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Concomitant Use of Opioids and Benzodiazepines in the Outpatient Setting
Author(s) -
Simon Jeremy,
Gehret Jeffrey,
Stolzenberg David,
Beredjiklian Pedro K.,
Teng Jonathon,
Paskey Taylor,
Raju Robin
Publication year - 2019
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2018.09.026
Subject(s) - medicine , medical prescription , benzodiazepine , concomitant , opioid , emergency medicine , outpatient clinic , anesthesia , pharmacology , receptor
Background Benzodiazepines have been identified as a concurrent factor in opioid‐related deaths. Although the dangers of concomitant administration of opioids and benzodiazepines are well documented, implementation of this knowledge into practice may be lagging behind. Objective To examine the concomitant use of opioids and benzodiazepines in the outpatient setting. Design Retrospective study. Setting Academic outpatient multispecialty practice. Participants Over 2000 outpatient clinic visits from January 2018 to April 2018 among four physiatrists were analyzed. Methods All patients were reviewed in the Prescription Drug Monitoring Program (PDMP) website to identify whether they have filled either opioid or benzodiazepine prescription(s) in the last 12 months. Main Outcome Measurements Number of opioid and benzodiazepine prescriptions, discrepancies in reporting of medications, providers prescribing medications, and cigarette/alcohol use. Results A total of 353 patients were identified to have filled either opioid or benzodiazepine prescription(s) in last 12 months. 49.4% of patients prescribed opioids were found to be taking benzodiazepines concurrently. Reporting discrepancies were noted between the outpatient electronic medical record and PDMP in 17.2% of patients. Among patients taking both opioids and benzodiazepines, 38.9% had multiple providers prescribing these medications, 41.9% were over 65 years old, and 11.9% were daily cigarette/alcohol users. Patients taking both types of drugs (opioids and benzodiazepines) were significantly more likely to use different providers (38.9%) compared to patients taking one type of drug (9.8%, P < .001). The former group was also noted to fill significantly more prescriptions than the latter group ( P < .001). Conclusion The study results emphasize that clinicians may not be aware that some of their patients are concurrently taking opioids and benzodiazepines. These results highlight the importance of routinely checking the PDMP and using that information to make fully informed decisions to minimize risks in use of these controlled substances. Level of Evidence III