Between and , overdose mortality involving benzodiazepines rose at a faster rate than did the percentage of individuals filling prescriptions and the quantity filled. From to , overdose death rates, opioid analgesic sales, and addiction treatment admissions related to opioid analgesics increased in parallel. There are several tools to assess risk of misuse and diversion prior to starting opioid analgesics. Depression and pain co-morbidity: First, increases in the total quantity filled reflected both an increase in the number of individuals filling benzodiazepine prescriptions and substantial increases in the amount each individual received. In , the age-adjusted rate of drug overdose deaths Its a no brainer about what to do here folks.
Hennessy conceptualized and designed the study and performed statistical analysis. Starrels supervised the study. To describe trends in benzodiazepine prescriptions and overdose mortality involving benzodiazepines among US adults. Between and , the percentage of adults filling a benzodiazepine prescription increased from 4. The quantity of benzodiazepines filled increased from 1. The overdose death rate increased from 0. Benzodiazepine prescriptions and overdose mortality have increased considerably.
Fatal overdoses involving benzodiazepines have plateaued overall; however, no evidence of decreases was found in any group. Interventions to reduce the use of benzodiazepines or improve their safety are needed. We investigated trends in prescriptions of benzodiazepines and fatal overdoses involving benzodiazepines among adults in the United States. We obtained data on filled benzodiazepine prescriptions from the Medical Expenditure Panel Survey.
To calculate the total quantity of benzodiazepine prescriptions filled each year, we summed the quantity of each benzodiazepine type and converted to milligram lorazepam equivalents. Overdose deaths involving benzodiazepines were extracted from multiple-cause-of-death data from the Centers for Disease Control and Prevention from to This captures all overdose deaths determined by the physician, medical examiner, or coroner to involve a benzodiazepine, including those involving other medications or illicit drugs.
To describe trends over time, we used the Joinpoint Regression Program Version 4. We summarized trends between joinpoints by calculating an annual percent change. We summarized overall trends by calculating the average annual percent change over the entire study period. A full description of the study methods is provided in the Appendix available as a supplement to the online version of this brief at http: Similarly, the percentage of adults filling a benzodiazepine prescription increased from 4.
The total quantity of benzodiazepines filled more than tripled from 1. In , the most common indications for benzodiazepine prescription were anxiety disorders The rate of overdose deaths involving benzodiazepines increased more than 4-fold from 0. Trends in prescriptions and overdose mortality varied between demographic groups Appendix, Table A, and Figure A, available as supplements to the online version of this brief at http: Despite an overall plateau in the rate of overdose deaths involving benzodiazepines, this rate continued to increase throughout the study period for adults aged 65 or older and for Black and Hispanic participants.
Between and , overdose mortality involving benzodiazepines rose at a faster rate than did the percentage of individuals filling prescriptions and the quantity filled. This could be the result of several factors. First, increases in the total quantity filled reflected both an increase in the number of individuals filling benzodiazepine prescriptions and substantial increases in the amount each individual received.
Among people who filled benzodiazepine prescriptions, the median quantity filled over the year more than doubled between and , suggesting either a higher daily dose or more days of treatment, which potentially increased the risk of fatal overdose. The proportion of fatal overdoses involving diverted versus prescribed benzodiazepines is unknown. Finally, increases in alcohol use or combining benzodiazepines with other medications e.
Future research should examine the roles of these potential mechanisms to identify effective policy interventions to improve benzodiazepine safety. In particular, as underscored by several recent reports, 6,10,12 interventions to reduce concurrent use of opioid analgesics or alcohol with benzodiazepines are needed. This study had several limitations. First, the Medical Expenditure Panel Survey was limited to the civilian, noninstitutionalized population, whereas institutionalized patients, such as those in correctional facilities or skilled nursing facilities, are likely to have different rates of benzodiazepine use and overdose.
Second, variation in methods used to characterize deaths over time and between states may have led to misclassification. States vary in methods used to characterize deaths, including use of toxicological testing. Third, we could not analyze long-term versus short-term use of benzodiazepines over time because the duration of treatment of prescriptions i. These categories are not mutually exclusive and therefore cannot be summed. Skip to main content. Drugs Involved in U. The figure above is a bar chart showing the total number of U.
These categories were equal in Since then, deaths involving both cocaine and opioids have more than doubled, while cocaine deaths not involving opioids have increased by only nine percent. Included in this number are opioid analgesics, along with heroin and illicit synthetic opioids. The chart is overlayed by a line graph showing the number of deaths of females and males.
From to there was a 2. Non-methadone synthetics is a category dominated by illicit fentanyl, and has been excluded to more accurately reflect deaths from prescription opioids. From to there was a 1.