The use of benzodiazepines, such as Xanax and Valium, may increase the risk of an opioid overdose, according to the findings of new research.
In a study published earlier this month in the medical journal The BMJ, researchers indicate that patients using benzodiazepines and opioid pain medications at the same time were more likely to need medical care in an emergency room or be admitted to the hospital for opioid overdose.
Researchers from Stanford University School of Medicine conducted a retrospective analysis of administrative health claims from 2001 to 2013 from database information. It focused on concurrent benzodiazepine and opioid use.
Data for more than 315,000 privately insured patients ages 18 to 64 who were continuously enrolled in a health plan with medical and pharmacy benefits were examined during the study period. Patients filled at least one prescription for an opioid. Concurrent use was defined as an overlap of at least one day during prescription use.
In 2001, nine percent of narcotic painkiller users also used benzodiazepines, such as Valium and Xanax. That number increased to 17% by 2013.
The study indicated patients who used both opioids and benzodiazepines simultaneously had an increased risk of emergency room visit or hospital admission for opioid overdose.
Nearly 30% of fatal opioid overdoses involve benzodiazepines. This study indicated those two are often used together, increasing the odds of a fatal overdose. The FDA issued a black box warning in 2016 for the combined use of the two drugs, citing severe health risks, including death.
Study authors said eliminating concurrent use of opioids and benzodiazepines could help reduce the risk of ER visits and hospital admissions for opioid overdose by 15%.
Researchers note that other studies have shown 47% of patients in methadone treatments in Spain, 52% of methadone patients in Switzerland, and high rates of heroin users in Australia also use benzodiazepines at the same time.
Nearly 30% of Veterans Health Administration patients who were prescribed opioids also received prescriptions for benzodiazepines at the same time, according to the findings.
Media attention focusing on narcotic painkiller use has increased as the opioid overdose epidemic has worsened, as use of high-potency opioids, like OxyContin, increased dramatically.
Researchers said the increase in concurrent benzodiazepine use was mainly driven by an increased use of opioids among intermittent users, or users who were not chronic users.
Benzodiazepines, like Xanax, are a class of drugs that work on the brain’s neurotransmitters. They cause sedative and hypnotic effects and are often used to treat anxiety, insomnia and seizures. Benzodiazepines also increase the effects opioids have on depressing respiratory function.