Taking opioids with other central nervous system depressants, such as benzodiazepines like Xanax, significantly raises the risk of a life-threatening overdose. This combination amplifies the dangers, making it critical to understand the risks involved. The Centers for Disease Control and Prevention (CDC) provides further information on the effects of polysubstance use, highlighting the dangers of mixing different types of drugs.
Image: Trend of opioid overdose deaths with and without benzodiazepine involvement in the United States from 2000 to 2020, illustrating the increased risk associated with combined use.
In 2021, almost 14% of opioid overdose deaths also involved benzodiazepines. Benzodiazepines, commonly known as “benzos,” are prescription sedatives used to treat anxiety and insomnia. Xanax, with the generic name alprazolam, is a well-known example of a benzodiazepine. These drugs work by increasing the levels of GABA, an inhibitory neurotransmitter in the brain, which leads to a calming and sedative effect. Other common benzodiazepines include diazepam (Valium) and clonazepam (Klonopin).
It’s concerning that researchers have found benzodiazepines in the illegal opioid supply in certain areas. This suggests that individuals might be unknowingly or knowingly consuming benzodiazepines along with illicit opioids.
The Heightened Danger of Co-Prescribing Opioids and Benzodiazepines
Every day, approximately 220 Americans succumb to opioid overdoses. Combining opioids and benzodiazepines, including Xanax, dramatically increases the overdose risk. Both drug types can cause sedation and respiratory depression, which is the primary cause of overdose fatalities. Furthermore, this combination impairs cognitive functions, intensifying the danger. Studies indicate that individuals who concurrently use opioids and benzodiazepines face a higher risk of emergency room visits, hospital admissions for drug-related emergencies, and fatal drug overdoses.
For instance, a study conducted in North Carolina revealed that the overdose death rate among patients prescribed both opioids and benzodiazepines was ten times higher compared to those only receiving opioids. Similarly, research on U.S. veterans with opioid prescriptions found that a benzodiazepine prescription was linked to an elevated risk of overdose death, and this risk increased with dosage.
The CDC’s Clinical Practice Guideline for Prescribing Opioids for Pain emphasizes the need for caution when prescribing benzodiazepines alongside opioids. Clinicians are urged to carefully consider whether the benefits of this combination outweigh the significant risks. Both prescription opioids and benzodiazepines now carry boxed warnings from the U.S. Food and Drug Administration on their labels, highlighting the serious dangers of using these drugs in combination.
Individuals prescribed any medication must inform their healthcare providers about all other substances and medications they are using. Consulting with healthcare teams is crucial for managing or avoiding the risks associated with combining certain medications and substances.
