYpppRPuaKg1uuSJHAbg/videos

    Twitter
    https://twitter.com/WorldBenzoDay

    Language Matters
    http://w-bad.org/addiction-dependency/

    NB: W-BAD does not seek to restrict access to these drugs for those who feel that they may benefit from them, nor does it seek to force anyone to stop or reduce against their own will. W-BAD is not associated with the illicit use or abuse of benzodiazepines which is a completely separate issue from iatrogenic physical dependence.
    http://w-bad.org/what/

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