{"id":52439,"date":"2023-05-11T20:12:41","date_gmt":"2023-05-11T20:12:41","guid":{"rendered":"https:\/\/www.freedomfrommedom.com\/wp3\/?p=52439"},"modified":"2023-05-11T20:12:41","modified_gmt":"2023-05-11T20:12:41","slug":"benzodiazepines-and-opioids","status":"publish","type":"post","link":"https:\/\/www.freedomfrommedom.com\/wp3\/believe\/benzodiazepines-and-opioids","title":{"rendered":"Benzodiazepines and Opioids"},"content":{"rendered":"<div class=\"above-content relative\">\n<div id=\"block-nidapagetitle\">\n<div class=\"page-banner\">\n<div class=\"page-banner--title\">\n<p class=\"h1\"><span style=\"font-size: 16px;\">Taking opioids in combination with other central nervous system depressants\u2014like benzodiazepines, alcohol, or <\/span><a style=\"font-size: 16px;\" href=\"https:\/\/nida.nih.gov\/drug-topics\/xylazine\">xylazine<\/a><span style=\"font-size: 16px;\">\u2014increases the risk of life-threatening overdose.<\/span><a style=\"font-size: 16px;\" href=\"https:\/\/nida.nih.gov\/research-topics\/opioids\/benzodiazepines-opioids#Reference\"><sup>1,2<\/sup><\/a><span style=\"font-size: 16px;\">\u00a0Learn more about\u00a0<\/span><a style=\"font-size: 16px;\" href=\"https:\/\/www.cdc.gov\/stopoverdose\/polysubstance-use\/index.html\">the effects of taking more than one type of drug (polysubstance use)<\/a><span style=\"font-size: 16px;\">\u00a0from the U.S. Centers for Disease Control and Prevention (CDC).<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"main-wrapper\">\n<div class=\"layout-center-content \">\n<div class=\"content-river\">\n<div id=\"block-nida-vic-adaptive-system-main\">\n<article role=\"article\" data-history-node-id=\"21651\">\n<div>\n<div class=\"align-right colorbox-medium\">\n<div class=\"media-image\">\n<div><a class=\"colorbox cboxElement\" title=\"\" role=\"button\" href=\"https:\/\/i0.wp.com\/nida.nih.gov\/sites\/default\/files\/images\/NIDA_DrugOverdoseDeathsInvolvingOpioids_LineGraph.jpg?ssl=1\" aria-controls=\"colorbox\" aria-label=\"{&quot;alt&quot;:&quot;National overdose deaths involving any opioid, by Benzodiazepine involvement - All ages 2000-2020. Any opioid deaths: 68,630. Any opioid and benzodiazepines deaths: 10,771&quot;}\" data-colorbox-gallery=\"gallery-all-aPDrnZi3Ry4\" data-cbox-img-attrs=\"{&quot;alt&quot;:&quot;National overdose deaths involving any opioid, by Benzodiazepine involvement - All ages 2000-2020. Any opioid deaths: 68,630. Any opioid and benzodiazepines deaths: 10,771&quot;}\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" src=\"https:\/\/i0.wp.com\/nida.nih.gov\/sites\/default\/files\/styles\/content_image_medium\/public\/images\/NIDA_DrugOverdoseDeathsInvolvingOpioids_LineGraph.jpg?resize=426%2C351&#038;ssl=1\" alt=\"National overdose deaths involving any opioid, by Benzodiazepine involvement - All ages 2000-2020. Any opioid deaths: 68,630. Any opioid and benzodiazepines deaths: 10,771\" width=\"426\" height=\"351\" \/><\/a><\/div>\n<\/div>\n<\/div>\n<p>In 2021, nearly 14% of overdose deaths\u00a0involving opioids also involved benzodiazepines, a type of prescription sedative commonly prescribed for anxiety or to help with insomnia.<a href=\"https:\/\/nida.nih.gov\/research-topics\/opioids\/benzodiazepines-opioids#Reference\"><sup>3<\/sup><\/a>\u00a0Benzodiazepines (sometimes called &#8220;benzos&#8221;) work to calm or sedate a person, by raising the level of the inhibitory neurotransmitter GABA in the brain. Common benzodiazepines include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin), among others.<\/p>\n<p>Researchers have also found benzodiazepines in the illicit opioid supply in some areas, which may mean that people are taking benzodiazepines in combination with illicit opioids knowingly or unknowingly.