Benzodiazepines and Opioids: A Quiz on the Dangerous Combination
The role of benziodiazepines in the opioid epidemic is largely overlooked. What do you know about the role of these agents in the mounting number of overdoses and deaths?
The opioid epidemic and the widespread harm it has caused continue to receive extensive media attention. An important component of the overodses and deaths attributed to opioids, however, has been largely overlooked and that is the role benzodiazepines appear to be playing in this crisis.See what you know about the benzo/opioid overlap with 9 short questions based on current literature. Good luck!
Benzodiazepines and Opioids: A Quiz on the Deadly Combination
Question #1: Between 1996 and 2013, how did the number of adults in the United States who filled a prescription for a benzodiazepine change?
Answer #1. D. Increased by 67% (the number of adults in the United States who filled a prescription for a benzodiazepine between 1996 and 2013)
Question #2. What percentage of deaths involving benzodiazepines also involve opioids?
Answer #2: A. 75% of deaths involving benzodiazepines also involve opioids.
Question #3: How did the number of concurrent prescription of opioids and benzodiazepines in the US change between 2001 and 2013
Answer #3. D. Almost doubled (the number of concurrent opioid/benzodiazepine prescriptions between 2001 and 2013)
Question #4: Concomitant use of opioids and benzodiazepines increases the risk for which of these adverse events?
Answer #4. D. All of the above (Concomitant use of the two drug classes increases the risk for respiratory depression, coma, death.)
Question # 5: What percentage of those who die from opioid overdoses also test positive for benzodiazepines?
Answer #5. Answer: C. 20% - 25% of those who die from opioid overdoses also test positive for benzodiazepines.
Question #6: True or False: Despite the risk of combining opioids and benzodiazepines, the combination may be beneficial because benzodiazepines can bolster the analgesic effects of opioids.
Answer #6. B. False (benzodiazepines are shown to reduce the anaglesic effects of opioids.
Question #7. Research indicates that concomitant use of opioids and benzodiazepines among veterans increase the risks for which of these?
Answer #7. D. All of the above (among US veterans taking benzodiazepines and opioids at the same time, increased risks were seen for accidents, self-inflicted injuries, alcohol and other drug-related accidents and overdoses)
Question #8: True or False? The only benzodiazepines available in the US are those that are available by prescription.
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Answer #8: B. False (there are also extremely potent non-prescription formulations of benzodiazepines available in the US)
Question #9: True or False? Virtually all people taking concomitant opioids and benzodiazepines have been prescribed both drugs.
Answer #9. B. False (In >50% of patients whose urine drug test results indicate use of both opioids and benzodiazepines, only one class of drugs was prescribed)
References
1. Bauchhuber MA, Hennessy S, Cunningham CO, et al. Increasing benzodiazepine prescriptions and overdose mortality in the United States. 1996-2013. Am J Public Health. 2016;106:686-688.
2. Sun EC, Dixit A, Humphreys K, et al. Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis. BMJ. 2017:356:j760.
3. Letter to [benzodiazepine manufacturer] Safety Labeling Change Notification.
4. National Institute on Drug Abuse. Benzodiazepine and opioids. Revised Sept. 2017.
5. Gressler LE, Martin BC, Hudson TJ, et al. Relationship between concomitant benzodiazepine-opioid use and adverse outcomes among US veterans. Pain. 2018;159:451-459.
6. Gear RW, Miaskowski C, Heller PH, et al. Benzodiazepine mediated antagonism of opioid analgesia. Pain. 1997;71:25-29.
7. Lembke A, Papac J, Humphreys K. Our other prescription drug problem. N Engl J Med. 2018;378:693-695.
8. McClure FL, Niles JK, Kaufman HW, et al. Concurrent use of opioids and benzodiazepines: evaluation of prescription drug monitoring by a United States Laboratory. J Addict Med. 2017;11:420-426.