Despite Dangers, Docs Continue to Co-Prescribe Benzos, Opioids

Megan Brooks

January 17, 2020

Despite well-known risks and recommendations to the contrary, benzodiazepines and opioids continue to be co-prescribed.

Results of newly released national survey data show that from 2014 to 2016, benzodiazepines were prescribed to adults at approximately 66 million office visits annually, corresponding to a rate of 27 annual visits per 100 adults.

Among office visits at which benzodiazepines were prescribed, more than one third (35%) involved an overlapping opioid prescription, for a rate of 10 annual visits per 100 adults.

Co-prescribing benzodiazepines with opioids is not recommended because of the increased risk for respiratory depression, Loredana Santo, MD, MPH, and colleagues from the US National Center for Health Statistics, of the Centers for Disease Control and Prevention (CDC), note in the report.

Office visits that resulted in a benzodiazepine prescription with or without an opioid were more common in women than men and increased with age.

"The percentage of visits with a new prescription for a benzodiazepine or a new prescription for both a benzodiazepine and an opioid was lower than the percentage of visits with continued prescriptions," the authors note.

A problem related to a chronic condition was the most common reason for visits at which benzodiazepines were prescribed or at which benzodiazepines were co-prescribed with opioids.

Mental disorders were the most common primary diagnosis category for visits at which benzodiazepines were prescribed. Musculoskeletal and connective tissue conditions were the most common primary diagnosis category for visits in which a benzodiazepine and an opioid were prescribed.

A recent study in JAMA Network Open showed that co-prescribing of benzodiazepines with opioids quadrupled from 2003 to 2015, from 0.5% to 2.0%. Co-prescribing with other sedating medications doubled during the study period, from 0.7% in 2003 to 1.5% in 2015, as reported by Medscape Medical News.

In 2017, 11,537 overdose deaths involving benzodiazepines occurred in the United States, according to data from the National Institute on Drug Abuse. About 85% of the 2017 overdose deaths involving benzodiazepines also involved an opioid.

Natl Health Stat Report. Published online January 17, 2020. Full text

For more Medscape Psychiatry news, join us on Facebook and Twitter.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.