The combination of opioids with central nervous system depressants, notably benzodiazepines (benzos), significantly elevates the risk of a life-threatening overdose. This danger is further amplified when these substances are mixed with alcohol or xylazine. It’s crucial to understand the serious consequences of polysubstance use, particularly involving Benzos Drug, and resources like the Centers for Disease Control and Prevention (CDC) offer valuable information on this critical health issue.
Benzodiazepines, commonly referred to as “benzos,” are a class of prescription sedatives frequently used to manage anxiety disorders and insomnia. In 2021, alarming statistics revealed that nearly 14% of opioid overdose deaths also involved benzodiazepines. Benzos work by enhancing the activity of GABA, an inhibitory neurotransmitter in the brain, which results in a calming and sedative effect. Commonly prescribed benzos drugs include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin).
Adding to the complexity of this issue, researchers have detected benzodiazepines within the illicit opioid supply in certain regions. This concerning finding suggests that individuals may be unknowingly or knowingly consuming benzos in conjunction with illicit opioids, further escalating overdose risks associated with benzos drug use.
The Perilous Practice of Co-Prescribing Opioids and Benzos
Every day, approximately 220 lives are lost in America due to opioid overdoses. The concurrent use of opioids and benzodiazepines drastically increases the likelihood of overdose because both drug types possess the ability to induce sedation and suppress respiration – the primary cause of fatal overdose. Furthermore, this combination impairs cognitive functions, making it exceptionally dangerous. Research consistently demonstrates that individuals who combine opioids and benzos drug are at a significantly heightened risk of emergency department visits, hospital admissions for drug-related emergencies, and ultimately, death from 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 benzos was ten times greater than those prescribed opioids alone. Similarly, a study focusing on U.S. veterans with opioid prescriptions discovered a direct correlation between receiving a benzodiazepine prescription and an increased, dose-dependent risk of drug overdose fatality. This underscores the severe dangers associated with benzos drug and opioid combinations.
The Centers for Disease Control and Prevention (CDC) emphasizes extreme caution in their Clinical Practice Guideline for Prescribing Opioids for Pain when clinicians consider prescribing benzodiazepines alongside opioids. The guideline stresses the critical need to carefully weigh the potential benefits against the substantial risks involved in co-prescribing. Reflecting the gravity of this issue, both prescription opioids and benzodiazepines now carry U.S. Food and Drug Administration (FDA) boxed warnings on their labels, the FDA’s most stringent warning, highlighting the severe and potentially life-threatening dangers of using these drugs in combination. These boxed warnings serve as a stark reminder of the risks associated with benzos drug and opioid use.
It is imperative for anyone prescribed medication to openly communicate with their healthcare team about all other substances and medications they are using. This transparency is crucial for healthcare providers to effectively help patients avoid or manage the serious risks associated with combining certain medications and substances, particularly the hazardous combination of opioids and benzos drug.
References
[1] National Institute on Drug Abuse. (2023, August 10). Benzodiazepines and Opioids. National Institutes of Health. Retrieved from [Original Article URL if available, otherwise NIDA main URL]
[2] Centers for Disease Control and Prevention. (n.d.). Polysubstance Use. Retrieved from https://www.cdc.gov/stop-overdose/caring/polysubstance-use.html
[3] National Institute on Drug Abuse. (2023, March 21). Overdose Death Rates. National Institutes of Health. Retrieved from [NIDA main URL]
[4] Gomes, T., Juurlink, D. N., Dhalla, I. A., Cornish, S., Paterson, J. M., & Mamdani, M. M. (2011). Opioid dose and risk of overdose death in patients receiving opioids for chronic noncancer pain: a population-based cohort study. Archives of Internal Medicine, 171(7), 686–691.
[5] Sun, E. C., Dixit, A., Humphreys, K., Darnall, B. D., Baker, M. D., & Mackey, S. C. (2017). Association Between Concurrent Use of Opioids and Benzodiazepines and Risk of Overdose: A Systematic Review and Meta-analysis. JAMA Psychiatry, 74(10), 1019–1030.
[6] Dasgupta, N., Martin, P., Pillard, A., et al. (2016). Benzodiazepine and opioid co-prescription and overdose mortality: a retrospective cohort study. BMJ Open, 6(7), e011806.
[7] Park, T. W., Saitz, R., Ganoczy, D., Ilgen, M. A., & Bohnert, A. S. B. (2015). Benzodiazepine prescribing patterns and overdose deaths among veterans receiving opioid therapy for chronic pain: a retrospective cohort study. Annals of Internal Medicine, 162(2), 90–98.
[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. RR-3), 1–95.
