Introduction
Although many clinical guidelines caution against the combined use of opioids and
benzodiazepines, overdose deaths and emergency department visits involving the co-ingestion
of these drugs are increasing.
Methods
In this ecologic time series study, the IMS Health Total Patient Tracker was used
to describe nationally projected trends of patients receiving opioids and benzodiazepines
in the U.S. outpatient retail setting between January 2002 and December 2014. The
IMS Health Data Extract Tool was used to examine trends in the concomitant prescribing
of these two medication classes among 177 million individuals receiving opioids during
this period. The annual proportion of opioid recipients who were prescribed benzodiazepines
concomitantly was calculated and stratified by gender, age, duration of opioid use,
immediate-release versus extended-release/long-acting opioids, and benzodiazepine
molecule. The proportion of patients with concomitancy receiving opioids and benzodiazepines
from the same prescriber was also analyzed. Analyses were conducted from April to
June 2015.
Results
The nationally projected number of patients receiving opioids and benzodiazepines
increased by 8% and 31%, respectively, from 2002 to 2014. During this period, the
annual proportion of opioid recipients dispensed a benzodiazepine concomitantly increased
from 6.8% to 9.6%, which corresponded to a relative increase of 41%. Approximately
half of these patients received both prescriptions from the same prescriber on the
same day. Concomitancy was more common in patients receiving opioids for ≥90 days,
women, and the elderly.
Conclusions
Concomitant prescribing of opioids and benzodiazepines is increasing and may play
a growing role in adverse patient outcomes related to these medications.
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Article Info
Publication History
Published online: April 11, 2016
This activity is available for CME credit. See page A3 for information.Identification
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