The misuse of drugs is a growing public health concern, and the dangers associated with combining different substances are particularly alarming. Taking opioids alongside other central nervous system depressants, most notably Benzo Drugs (benzodiazepines), significantly elevates the risk of life-threatening overdose. This dangerous combination demands increased awareness and caution, especially given the prevalence of both types of medications and the potential for unintentional polysubstance use. Organizations like the Centers for Disease Control and Prevention (CDC) are actively working to educate the public about the risks of polysubstance use, including the potentially fatal interaction between opioids and benzo drugs.
In 2021, alarming statistics revealed that nearly 14% of all overdose deaths involving opioids also implicated benzo drugs. Benzo drugs, commonly known as benzodiazepines or “benzos,” are a class of prescription sedatives frequently prescribed to manage anxiety disorders and insomnia. These medications, including well-known names like diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin), exert their calming and sedative effects by enhancing the activity of GABA, an inhibitory neurotransmitter in the brain. This mechanism of action, while therapeutically beneficial for certain conditions, becomes hazardous when coupled with opioids.
Furthermore, disturbing research has uncovered the presence of benzo drugs within the illicit opioid supply in certain regions. This unsettling discovery suggests that individuals may be unknowingly or knowingly consuming benzo drugs in conjunction with illicit opioids, further compounding the risks associated with this polysubstance use.
The Perilous Practice of Co-Prescribing Opioids and Benzo Drugs
Every single day, approximately 220 lives are lost in the United States due to opioid overdose. The concurrent use of opioids and benzo drugs drastically escalates the likelihood of overdose because both drug classes share the capacity to induce profound sedation and suppress respiratory function. Respiratory depression, the slowing or cessation of breathing, is the primary cause of fatality in overdose situations. Beyond the immediate risk of overdose, combining these substances also impairs cognitive functions, increasing the potential for accidents and injuries. Research consistently demonstrates that individuals who use opioids and benzo drugs simultaneously face a significantly elevated risk of emergency department visits, hospitalization for drug-related emergencies, and ultimately, death by drug overdose.
For instance, a comprehensive cohort study conducted in North Carolina revealed a stark reality: the overdose death rate among patients prescribed both opioids and benzo drugs was a staggering ten times higher compared to those solely receiving opioids. Another study focusing on U.S. veterans with opioid prescriptions further corroborated these findings, establishing a clear link between benzodiazepine prescriptions and an increased, dose-dependent risk of drug overdose death.
Recognizing the gravity of this issue, the Centers for Disease Control and Prevention (CDC) has issued explicit recommendations in their Clinical Practice Guideline for Prescribing Opioids for Pain. The CDC strongly advises clinicians to exercise extreme caution when considering the co-prescription of benzo drugs and opioids, emphasizing a careful evaluation of whether the potential benefits outweigh the significant risks. Adding to the urgency, both prescription opioids and benzo drugs now carry U.S. Food and Drug Administration (FDA) boxed warnings prominently displayed on their labels. These boxed warnings, the FDA’s most stringent form of warning, underscore the severe and potentially life-threatening dangers associated with the combined use of these medications.
It is therefore crucial for anyone prescribed any medication to openly communicate with their healthcare providers about all other substances and medications they are using. This transparent disclosure enables healthcare teams to effectively assess and mitigate the risks associated with combining certain medications and substances, ensuring patient safety and preventing potentially fatal consequences of drug interactions, particularly involving benzo drugs and opioids.
