Determining Efficacy of Intervention in the Limitation of Opioid and Benzodiazepine Co-Prescription.

INTRODUCTION

Multiplying the effects of central nervous system and respiratory depression, benzodiazepines are involved in 30 percent of opioid overdoses. The mortality rate in co-administration of both medications is 10 times higher than those taking only opioids. The medication labels even contain direct instructions or "black box" labels warning against their use in conjunction. However, opioids and benzodiazepines are commonly prescribed together by providers, regardless of these contraindications. The purpose of this manuscript was to bring further attention to the opioid crisis and to study the effect of a simple and cost-effective intervention in reducing the co-administration of benzodiazepines and opioids.

METHODS

A didactic clinical presentation along with handouts outlining the epidemiology of co-administration of benzodiazepines and opioids, side effects of each medication class, alternatives to consider prior to initiating therapy, guidelines on how to avoid medication misuse, recommendations for when to taper medications, and examples of how to taper these medications was made to attendings and residents of one family medicine clinic in a small, midwestern community. The number of patients co-prescribed these medications at this clinic was determined by searching the electronic medical record, the intervention was given, and three months later the number was measured again for comparison.

RESULTS

The intervention did not result in a significant decrease in those co-prescribed benzodiazepines and opioids.

CONCLUSIONS

This study opens the door to future studies investigating longer time frames, decreases in dosages, and patients appropriately prescribed these medications. Alternative interventions such as medical record notifications and more frequent education sessions provide direction for continued research in an effort to impact the epidemic our country is facing with the use of opioids, benzodiazepines and other prescription pain medications.