Veterans who were prescribed an opioid and a benzodiazepine at the same time by the Veterans Health Administration (VHA) faced an increased risk of death, says a new report from the National Academies of Sciences, Engineering, and Medicine that analyzed millions of VHA medical records from 2007 to 2019. The report also finds some evidence that co-prescribing opioids and benzodiazepines increased veterans’ risk of death from suicide.
Death associated with co-prescribing opioids and benzodiazepines has raised concerns among health care providers, federal agencies, veterans, and the public for decades. Opioids are commonly prescribed for pain, and benzodiazepines are often prescribed for anxiety, panic disorders, insomnia, and seizures. The combination of taking both drugs at the same time is known to have potential adverse health effects, including suppressing breathing.
Concerns about prescribing opioids and their interaction with benzodiazepines first appeared in the VA/DOD Clinical Practice Guidelines in 2010. The report notes that in response to adverse outcomes, the VHA changed its clinical guidelines and policies – including during the years that the report examines.
Institute co-director Dr. Amy Bohnert served Committee on Evaluating the Effects of Opioids and Benzodiazepines on All-Cause Mortality in Veterans which led the report development.