Concurrent Opioid and Benzodiazepine Prescriptions for Pain Relief Fall But Still Common  What are the main findings?

Response: Our study found that the number of patients with concurrent opioid and benzodiazepine prescriptions in the U.S. declined significantly by 42% since 2016, particularly the number of young adults and number of patients newly initiated with concurrent prescriptions, with the former declined 64% and the latter declined 59%. We also found significant variation in the decline among states. What should readers take away from your report?

Response: Our findings indicated that the downward trend in concurrent use of these two drugs at the population level is promising; however, receiving concurrent opioids and benzodiazepines remains relatively common, despite the known risks. Additionally, almost two thirds of these patients received concurrent prescriptions from the same clinicians.

What is interesting and encouraging is that far fewer new patients initiated treatment with opioids and benzodiazepines together, indicating that clinicians may have better adherence to clinical guidelines when treating patients new to these drugs, compared with weaning off patients who were already using these drugs concurrently.

Our findings highlight the need for continued public health and clinical actions, including greater adherence to evidence-based prescribing guidelines, more patient education about the overdose risk resulted from concurrent use, and alternative pain-management options particularly among patients whose benzodiazepines were indicated. What recommendations do you have for future research as a result of this work?

Response: Future research should keep tracking the trends particularly among those groups that had smaller decline found by this study. Future research should also examine the causes of the great state-level variation in the declining of concurrent use found by our study. This will shed some lights on what type of efforts and interventions are most effective at preventing concurrent use of these two drugs and improving patient safety. 

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Kun Zhang, Andrea E. Strahan, Gery P. Guy, et al; Trends in Concurrent Opioid and Benzodiazepine Prescriptions in the United States, 2016 to 2019. Ann Intern Med. [Epub 7 June 2022]. doi:10.7326/M21-4656

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