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Benzodiazepines Up Risk for Nonfatal Drug-Related Poisoning in OUD

FRIDAY, April 2, 2021 -- An increased risk for nonfatal drug-related poisoning is associated with benzodiazepine treatment in patients with opioid use disorder, according to a study published online March 3 in The American Journal of Psychiatry.

Kevin Y. Xu, M.D., from the Washington University School of Medicine in St. Louis, and colleagues used data from the IBM MarketScan database (2006 to 2016) to identify prescription claims in persons (aged 12 to 64 years) with opioid use disorder who were prescribed buprenorphine and who experienced drug-related poisoning.

The researchers found that buprenorphine treatment days were associated with a reduction in the risk for poisoning events (odds ratio [OR], 0.63) relative to nontreatment days. Benzodiazepine treatment days were associated with an increase in the risk for such events (OR, 1.88). There was an increase seen in poisonings associated with low-dose (OR, 1.78) and high-dose benzodiazepine treatment (OR, 2.22). High-dose benzodiazepine treatment was associated with increased poisonings in combination with buprenorphine cotreatment (OR, 1.64), but this was lower than the risk associated with benzodiazepine treatment in the absence of buprenorphine (ORs, 1.69 and 2.23 for low-dose and high-dose, respectively).

"Dose reduction of benzodiazepines while maintaining buprenorphine treatment may have the advantage of lowering drug-related poisoning risk," the authors write.

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