It's long been feared that treating patients addicted to opioids with buprenorphine while those patients were also using various benzodiazepines (i.e., sedating drugs such as Valium, Xanax, and Ativan, etc.) might cause harm.
Researchers at Washington University School of Medicine in St. Louis have just released data on 23,000 patients treated for opioid addiction. The new data appears to show that it is, in fact, safe to use both classes of drugs simultaneously.
The study can be found in The American Journal of Psychiatry.
According to Kevin Xu, MD, a physician in the Department of Psychiatry at the Washington University School of Medicine and lead study author, "It's well known that buprenorphine saves lives in patients with opioid use disorder, but because the drug has central nervous system depressing effects, there have been big questions about safety when patients also take benzodiazepines, which also depress the central nervous system. Our findings, however, indicate that buprenorphine makes overdose less likely, even in people also taking benzodiazepines."
According to Xu, many opioid use disorder patients are turned away by treatment centers if it is discovered those patients are also using benzodiazepines to manage other symptoms. Other providers accept these clients but then rapidly taper off the use of the benzodiazepines. It is Xu's belief that such a practice can have a damaging destabilizing effect on those in treatment.
Some of the details of the study
While studying whether buprenorphine prevents future opioid overdoses, the researchers also sought to determine whether taking benzodiazepines at the same time might increase overdose risk.
What they found was opioid users who took buprenorphine alone saw a 40 reduction in overdoses compared to those not receiving the drug.
They also found that opioid users with benzodiazepine prescriptions and not using buprenorphine had almost double the risk of an overdose requiring hospitalization.
According to Dr. Xu, the data suggests that taking buprenorphine alone has a more significant protective effect against future overdose events than when the two classes of drugs are combined. But it is also clear that when the two categories of drugs are used in tandem, opioid overdose likelihood drops.
Interestingly, the study drew no conclusions about how opioids, buprenorphine, and benzodiazepines interact when combined in the central nervous system.
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