February 17, 2019
Opioid Prescription - with warning not to prescribe with benzodiazepines

Benzos and Opioids: A Dangerous Mix

by Stephanie Watson  

Are you taking both a benzodiazepine and an opioid at the same time? If so, your risk of a fatal overdose is four times that of people who are taking an opioid alone. This drug combination is so deadly that, in 2016, the FDA issued a black-box warning—its strictest warning on drug products—cautioning about the risks.

People who get their medications from two separate health insurance plans, such as the VA and Medicare Part D, are vulnerable to dual prescribing. A study in October 2018 in the Annals of Internal Medicine of nearly 369,000 older adults (mostly men) enrolled in both plans found that more than 27 percent of them took opioids and benzodiazepines at the same time.

Also beware of combining opioids with so-called Z-drugs, which are sedative hypnotics that, like benzodiazepines, depress the central nervous system. Doctors sometimes prescribe Z-drugs—zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta)—to replace benzodiazepines, but they can be just as dangerous.

This article first appeared in the January 2019 issue of UC Berkeley Health After 50.