Anti-anxiety medications play a large but overlooked part in the opioid-related deaths that are currently grabbing headlines, according to an article posted on the STAT website. In 2013, benzodiazepines, such as alprazolam (Xanax, Pfizer) and diazepam (Valium, Roche), were involved in more than 30% of U.S. deaths from prescription-drug overdoses.
“There’s a lot of attention on opioids,” said Dr. Joanna Starrels, an internist and addiction medicine specialist at Albert Einstein College of Medicine in New York. “But I think that epidemiologists need to pay closer attention to the role of benzodiazepines in overdose deaths.”
Starrels and her colleagues examined data from the Medical Expenditure Panel Survey and multiple-cause-of-death data from the Centers for Disease Control and Prevention for the years between 1996 and 2013. They found that the percentage of adults filling a benzodiazepine prescription increased from 4.1% to 5.6% during that period, with an annual percent change of 2.5%.The quantity of benzodiazepines filled increased from 1.1 to 3.6 kilogram lorazepam equivalents per 100,000 adults (annual percent change, 9.0%). The overdose death rate increased from 0.58 to 3.07 per 100,000 adults, with a plateau seen after 2010.
The team’s findings were published in the American Journal of Public Health.
Illicit drug users often combine benzodiazepines with opioids, which can lead to difficulty breathing, coma, or death, the authors noted.
“Prescribing opioids and benzodiazepines together is like putting gasoline on a fire,” said Dr. David Juurlink, head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Center in Toronto, who was not involved with the study.
But benzodiazepines alone or in combination with alcohol are also to blame for some of the increase in overdoses. Moreover, as Starrels and her team found, it’s not just the number of benzodiazepine prescriptions but the quantity filled in each script that has climbed in recent years.
“Benzodiazepines are grossly overprescribed, and many people don’t necessarily benefit from them,” Juurlink said.
Source: STAT; February 18, 2016.