In a recent study published in PLOS Medicine, researchers examined more the 400,000 Medicare patients taking medications for insomnia.
They found that the risk of death is increased when either benzodiazepines or ‘z-drugs’ are taken with opioids.
The study is from Vanderbilt University. One author is Wayne Ray, Ph.D.
In the study, the team compared patients taking these drugs with opioids to comparable patients taking trazodone, another commonly prescribed sleep medication for older patients.
They found that those using benzodiazepines had a 221% increase in the risk of death from any cause and those taking non-benzodiazepine hypnotics, or ‘z-drugs’, had a 68% increased risk.
These findings indicate that the risks of benzodiazepine-opioid use go well beyond the recognized hazards of overdose.
They also suggest that the z-drugs, thought to have better safety than the benzodiazepines, in fact are dangerous when prescribed in combination with opioid pain medications.
Benzodiazepines, including brand names such as Restoril, Ativan, and Halcion and the ‘z-drugs’, a type of medication known more commonly under names like Ambien, Lunesta and Sonata, are among the most frequently prescribed medications for older adults.
Trazodone, a medication initially introduced for depression, is often prescribed in low doses for insomnia.
Although researchers have speculated about the relative safety of these sleep medications, there is limited relative safety data.
The team says the study findings could help to fill this data gap and thus lead to changes in both provider behavior and policy.
The findings add urgency to efforts to limit concurrent prescribing of benzodiazepines and opioids.
They also suggest that targeted warnings are needed to advise older patients and their providers regarding the potential risks of taking z-drugs with opioids.
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