Warnings Unheeded: The Risks of Co-Prescribing Opi ids and Benzodiazepines

Sharon L. Walsh, PhD Center on Drug and Alcohol Research Departments of Behavioral Science, Psychiatry, Pharmacology, and Pharmaceutical Sciences Lexington, KY 40508, USA Email: [email protected] D espite this common warning found in virtually all opioid product package inserts, reports on prescribing practices suggest that all too often this warning is ignored—with grave consequences. Not only are opioids and benzodiazepines (the most commonly prescribed sedative class) widely prescribed in the United States, they are commonly co-prescribed for patients. Analysis of a commercial database on prescription drugs by the Centers for Disease Control (CDC) indicated that, in 2012, health-care professionals wrote 82.5 opioid prescriptions and 37.6 benzodiazepine prescriptions for every 100 people in the United States. Moreover, of the top 25 medications dispensed from U.S. pharmacies, three opioids and one benzodiazepine made the list (hydrocodone/acetaminophen [#1], tramadol [#20], oxycodone/acetaminophen [#23], and alprazolam [#13]).