Combining opioids with other central nervous system depressants, especially benzodiazepines (often called “Benzo Drugs”), significantly elevates the risk of a life-threatening overdose. This dangerous combination is further compounded when mixed with alcohol or substances like xylazine. Understanding the risks of polysubstance use, particularly involving benzo drugs, is crucial for preventing tragic outcomes.
In 2021, alarming statistics revealed that nearly 14% of opioid overdose fatalities also involved benzodiazepines. Benzo drugs, commonly prescribed sedatives, are used to manage anxiety and insomnia. These medications, including diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin), work by increasing the levels of GABA, an inhibitory neurotransmitter, in the brain, leading to a calming or sedative effect. Adding to the concern, benzo drugs have been detected in the illicit opioid supply in certain regions, meaning individuals might unknowingly consume them alongside illicit opioids.
The Heightened Overdose Risk with Benzo Drugs and Opioids
Every day, approximately 220 lives are lost in the United States due to opioid overdoses. The concurrent use of opioids and benzo drugs dramatically escalates overdose risk because both drug types induce sedation and respiratory depression – the primary cause of overdose deaths – in addition to impairing cognitive functions. Research consistently demonstrates that individuals using opioids and benzo drugs together face a significantly higher likelihood of emergency department visits, hospitalization for drug-related emergencies, and fatal overdose.
A North Carolina cohort study highlighted a stark reality: the overdose death rate among patients prescribed both opioids and benzo drugs was ten times greater than those only receiving opioids. Similarly, a study focusing on U.S. veterans with opioid prescriptions found that receiving a benzo drug prescription was linked to an increased risk of overdose death, with the risk escalating with higher doses of benzodiazepines.
The Centers for Disease Control and Prevention (CDC) guidelines for prescribing opioids for pain emphasize the critical need for caution when prescribing benzo drugs alongside opioids. Clinicians are urged to carefully evaluate if the benefits of co-prescribing outweigh the substantial risks. Both prescription opioids and benzo drugs now carry U.S. Food and Drug Administration “boxed warnings” on their labels, the agency’s most stringent warning, clearly stating the potential dangers of combining these medications.
It is vital for anyone prescribed medication to openly communicate with their healthcare team about all substances and medications they are using. This transparency is crucial for healthcare providers to help patients avoid or effectively manage the serious risks associated with combining certain medications, especially the dangerous combination of benzo drugs and opioids.
