Combining “Benzo Pills,” also known as benzodiazepines, with opioids significantly elevates the risk of a life-threatening overdose. This dangerous combination amplifies the depressant effects on the central nervous system, potentially leading to fatal respiratory issues. It’s crucial to understand the risks of polysubstance use, especially when “benzo pills” are involved with opioids.
In 2021, benzodiazepines were implicated in almost 14% of opioid-related overdose deaths. “Benzo pills,” prescribed for anxiety and insomnia, include common medications such as diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin). These drugs work by increasing GABA levels in the brain, resulting in sedation and calming effects. Alarmingly, benzodiazepines have been detected in the illicit opioid supply, meaning individuals might unknowingly consume “benzo pills” alongside illicit opioids.
The Danger of Combining Opioids and “Benzo Pills”
Every day, approximately 220 Americans succumb to opioid overdoses. The concurrent use of opioids and “benzo pills” intensifies overdose risk because both drug types induce sedation and respiratory depression – the primary cause of overdose fatalities. Furthermore, this combination impairs cognitive functions, escalating the danger. Research indicates that individuals using both opioids and benzodiazepines face a heightened risk of emergency room visits, hospital admissions for drug-related emergencies, and fatal overdoses.
A study conducted in North Carolina highlighted a stark reality: the overdose death rate among patients prescribed both opioids and “benzo pills” was ten times higher compared to those only on opioids. Similarly, research involving U.S. veterans with opioid prescriptions revealed a dose-dependent correlation between benzodiazepine prescriptions and an increased risk of overdose death. The higher the dose of “benzo pills,” the greater the overdose risk when combined with opioids.
The Centers for Disease Control and Prevention (CDC) provides explicit guidance in its Clinical Practice Guideline for Prescribing Opioids for Pain, urging clinicians to exercise extreme caution when prescribing benzodiazepines with opioids. The guideline emphasizes a careful evaluation of whether the benefits of co-prescription outweigh the significant risks. Reflecting the severity of these risks, both prescription opioids and “benzo pills” now carry FDA “boxed warnings” on their labels, the agency’s most stringent warning, highlighting the severe dangers of using these medications together.
It is paramount for individuals prescribed any medication to fully disclose all other substances and medications they are using. Consulting with healthcare providers about the potential risks of combining medications, especially “benzo pills” and opioids, is crucial for managing and mitigating these dangers.
References
[1] National Institute on Drug Abuse. (2023, March 21). Benzodiazepines and Opioids. National Institutes of Health. https://nida.nih.gov/drug-topics/opioids/benzodiazepines-opioids
[2] National Institute on Drug Abuse. (2023, May 30). Xylazine. National Institutes of Health. https://nida.nih.gov/drug-topics/xylazine
[3] Centers for Disease Control and Prevention. (2023, March 17). Overdose Deaths Involving Opioids, Benzodiazepines, and Cocaine — United States, 2021. MMWR. Morbidity and Mortality Weekly Report, 72(11), 293–301. https://doi.org/10.15585/mmwr.mm7211a1
[4] Park, T. W., Saitz, R., Ganoczy, D., Ilgen, M. A., & Bohnert, A. S. B. (2015). Benzodiazepine prescribing patterns and deaths from drug overdose among US veterans receiving opioid analgesics: case-cohort study. BMJ, 350, h2698. https://doi.org/10.1136/bmj.h2698
[5] Gomes, T., Juurlink, D. N., Dhalla, I. A., Mailis-Gagnon, A., Paterson, J. M., & Mamdani, M. M. (2011). Co-prescription of opioids and benzodiazepines and risk of mortality from drug overdose. JAMA internal medicine, 171(8), 730–736. https://doi.org/10.1001/archinternmed.2011.117
[6] Dasgupta, N., Funk, M. J., Proescholdbell, S., Hirsch, D. E., & Ribisl, K. M. (2011). Cohort study of the impact of high-dose opioid analgesics on overdose mortality. Pain medicine (Malden, Mass.), 12(1), 73–81. https://doi.org/10.1111/j.1526-4637.2010.01020.x
[7] Park, T. W., et al. (2015). BMJ, 350, h2698. (Reference repeated for clarity as in original text structure).
[8] Dowell, D., Ragan, K. R., Jones, C. M., Baldwin, G. T., & Chou, R. (2022). CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR. Recommendations and Reports, 71(No. 3), 1–95. https://doi.org/10.15585/mmwr.rr7103a1
