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  • Robert Preidt
  • Posted January 17, 2019

More Americans Mixing Opioids With Sedatives

As if the opioid crisis wasn't already bad enough, new research shows a sharp rise in the number of Americans taking dangerous combinations of opioids and sedatives.

These sedatives, known as benzodiazepines, are prescribed for pain, insomnia and anxiety. And another class of similar medications, called Z-drugs, are also being taken with sedatives at alarming rates, the researchers found.

For the study, Canadian researchers analyzed data from eight U.S. National Health and Nutrition Examination Survey cycles between 1999 and 2014. During that time, combination use of opioids and benzodiazepines increased 250 percent, and combination use of benzodiazepines and Z-drugs rose 850 percent.

In 2014, the rate of benzodiazepine and opioid co-usage had reached 1.36 percent, and the rate of benzodiazepine and Z-drug co-usage was 0.47 percent, the investigators found.

The findings are cause for concern because these combinations pose serious risks, including breathing problems and death, said study author Nicholas Vozoris. He is an associate scientist at Li Ka Shing Knowledge Institute at St. Michael's Hospital in Toronto.

"While the proportions may seem small, these percentages at a population-level correspond to millions of people, and the growth of these numbers is alarming," Vozoris, a sleep medicine doctor, said in a hospital news release.

The 1.36 percent rate of benzodiazepine and opioid co-usage amounts to about 4.3 million people, while the 0.47 percent rate of benzodiazepine and Z-drug co-usage amounts to about 1.5 million people.

The U.S. Food and Drug Administration "has gone as far as to issue its strongest form of safety warning about this suboptimal prescribing practice and mixing of opioids and benzodiazepines," he noted.

Vozoris said there's lot of confusion about benzodiazepines and Z-drugs among both patients and health care providers.

"I wanted to understand the trends in use of such worrisome drug combinations and which types of individuals were more likely to receive such drug combinations," he explained.

Benzodiazepines include alprazolam (Xanax), clonazepam (Klonopin) and lorazepam (Ativan), while Z-drugs include zaleplon (Sonata), zolpidem (Ambien) and zopiclone (Imovane).

"There are doctors and members of the public often not realizing that Z-drugs are very similar in action to benzodiazepine drugs -- sometimes patients get put on both a benzo and a Z-drug and think they're two very different drugs," Vozoris said.

The report was published Jan. 17 in the journal Sleep.

More information

The U.S. National Institute on Drug Abuse has more about opioids and benzodiazepines.

SOURCE: St. Michael's Hospital, news release, Jan. 17, 2019
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