Combining opioids with benzodiazepines, often referred to as “benzos,” significantly elevates the risk of a life-threatening overdose. This dangerous interaction is further amplified when these substances are mixed with other central nervous system (CNS) depressants like alcohol or xylazine. Understanding the risks associated with mixing benzos and opioids is crucial for preventing tragic outcomes.
In 2021, alarming statistics revealed that nearly 14% of opioid overdose fatalities also involved benzodiazepines. Benzodiazepines are a class of prescription sedatives commonly used to treat anxiety and insomnia. These drugs, including diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin), work by increasing the levels of the neurotransmitter GABA in the brain, leading to a calming or sedative effect.
Adding to the complexity, benzodiazepines have been detected in the illicit opioid supply in certain regions. This raises concerns that individuals may unknowingly or knowingly be consuming benzodiazepines alongside illicit opioids.
The Dangers of Co-Prescribing Opioids and Benzodiazepines
Every day, approximately 220 lives are lost in America due to opioid overdoses. The concurrent use of opioids and benzodiazepines intensifies the overdose risk because both drug types can induce sedation and respiratory depression – the primary cause of overdose deaths. Furthermore, this combination impairs cognitive functions, exacerbating the danger. Research consistently demonstrates that individuals who use opioids and benzodiazepines together face a significantly heightened risk of emergency department visits, hospital admissions for drug-related emergencies, and fatal drug overdoses.
A study conducted in North Carolina highlighted the severity of this risk, revealing that the overdose death rate among patients prescribed both opioids and benzodiazepines was a staggering ten times higher compared to those only receiving opioids. Similarly, research involving U.S. veterans with opioid prescriptions found a dose-dependent increase in the risk of drug overdose death associated with benzodiazepine prescriptions.
Recognizing this critical danger, the Centers for Disease Control and Prevention (CDC) in their Clinical Practice Guideline for Prescribing Opioids for Pain, strongly advises clinicians to exercise extreme caution when prescribing benzodiazepines alongside opioids. They emphasize the need to carefully weigh the potential benefits against the significant risks. Both prescription opioids and benzodiazepines now carry boxed warnings from the U.S. Food and Drug Administration (FDA) on their labels, explicitly highlighting the serious dangers of using these drugs in combination.
It is imperative for anyone prescribed medication to transparently disclose all other substances and medications they are using to their healthcare providers. Consulting with healthcare teams about the risks associated with combining medications and substances is crucial for managing and mitigating potential dangers.
