Takeaway
- Despite a recent decline in the concurrent use of opioids and benzodiazepines (BZD) or nonbenzodiazepine sedatives (S) among cancer patients, nearly one-third continue to receive prescriptions for both drugs.
Why this matters
- Studies suggest concurrent use of opioids and BZD/S increases the risk of overdose death nearly 5-fold, which prompted the US Surgeon General, the FDA, and leading oncology organizations to warn against their combination.
Study design
- Study of 836 outpatients (age, >18 years) with cancer and who were prescribed either concurrent use of opioids and BZD/S (n=418) or opioids only (n=418) during 2011-2016.
- Funding: None disclosed.
Key results
- The concurrent use of opioids+BZD/S declined from 43% to 31% during 2011-2016 (P=.0008).
- Concurrent opioids+BZD/S vs opioids alone was associated with significantly greater:
- Proportion of females (P=.007) and whites (P=.002).
- Median morphine equivalent daily dose (67.5 vs 60 mg/day; P=.034).
- Median Edmonton System Assessment Scores for depression (P=.0001), anxiety (P≤.0001), drowsiness (P=.048), and worst feeling of well-being (P=.001).
- Risk factors for concurrent opioids+BZD/S included:
- Anxiety (OR, 1.18; P≤.0001).
- Race (Asian vs white: OR, 0.33; P=.0034 and black vs white: OR, 0.49; P=.0092).
- Eastern Cooperative Oncology Group performance status (OR, 1.22; P=.0017).
Limitations
- Retrospective design.
Coauthored with Chitra Ravi, MPharm
References
References
