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An Examination of Concurrent Opioid and Benzodiazepine Prescribing in 9 States, 2015.
Am J Prev Med. 2019 11; 57(5):629-636.AJ

Abstract

INTRODUCTION

Concurrent prescribing of opioids and benzodiazepines is discouraged by evidence-based clinical guidelines because of the known risks of taking these medications in combination.

METHODS

This study analyzed concurrent opioid and benzodiazepine prescribing in 9 states using the 2015 Prescription Behavior Surveillance System, a multistate database of de-identified prescription drug monitoring program data. Concurrent prescribing rates were examined among individuals with both an opioid and a benzodiazepine prescription. Among patients with concurrent prescribing, total days of opioid supply, daily dosage of opioids, and total days of concurrent prescriptions were examined. Analyses were stratified by whether concurrent prescribing was from a single prescriber or multiple prescribers. Opioid prescribing and concurrent opioid and benzodiazepine prescribing rates were examined by age and sex. Analyses were conducted in 2018.

RESULTS

Among 19,977,642 patients that were prescribed an opioid, 21.6% (4,324,092) were also prescribed a benzodiazepine, of which 54.9% (2,375,219) had concurrent prescriptions. More than half of patients with concurrent opioids and benzodiazepines received prescriptions from 2 or more distinct prescribers. Mean total opioid days, daily opioid dosage, and days of concurrent prescribing were higher among patients when multiple prescribers were involved compared with concurrent prescriptions from the same prescriber. Concurrent prescribing was more common among adults aged ≥50 years and female patients.

CONCLUSIONS

Public health interventions are needed to reduce concurrent prescribing of opioids and benzodiazepines. Evidence-based guidelines can help reduce concurrent prescribing when one prescriber is involved, and utilization of prescription drug monitoring programs and improved care coordination could help address concurrent prescribing when multiple prescribers are involved.

Authors+Show Affiliations

Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: irm2@cdc.gov.Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31564606

Citation

Guy, Gery P., et al. "An Examination of Concurrent Opioid and Benzodiazepine Prescribing in 9 States, 2015." American Journal of Preventive Medicine, vol. 57, no. 5, 2019, pp. 629-636.
Guy GP, Zhang K, Halpin J, et al. An Examination of Concurrent Opioid and Benzodiazepine Prescribing in 9 States, 2015. Am J Prev Med. 2019;57(5):629-636.
Guy, G. P., Zhang, K., Halpin, J., & Sargent, W. (2019). An Examination of Concurrent Opioid and Benzodiazepine Prescribing in 9 States, 2015. American Journal of Preventive Medicine, 57(5), 629-636. https://doi.org/10.1016/j.amepre.2019.06.007
Guy GP, et al. An Examination of Concurrent Opioid and Benzodiazepine Prescribing in 9 States, 2015. Am J Prev Med. 2019;57(5):629-636. PubMed PMID: 31564606.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An Examination of Concurrent Opioid and Benzodiazepine Prescribing in 9 States, 2015. AU - Guy,Gery P,Jr AU - Zhang,Kun, AU - Halpin,John, AU - Sargent,Wesley, Y1 - 2019/09/27/ PY - 2018/12/06/received PY - 2019/06/18/revised PY - 2019/06/19/accepted PY - 2019/10/1/pubmed PY - 2020/5/26/medline PY - 2019/10/1/entrez SP - 629 EP - 636 JF - American journal of preventive medicine JO - Am J Prev Med VL - 57 IS - 5 N2 - INTRODUCTION: Concurrent prescribing of opioids and benzodiazepines is discouraged by evidence-based clinical guidelines because of the known risks of taking these medications in combination. METHODS: This study analyzed concurrent opioid and benzodiazepine prescribing in 9 states using the 2015 Prescription Behavior Surveillance System, a multistate database of de-identified prescription drug monitoring program data. Concurrent prescribing rates were examined among individuals with both an opioid and a benzodiazepine prescription. Among patients with concurrent prescribing, total days of opioid supply, daily dosage of opioids, and total days of concurrent prescriptions were examined. Analyses were stratified by whether concurrent prescribing was from a single prescriber or multiple prescribers. Opioid prescribing and concurrent opioid and benzodiazepine prescribing rates were examined by age and sex. Analyses were conducted in 2018. RESULTS: Among 19,977,642 patients that were prescribed an opioid, 21.6% (4,324,092) were also prescribed a benzodiazepine, of which 54.9% (2,375,219) had concurrent prescriptions. More than half of patients with concurrent opioids and benzodiazepines received prescriptions from 2 or more distinct prescribers. Mean total opioid days, daily opioid dosage, and days of concurrent prescribing were higher among patients when multiple prescribers were involved compared with concurrent prescriptions from the same prescriber. Concurrent prescribing was more common among adults aged ≥50 years and female patients. CONCLUSIONS: Public health interventions are needed to reduce concurrent prescribing of opioids and benzodiazepines. Evidence-based guidelines can help reduce concurrent prescribing when one prescriber is involved, and utilization of prescription drug monitoring programs and improved care coordination could help address concurrent prescribing when multiple prescribers are involved. SN - 1873-2607 UR - https://www.unboundmedicine.com/medline/citation/31564606/An_Examination_of_Concurrent_Opioid_and_Benzodiazepine_Prescribing_in_9_States_2015_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(19)30274-0 DB - PRIME DP - Unbound Medicine ER -