Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis
Top Cited Papers
Open Access
- 14 March 2017
- Vol. 356, j760
- https://doi.org/10.1136/bmj.j760
Abstract
Objectives To identify trends in concurrent use of a benzodiazepine and an opioid and to identify the impact of these trends on admissions to hospital and emergency room visits for opioid overdose. Design Retrospective analysis of claims data, 2001-13. Setting Administrative health claims database. Participants 315 428 privately insured people aged 18-64 who were continuously enrolled in a health plan with medical and pharmacy benefits during the study period and who also filled at least one prescription for an opioid. Interventions Concurrent benzodiazepine/opioid use, defined as an overlap of at least one day in the time periods covered by prescriptions for each drug. Main outcome measures Annual percentage of opioid users with concurrent benzodiazepine use; annual incidence of visits to emergency room and inpatient admissions for opioid overdose. Results 9% of opioid users also used a benzodiazepine in 2001, increasing to 17% in 2013 (80% relative increase). This increase was driven mainly by increases among intermittent, as opposed to chronic, opioid users. Compared with opioid users who did not use benzodiazepines, concurrent use of both drugs was associated with an increased risk of an emergency room visit or inpatient admission for opioid overdose (adjusted odds ratio 2.14, 95% confidence interval 2.05 to 2.24; PConclusions From 2001 to 2013, concurrent benzodiazepine/opioid use sharply increased in a large sample of privately insured patients in the US and significantly contributed to the overall population risk of opioid overdose.Keywords
This publication has 39 references indexed in Scilit:
- Benzodiazepine prescribing patterns and deaths from drug overdose among US veterans receiving opioid analgesics: case-cohort studyBMJ, 2015
- Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 20122014
- Concurrent Use of Alcohol and Sedatives Among Persons Prescribed Chronic Opioid Therapy: Prevalence and Risk FactorsThe Journal of Pain, 2012
- Out-of-Pocket Medication Costs and Use of Medications and Health Care Services Among Children With AsthmaJAMA, 2012
- Opioid Dose and Drug-Related Mortality in Patients With Nonmalignant PainArchives of Internal Medicine, 2011
- Updating and Validating the Charlson Comorbidity Index and Score for Risk Adjustment in Hospital Discharge Abstracts Using Data From 6 CountriesAmerican Journal of Epidemiology, 2011
- Clinical characteristics of veterans prescribed high doses of opioid medications for chronic non-cancer painPain, 2010
- [Benzodiazepine use in a sample of patients on a treatment program with opiate derivatives (PTDO)].2009
- Assessing the Sensitivity of Regression Results to Unmeasured Confounders in Observational StudiesPublished by JSTOR ,1998
- Benzodiazepine use and HIV risk-taking behaviour among injecting drug usersDrug and Alcohol Dependence, 1992