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Prescription of benzodiazepines, z-drugs, and gabapentinoids and mortality risk in people receiving opioid agonist treatment: Observational study based on the UK Clinical Practice Research Datalink and Office for National Statistics death records

PLoS Medicine Dec 12, 2019

Macleod J, Steer C, Tilling K, et al. - By analyzing data from the Clinical Practice Research Datalink, researchers examined 12,118 patients aged 15–64 years prescribed opioid agonist treatment (OAT) between 1998 and 2014, to determine whether an increased risk of mortality overall, regardless of any increased treatment duration, may be seen in relation to prescription of benzodiazepines in patients receiving OAT. The Office for National Statistics provided data for 7,016 of these patients concerning their death and cause of death. Evaluation of all-cause mortality, drug-related poisoning (DRP) mortality, and mortality not attributable to DRP (non-DRP) was done. Findings revealed a specific link of co-prescription of benzodiazepine with increased risk of DRP in opioid-dependent people. Increased mortality risk was observed in relation to co-prescription of z-drugs and gabapentinoids; however, they found no proof for a dose–response impact on DRP for z-drugs, and for gabapentinoids the increased mortality risk was not specific to DRP. Findings revealed the link of concurrent prescription of benzodiazepine with longer treatment but still heightened risk of mortality overall. Exercising caution regarding prescribing benzodiazepines to opioid-dependent people was recommended to clinicians.
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