Opioid-Benzodiazepine Mix Raises Risk of Lethal Overdose

Opioid-Benzodiazepine Mix Raises Risk of Lethal Overdose

Drug overdoses are now the leading cause of death among Americans under the age of 50.1 Preliminary data for 2016 reveals the death toll may be as high as 65,0002 — a 19 percent increase in a single year. Opioids, narcotic pain killers, are responsible for nearly two-thirds, about 42,000, of these deaths.3 Between 2002 and 2015, more than 202,600 Americans died from opioid overdoses.4

While such statistics are sobering enough, recent research5 suggests the death toll may still be underestimated due to incomplete drug reporting of overdose deaths. The researchers believe upward of 70,000 opioid overdose deaths were excluded from national estimates between 1999 and 2015, for the simple reasons that coroners routinely fail to specify opioid use as a contributing cause of death. According to lead author Jeanine Buchanich, research associate professor at University of Pittsburgh School of Public Health:6

“Proper allocation of resources for the opioid epidemic depends on understanding the magnitude of the problem. Incomplete death certificate reporting hampers the efforts of lawmakers, treatment specialists and public health officials. And the large differences we found between states in the completeness of opioid-related overdose mortality reporting makes it more difficult to identify geographic regions most at risk.”

The most common drugs involved in prescription opioid overdose deaths include7 methadone, oxycodone (such as OxyContin®) and hydrocodone (such as Vicodin®). Extremely potent synthetic opioids like fentanyl are also being abused by a rising number of people. Now, researchers warn a particularly powerful combination of commonly prescribed drugs significantly raises your risk of death.

Benzodiazepine Overdoses Are Also Rising
While opioids make the most frequent headlines, another class of drugs — benzodiazepines8 or “benzos,” widely prescribed for anxiety and insomnia — also claims its share of lives. Prescriptions for these drugs, which include Valium, Ativan, Klonopin and Xanax, tripled from 1996 to 2013, but this doesn’t fully account for the uptick in overdoses, which quadrupled during that time.9

As for why the rate of overdose deaths rose faster than the rate of prescriptions, Dr. Chinazo Cunningham, one of the study’s authors, told STAT News,10 “Our guess is that people are using these prescriptions in a riskier way.” The number of pills prescribed to each adult increased over the study period, for instance, which suggests Americans may be taking higher doses or taking the drugs for longer periods, both of which increase the risk of overdose.

Combining the drugs — which act as sedatives — with alcohol is also risky, as is using the drugs along with opioids. Prescription records also show the use of benzos has risen alongside the use of opioids, and that the sedatives are often used alongside the painkillers to enhance the high.11

According to Dr. David Juurlink, head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Center in Toronto,12 “Prescribing opioids and benzodiazepines together is like putting gasoline on a fire,” adding that “Benzodiazepines are grossly overprescribed … and many people don’t necessarily benefit from them.”

Estimates suggest more than 4 in 10 seniors use benzos for anxiety or insomnia, even though their long-term effectiveness and safety remain unproven, and their use has been linked to a higher risk of Alzheimer’s disease.13

Older adults who used benzodiazepines for three months or more had a 51 percent greater risk of Alzheimer’s disease than those who did not, and the risk increased the longer the drugs were used. According to the authors, “The stronger association observed for long term exposures reinforces the suspicion of a possible direct association …”

Opioid-Benzodiazepine Combination Raises Risk of Death Fivefold
A number of studies have already highlighted the deadly risk you take when combining opioids with benzos. Most recently, research14,15 published in JAMA looked at how the risk of overdose changes when you combine the two drugs for a number of days in a row.

As it turns out, during the first 90 days of concurrent use, your risk of a deadly overdose rises fivefold, compared to taking an opioid alone. Between days 91 and 180, the risk remains nearly doubled, after which the risk tapers off, becoming roughly equal to taking an opioid alone. According to the authors:

“Policy interventions should focus on preventing concurrent opioid and benzodiazepine use in the first place instead of reducing the length of concurrent use. Patients using both medications should be closely monitored, particularly during the first days of concurrent use.”

via Dr Mercola Opioid-Benzodiazepine Mix Raises Risk of Lethal Overdose