New opioid scripts declining among benzodiazepine-treated patients

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Takeaway

  • The number of new opioid prescriptions to patients using benzodiazepines in the United States increased dramatically from 2005 to 2010, but decreased significantly between 2010 and 2015.
  • Despite that decrease, people using benzodiazepines were nearly twice as likely to receive a new opioid prescription than those not using benzodiazepines.

Why this matters

  • The findings suggest that the recent increases in opioid-related deaths may be associated with something other than physicians writing new opioid prescriptions.

Study design

  • This study assessed 13,146 hospital visits by adults ≥20 years of age and receiving new opioid prescriptions and concurrently using a benzodiazepine.
  • Funding: National, Heart, Lung, and Blood Institute and others.

Key results

  • In adults using benzodiazepines, new opioid prescription rates increased from 189 to 351 per 1000 persons between 2005 and 2010 (95% CI, 29-295) and decreased to 172 per 1000 persons by 2015 (95% CI, −310 to −48).
  • Risk for receipt of new opioid prescription was significantly high in patients already using benzodiazepines vs those not using benzodiazepines (adjusted relative risk, 1.83; P<.001>
  • In patients using benzodiazepines, a significant interaction between initial opioid prescription and both race/ethnicity and age was observed.

Limitations

  • Duration of opioid treatment was not established.

Coauthored with Anand Ramanathan, PharmD