Benzodiazepines or z-drugs when taken with opioids increase death risk: Study
Those using benzodiazepines had a 221% increase in the risk of death from any cause and those taking non-benzodiazepine hypnotics, or "z-drugs," had a 68% increased risk.
USA: Benzodiazepines or "z-drugs", when taken with opioids, increases death risk, according to findings from a study involving more than 400,000 Medicare patients taking medications for insomnia.
The findings of the study, published in the journal PLOS Medicine, suggest that z-drugs in combination with opioids may be more hazardous than previously thought. They indicate that the dangers of coadministration of benzodiazepine–opioids go beyond the documented association with an overdose death.
The study, led by Wayne Ray, professor of Health Policy at Vanderbilt University School of Medicine (VUMC), compared patients taking these drugs with opioids to comparable patients taking trazodone, another commonly prescribed sleep medication for older patients. The researchers found that those using benzodiazepines had a 221% increase in the risk of death from any cause and those taking non-benzodiazepine hypnotics, or "z-drugs," had a 68% increased risk.
Benzodiazepines, including brand names such as Restoril, Ativan, and Halcion and the "z-drugs", a type of medication known more commonly under names like Ambien, Lunesta and Sonata, are among the most frequently prescribed medications for older adults.
Trazodone, a medication initially introduced for depression, is often prescribed in low doses for insomnia. Although researchers have speculated about the relative safety of these sleep medications, there is limited relative safety data.
Ray said the study findings could help to fill this data gap and thus lead to changes in both provider behavior and policy.
"Our findings add urgency to efforts to limit concurrent prescribing of benzodiazepines and opioids. They also suggest that targeted warnings are needed to advise older patients and their providers regarding the potential risks of taking z-drugs with opioids," Ray said.
Reference:
The study titled, "Mortality and concurrent use of opioids and hypnotics in older patients: A retrospective cohort study," is published in the journal PLOS Medicine.
DOI: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003709
