HealthDay (3/15, Reinberg) reports that mixing opioid pain analgesics with benzodiazepine medications may be “a prescription for a deadly overdose,” researchers concluded after examining data on some “300,000 privately insured patients.”

The study published on March 14, 2017, in the British Medical Journal (BMJ), sought to identify trends in the concurrent use of benzodiazepine and an opioid.  Data collected from 2001 to 2013 looked at the impact of mixing these drugs on admissions to hospitals and emergency rooms for opioid overdose.  The study concluded that “concurrent benzodiazepine/opioid use sharply increased in a large sample of privately insured patients in the US and significantly contributed to the overall population risk of opioid overdose.”

Benzodiazepines (benzos) are a class of psychoactive drugs that work on the central nervous system and are used to treat a range of conditions including anxiety and insomnia.  These drugs work by enhancing the effect of the neurotransmitter gamma-aminobutyric acid (GABA).    They are responsible for reducing the activity of neurons that cause stress and anxiety.  These drugs are generally safe and efficient for short-term use.  However, benzos can be habit-forming, and the risks of long-term use are still being debated.

The more commonly prescribed benzos include Alprazolam (e.g., Xanax), lorazepam (e.g., Ativan), clonazepam (e.g., Klonopin), diazepam (e.g., Valium), and temazepam (e.g., Restoril) are the five most prescribed

Opioid addiction is at an epidemic level in the United States and in a December 2014 Express Script report it is estimated that 80 percent of the drugs are consumed by Americans.  Opioids work by blocking pain signals to the brain.   The more commonly known and prescribed painkillers include codeine, morphine, OxyContin® (oxycodone HCI), and Vicodin® (hydrocodone bitartate and acetaminophen).

“Nearly 60% of patients using opioids were taking a combination of drugs that are dangerous and potentially fatal; among these mixtures, almost one in three patients were prescribed anti-anxiety drugs known as benzodiazepines along with an opioid – the most common cause of overdose deaths involving multiple drugs,” the report (pdf), published by pharmacy benefit manager Express Scripts, said. [1]

The immediate risk of excessive use of benzos is the chance that they will be used in combination with alcohol or other drugs like opioids and cause an accidental overdose. Per the report, benzodiazepines have received less public safety attention than opioids, the combination of the two drugs is dangerous because benzodiazepines potentiate the respiratory depressant effects of opioids.[2]

Medical professionals need to make sure that patients fully understand the side effects of the drugs they are taking and the potential dangers of mixing these drugs with other drugs and alcohol.

Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription.

[1] “U.S.: 5% of World Population; 80% of Opioid Consumption.” Express Script Report December 2014. N.p., n.d. Web. 26 Mar. 2017 %3chttp:/

[2] “Association between concurrent use of prescription opioids …” N.p., n.d. Web. 26 Mar. 2017 %3chttp:/