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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 10, 2019

Macleod J, et al. - Utilizing a large database of medical records from UK primary care linked to death records, researchers tested the assumption that prescription of benzodiazepines in patients receiving opioid agonist treatment (OAT) would raise the risk of mortality overall, irrespective of any increased treatment duration. Data from the Clinical Practice Research Datalink were collected for 12,118 patients aged 15–64 years prescribed OAT between 1998 and 2014. Findings showed an increased risk of death among people additionally prescribed a particular type of sedative—benzodiazepines—from overdose, despite staying in treatment longer. In addition, there was an association of co-prescription of z-drugs and gabapentinoids with increased mortality risk; however, for z-drugs, no evidence for a dose-response effect on drug-related poisoning (DRP) was identified, and for gabapentinoids, the elevated mortality risk was not specific to DRP. Clinicians should be careful to prescribe benzodiazepines to patients who are opioid-dependent.
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