PROVIDENCE, R.I. - In a recent study, nearly half of all veterans who died from drug overdoses while prescribed opioids for pain were also receiving benzodiazepines, or benzos, which are common medications for the treatment of anxiety, insomnia and alcohol withdrawal. Veterans prescribed higher doses of benzodiazepines while concurrently receiving opioids were at greater risk of overdose death than those on lower doses of benzodiazepines. The results of the study by researchers from Rhode Island Hospital, Boston Medical Center, and the Veteran Affairs Ann Arbor Healthcare System were published online in the BMJ today.
"The risk of receiving both opioids and benzodiazepines during this six-year period was approximately four times higher than in those who received opioids alone," said Tae Woo Park, M.D., attending physician at Rhode Island Hospital. "From a public health perspective, this is deeply troubling, because drug overdoses are a leading cause of death in the U.S. and prescribing benzodiazepines to patients taking opioids for pain is quite common. In 2010, 75 percent of pharmaceutical-related drug-overdose deaths involved opioids. As we learn more about pharmaceuticals and how they interact with each other, we can try to reduce the risk of harm to patients."
The Veterans Health Administration (VHA) is the largest integrated health care system in the U.S., serving nearly nine million former military personnel across 150 hospitals and 800 outpatient centers. Patient records of veterans who died from drug overdoses while receiving medical services as an outpatient at the VHA between October 2004 and September 2009 were examined for the relationship between the opioids and benzodiazepines when prescribed concurrently.
Common opioids include the well-known brands Vicodin, Percocet and OxyContin; and the generic formularies are morphine, codeine, oxycodone, hydrocodone, fentanyl and methadone. The most common brands of benzodiazepines are Xanax, Valium and Klonopin, and common generic forms are alprozolam, chlordiazepoxide, clonazepam, diazepam, lorazepam and temazepam. The drugs are often used for treating anxiety disorders, insomnia and alcohol withdrawal.
The study was funded by the National Institutes of Health and by a Veteran Affairs Health Services Research & Development Service Career Development Award. Park's principal affiliation is Rhode Island Hospital, a member of the Lifespan health system. He also has an academic appointment at the Alpert Medical School of Brown University in the departments of medicine and psychiatry and human behavior. Other researchers involved in the study were Richard Saitz, M.D., MPH, chairman of the department of community health sciences at Boston University School of Public Health; Dara Ganoczy, MPH, a research health science specialist in the health services research & development division of the Department of Veteran Affairs; and Mark A. Ilgen, Ph.D. and Amy S. B. Bohnert, Ph.D., both associate professors in the department of psychiatry at the University of Michigan Medical School and also with the Department of Veterans Affairs.
About Rhode Island Hospital
Founded in 1863, Rhode Island Hospital in Providence, R.I., is a private, not-for-profit hospital and is the principal teaching hospital of The Warren Alpert Medical School of Brown University. A major trauma center for southeastern New England, the hospital is dedicated to being on the cutting edge of medicine and research. Last year, Rhode Island Hospital received more than $50 million in external research funding. It is also home to Hasbro Children's Hospital, the state's only facility dedicated to pediatric care. For more information on Rhode Island Hospital, visit http://www.