<a href=\"https:\/\/nida.nih.gov\/research-topics\/opioids\/benzodiazepines-opioids#Reference\"><sup>2<\/sup><\/a><\/p>\n<h2><span style=\"font-size: 14pt; color: #c7b087;\">Co-Prescribing Opioids and Benzodiazepines<\/span><\/h2>\n<p>Every day, approximately 220 Americans die after overdosing on opioids.<a href=\"https:\/\/nida.nih.gov\/research-topics\/opioids\/benzodiazepines-opioids#Reference\"><sup>3<\/sup><\/a>\u00a0 Combining opioids and benzodiazepines can increase risk of overdose because both types of drugs can cause sedation and suppress breathing\u2014the cause of overdose fatality\u2014in addition to impairing cognitive functions. Research shows that people who use opioids and benzodiazepines concurrently are at higher risk of visiting the emergency department, being admitted to a hospital for a drug-related emergency, and dying of drug overdose.<a href=\"https:\/\/nida.nih.gov\/research-topics\/opioids\/benzodiazepines-opioids#Reference\"><sup>4,5<\/sup><\/a><\/p>\n<p>For example, a cohort study in North Carolina found that the overdose death rate among patients receiving both types of medications was 10 times higher than among those only receiving opioids.<a href=\"https:\/\/nida.nih.gov\/research-topics\/opioids\/benzodiazepines-opioids#Reference\"><sup>6<\/sup><\/a>\u00a0A study among U.S. veterans with an opioid prescription found that receiving a benzodiazepine prescription was associated with increased risk of drug overdose death in a dose-dependent manner.<a href=\"https:\/\/nida.nih.gov\/research-topics\/opioids\/benzodiazepines-opioids#Reference\"><sup>7<\/sup><\/a><\/p>\n<p>The Centers for Disease Control and Prevention (CDC)\u00a0<a href=\"https:\/\/www.cdc.gov\/mmwr\/volumes\/71\/rr\/rr7103a1.htm?s_cid=rr7103a1_w\">Clinical Practice Guideline for Prescribing Opioids for Pain<\/a>\u00a0recommends that clinicians use particular caution when prescribing benzodiazepines concurrently with opioids and consider whether benefits outweigh risks.<a href=\"https:\/\/nida.nih.gov\/research-topics\/opioids\/benzodiazepines-opioids#Reference\"><sup>8<\/sup><\/a>\u00a0 Both prescription opioids and benzodiazepines now carry U.S. Food and Drug Administration\u00a0<a href=\"https:\/\/clinicalinfo.hiv.gov\/en\/glossary\/boxed-warning#:~:text=The%20strongest%20form%20of%20warning,on%20use%20of%20a%20drug.\"><i>boxed\u00a0warnings<\/i><\/a><i>\u00a0<\/i>on their labels highlighting the potential dangers of using these drugs together.<\/p>\n<p>People being prescribed any medication should disclose all other substances and medications they use and consult with their health care teams about avoiding or managing the risks of using certain medications and substances in combination.<\/p>\n<h2 class=\"source\"><span style=\"font-size: 14pt; color: #c7b087;\">References<\/span><\/h2>\n<ol>\n<li>Liu S, O&#8217;Donnell J, Gladden RM, McGlone L, Chowdhury F.\u00a0<a class=\"ext\" href=\"https:\/\/doi.org\/10.15585\/mmwr.mm7034a2\" target=\"_blank\" rel=\"noopener noreferrer\" data-extlink=\"\">Trends in nonfatal and fatal overdoses involving benzodiazepines\u201438 States and the District of Columbia, 2019-2020<\/a>.\u00a0<i>MMWR Morb Mortal Wkly Rep<\/i>. 2021;70(34):1136-1141. Published 2021 Aug 27. doi:10.15585\/mmwr.mm7034a2<\/li>\n<li>Laing MK, Ti L, Marmel A, et al.\u00a0<a class=\"ext\" href=\"https:\/\/doi.org\/10.1016\/j.drugpo.2021.103169\" target=\"_blank\" rel=\"noopener noreferrer\" data-extlink=\"\">An outbreak of novel psychoactive substance benzodiazepines in the unregulated drug supply: Preliminary results from a community drug checking program using point-of-care and confirmatory methods<\/a>.\u00a0<i>Int J Drug Policy<\/i>. 2021;93:103169. doi:10.1016\/j.drugpo.2021.103169<\/li>\n<li>CDC WONDER. Multiple Cause of Death 1999-2021. Centers for Disease Control and Prevention, National Center on Health Statistics. Released January 2023. Accessed January 2023.<\/li>\n<li>Bachhuber MA, Hennessy S, Cunningham CO, Starrels JL.