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Two medications that are often prescribed together have been shown to be a potentially dangerous combination. Benzodiazepines and opioids, a sedative and a pain relief drug, are now known to be a risky cotreatment. The two medications together may be abused, be misused, or lead to overdoses with deadly results. A recent study linked the two prescription drugs to mortality among a number of patients.

Opioids for Pain

Even though opioids tend to be associated with illegal drugs, there are many prescription opioids designed to relax the body and relieve pain. Opioids are generally prescribed for moderate to severe pain, and occasionally for coughing and diarrhea. Common prescription opioids include Vicodin, OxyContin, Percocet, morphine, codeine, and fentanyl.

Benzodiazepines for Sleep

The prescription medication benzodiazepine works to calm or sedate an individual and is used to treat anxiety or insomnia. The medication in benzodiazepines works by raising the level of an inhibitory neurotransmitter in the brain. Common prescription benzodiazepines include Valium, Xanax, and Klonopin.

Risky Co-Prescriptions

According to the National Institute on Drug Abuse (NIDA), over 30 percent of the overdoses involving opioids also involve benzodiazepines. The Centers for Disease Control and Prevention (CDC) issued guidelines in 2016, recommending that healthcare providers avoid prescribing benzodiazepines at the same time as opioids whenever possible. In addition, prescription opioids and benzodiazepines now have FDA “black box” warnings that highlight the dangers of using these drugs together.

Link to Mortality

A study of patients who were prescribed both opioids and benzodiazepines as part of a cotreatment found that the combination was linked to mortality rates among those patients. The study also found that, even though opioid use has remained steady in recent years in the US, these co-prescriptions have continued to increase.

One of the researchers, Kevin Y. Xu, MD, MPH, of the department of psychiatry at Washington University School of Medicine in Missouri, along with his colleagues wrote in the report that “When benzodiazepines are alone taken, long-term use is associated with falls, cognitive impairment and life-threatening withdrawal. When taken together with opioids, benzodiazepines can further suppress breathing, a common cause of death from opioid overdose.”

The researchers found that up to 13% of US adults have reported benzodiazepine use in the last year, with ambulatory benzodiazepine prescriptions more than doubling in the last decade. 20% to 30% of all benzodiazepine recipients in the US are estimated to also have a prescription for opioids. They re-emphasized that more than 30% of the opioid overdose deaths have been found to involve benzodiazepines.

Younger People at Greater Risk

An increased mortality risk in patients younger than 65 was found as part of the study as well. In fact, in their study, the researchers found no increased risk of death associated with cotreatment in patients over the age of 65. The increased risk was also present in patients under 65 who received benzodiazepines without opioids. The researchers stated that this may be associated with the surging drug poisoning-related mortality that disproportionately affect the younger generations in the US.

Recommendations for Healthcare Professionals

Xu and his co-researchers wrote that “Concerted efforts by physicians, scientists and policymakers are warranted to decrease overprescribing of these medications, identify patients at elevated risk and ultimately implement targeted interventions.” In addition, the increase in benzodiazepine prescriptions has clinical relevance in a world that is seeing an opioid overdose epidemic and declining life expectancies.

The study found that benzodiazepine use, with or without opioid use, has been associated with double the mortality risk of that seen in the use of low-risk antidepressants. The results of their research, which involved study of 5212 individuals from a large, nationally representative data set, show that benzodiazepine and opioid cotreatment may confer an increased long-term mortality risk.

Get Help for Your Addiction at South Miami Recovery

Overcoming an addiction to opioids and benzodiazepines is not easy. At South Miami Recovery, we are here to help you get started on your recovery. You deserve to enjoy true freedom from active substance dependency, so you can live a healthier life.  During the COVID-19 pandemic, we want you to stay safe and healthy, so we offer HIPAA-compliant telehealth services to help you get the treatment you need now. To learn more and to sign up for telehealth substance abuse services, contact us today. Call South Miami Recovery at 305.661.0055.

As the first people on the scene in emergencies, first responders are challenged with caring for and calming victims as they work to resolve the situation itself. These police officers, fire fighters, and emergency medical professionals often find that they experience physical and mental health issues as a direct result of their jobs. A grant and planned hotline improvements have recently been announced as part of a move toward improving mental health resources for Florida first responders.

State Announces Grant

Florida governor Ron DeSantis recently announced a $4.9 million grant that has been made available through the state’s Department of Children and Families. The funds will be used to improve Florida’s 211 crisis hotline system.

As part of the planned improvements, first responders themselves will be hired to answer the 211 crisis calls so that they can act as a peer counselor and referral service to those first responders calling in for help. First Lady Casey DeSantis said, when announcing the grant, that first responders “need an outlet, they need a peer, they need someone that they can call, they know that they can relate to who understands what they endure day in and day out.”

The governor is also allocating over $23 million from CARES Act funds to support Florida’s mental health system. Out of that, $18 million will go to community-based services for adults and children, and $4.5 million will be used to enhance mental health treatment facilities throughout the state. DeSantis said, “The effects of the pandemic on mental health have been significant, and these funds are an important resource to help Floridians recover from COVID-19.”

Mental Health and COVID

The COVID-19 pandemic has increased stress levels for these emergency workers, beyond their normal duties, as well as for most people across the country. That added stress and worry over safety and health have increased the level of mental health issues and substance use disorders.

In a poll conducted in July 2020, it was found that 53% of adults in the US reported that their mental health had been negatively impacted due to worry and stress over the pandemic. Impacts on an individual’s health and well-being, resulting from the isolation and uncertainty of the COVID-19 outbreak, can include difficulty sleeping or eating, increases in drug or alcohol use, and worsening chronic conditions.

Increased Risk of Trauma

When first responders arrive on the scene of an emergency, they face challenging and often dangerous situations, even during “normal” times. In a disaster, either natural or manmade, first responders provide emotional and physical support to the victims. All of this puts these responders, including police, firefighters, search and rescue personnel, and emergency and paramedical teams, at an increased risk of trauma.

Improving mental health resources for Florida first responders is a step toward helping to alleviate some of the trauma they experience daily in their jobs. For example, they are often exposed (directly or indirectly) to death, grief, injury, pain, or loss as well as experiencing direct exposure to threats to personal safety, long hours of work, frequent shifts and longer shift hours, poor sleep, physical hardships, and other negative experiences.

Continuing PTSD

The trauma that first responders experience on the job often follows them long after they clock out. The emotional stress they deal with when responding to emergencies or treating victims can affect their mental health in different ways, causing post-traumatic stress disorder (PTSD), depression, anxiety, and other long-lasting issues.

Many first responders continue to battle with PTSD, along with the physical strain of their job, long work hours, and lack of sleep. These factors can increase the likelihood of mental health problems and substance abuse. Offering peer counseling as part of the improved mental health resources for Florida first responders is a positive step toward encouraging them to reach out for help, as they will be assured that the person answering the phone truly understands their struggles.

Contact South Miami Recovery for Help

At South Miami Recovery, we offer you evidence-based therapies to help with your stress and anxiety, including mindfulness therapy. Our professional team is also here to help with your substance use issues, as we address the spiritual, physical, mental, and emotional aspects of your recovery. We know that your well-being is of the utmost importance during the COVID-19 pandemic, so South Miami Recovery offers HIPAA-compliant telehealth services to enable you to get the treatment you need now. Contact us today for help. Call South Miami Recovery at 305.661.0055.