Combining opioids with other central nervous system (CNS) depressants, especially Benzo Medications like benzodiazepines, significantly elevates the risk of a life-threatening overdose. This dangerous interaction is a critical concern in public health, as highlighted by the U.S. Centers for Disease Control and Prevention (CDC). It’s essential to understand the risks associated with polysubstance use, particularly the combination of opioids and benzo medications.
In 2021, alarming statistics revealed that nearly 14% of opioid overdose fatalities also involved benzodiazepines. These benzo medications, commonly prescribed to manage anxiety and insomnia, include well-known drugs such as diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin). Benzodiazepines, often referred to as “benzos,” work by enhancing the effects of GABA, a neurotransmitter that calms brain activity.
Adding to the complexity, researchers have detected benzodiazepines in the illegal opioid supply in certain regions. This indicates that individuals might be unknowingly consuming benzo medications alongside illicit opioids, further compounding the risks of overdose.
The Dangers of Co-Prescribing Opioids and Benzo Medications
Every day, approximately 220 lives are lost in the United States due to opioid overdoses. The concurrent use of opioids and benzo medications intensifies the overdose risk because both drug classes can induce sedation and respiratory depression – the primary cause of overdose deaths. Furthermore, this combination impairs cognitive functions, increasing overall danger.
Studies consistently demonstrate that individuals using both opioids and benzo medications face a heightened risk of emergency department visits, hospital admissions for drug-related emergencies, and fatal overdoses.
For instance, research conducted in North Carolina revealed a startling statistic: the overdose death rate among patients prescribed both opioids and benzo medications was ten times higher compared to those only receiving opioids. Similarly, a study focusing on U.S. veterans with opioid prescriptions found a direct correlation between benzodiazepine prescriptions and an increased risk of overdose death, with the risk escalating with higher doses of benzo medications.
Recognizing these severe risks, the CDC’s Clinical Practice Guideline for Prescribing Opioids for Pain strongly advises clinicians to exercise extreme caution when prescribing benzo medications and opioids together. The guideline emphasizes a careful evaluation of whether the benefits of co-prescription outweigh the significant risks. Both prescription opioids and benzodiazepines now carry “boxed warnings” from the U.S. Food and Drug Administration (FDA) on their labels, explicitly highlighting the potential hazards of combining these medications. These boxed warnings are the FDA’s most stringent safety alerts.
It is crucial for anyone prescribed any medication to openly communicate with their healthcare providers about all substances and medications they are using. This transparency is vital for healthcare teams to effectively manage and mitigate the risks associated with combining certain medications and substances, especially benzo medications and opioids.
