Benzodiazepines are some of the most commonly prescribed medications in the country, often used to treat anxiety. But a new study warns that taking benzodiazepines can be both helpful and risky for those with opioid use disorder.
The study shows a paradox. It found that patients prescribed benzodiazepines — or "benzos" — were less likely to stop taking their buprenorphine, an addiction medication that eases opioid cravings.
"Keeping people in care wasn't something we necessarily expected to find," said Boston Medical Center psychiatrist Dr. Tae Woo Park, first author of the study. "People in buprenophine treatment often have co-occurring mental health disorders, and benzodiazepines are an efficacious way to treat anxiety."
But the study also found that patients prescribed both benzos and buprenorphine also had an increased risk of overdose, largely because benzos are also a respiratory depressant. Park says the study is a cautionary note for doctors.
"The main message is that benzodiazepines have the potential to both hurt and help patients on bupenorphine for opioid use disorder," Park said. "Clinicians who are prescribing should take caution and have caution if you're going to take someone off the medication while they're on buprenorphine."
The study looked at more than 60,000 Massachusetts patients who received buprenorphine treatment between 2012 and 2015. About a quarter of those studied had a benzodiazepine prescription as well.
Another unexpected finding was that just 4% of overdose deaths during the study period involved people actively receiving buprenorphine.
"Another main takeaway in my mind is that buprenorphine saves lives," Dr. Park said.
The study is in the journal Addiction, published by the Society for the Study of Addiction.