\u00a0<a class=\"ext\" href=\"https:\/\/doi.org\/10.2105\/ajph.2016.303061\" target=\"_blank\" rel=\"noopener noreferrer\" data-extlink=\"\">Increasing benzodiazepine prescriptions and overdose mortality in the United States, 1996-2013<\/a>.\u00a0<i>Am J Public Health<\/i>. 2016;106(4):686-688. doi:10.2105\/AJPH.2016.303061<\/li>\n<li>Sun EC, Dixit A, Humphreys K, Darnall BD, Baker LC, Mackey S.\u00a0<a class=\"ext\" href=\"https:\/\/doi.org\/10.1136\/bmj.j760\" target=\"_blank\" rel=\"noopener noreferrer\" data-extlink=\"\">Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis<\/a>.\u00a0<i>BMJ<\/i>. 2017;356:j760. Published 2017 Mar 14. doi:10.1136\/bmj.j760<\/li>\n<li>Dasgupta N, Funk MJ, Proescholdbell S, Hirsch A, Ribisl KM, Marshall S.\u00a0<a class=\"ext\" href=\"https:\/\/doi.org\/10.1111\/pme.12907\" target=\"_blank\" rel=\"noopener noreferrer\" data-extlink=\"\">Cohort study of the impact of high-dose opioid analgesics on overdose mortality<\/a>.\u00a0<i>Pain Med<\/i>. 2016;17(1):85-98. doi:10.1111\/pme.12907<\/li>\n<li>Park TW, Saitz R, Ganoczy D, Ilgen MA, Bohnert AS.\u00a0<a class=\"ext\" href=\"https:\/\/doi.org\/10.1136\/bmj.h2698\" target=\"_blank\" rel=\"noopener noreferrer\" data-extlink=\"\">Benzodiazepine prescribing patterns and deaths from drug overdose among US veterans receiving opioid analgesics: case-cohort study<\/a>.\u00a0<i>BMJ<\/i>. 2015;350:h2698. Published 2015 Jun 10. doi:10.1136\/bmj.h2698<\/li>\n<li>Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R.\u00a0<a href=\"https:\/\/www.cdc.gov\/mmwr\/volumes\/71\/rr\/rr7103a1.htm?s_cid=rr7103a1_w\">CDC clinical practice guideline for prescribing opioids for pain \u2014 United States, 2022<\/a>.\u00a0<i>MMWR Recomm Rep\u00a0<\/i>2022;71(No. RR-3):1\u201395. doi: 10.15585\/mmwr.rr7103a1<\/li>\n<\/ol>\n<\/div>\n<div class=\"article-meta pt-1-2\">\n<div class=\"meta-data text-small\"><span class=\"date\"><time datetime=\"2022-11-07T12:00:00Z\">November 7, 2022<\/time><\/span><\/div>\n<\/div>\n<\/article>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Taking opioids in combination with other central nervous system depressants\u2014like benzodiazepines, alcohol, or xylazine\u2014increases the risk of life-threatening overdose.1,2\u00a0Learn more about\u00a0the effects of taking more than one type of drug (polysubstance use)\u00a0from the U.S. Centers for Disease Control and Prevention &hellip; <a href=\"https:\/\/www.freedomfrommedom.com\/wp3\/believe\/benzodiazepines-and-opioids\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[4],"tags":[],"class_list":["post-52439","post","type-post","status-publish","format-standard","hentry","category-believe"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_likes_enabled":false,"_links":{"self":[{"href":"https:\/\/www.freedomfrommedom.com\/wp3\/wp-json\/wp\/v2\/posts\/52439","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.freedomfrommedom.com\/wp3\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.freedomfrommedom.com\/wp3\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.freedomfrommedom.com\/wp3\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.freedomfrommedom.com\/wp3\/wp-json\/wp\/v2\/comments?post=52439"}],"version-history":[{"count":1,"href":"https:\/\/www.freedomfrommedom.com\/wp3\/wp-json\/wp\/v2\/posts\/52439\/revisions"}],"predecessor-version":[{"id":52440,"href":"https:\/\/www.freedomfrommedom.com\/wp3\/wp-json\/wp\/v2\/posts\/52439\/revisions\/52440"}],"wp:attachment":[{"href":"https:\/\/www.freedomfrommedom.com\/wp3\/wp-json\/wp\/v2\/media?parent=52439"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.freedomfrommedom.com\/wp3\/wp-json\/wp\/v2\/categories?post=52439"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.freedomfrommedom.com\/wp3\/wp-json\/wp\/v2\/tags?post=52439"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}