Mixing opioid painkillers and sleep medications -prescription for a deadly overdose (


The use of the very strong opioid painkillers such as Oxycontin, Percocet, and Vicodin, is already well-known for their risk of physical dependence, drowsiness, breathing and heart problems, constipation and bowel dysfunction, fractures and depression.  Now, a new study published March 14, 2017 in The BMJ finds that users of opioids who also use benzodiazepine such as Xanax or Valium for sleep or anxiety at the same time, are placing themselves at risk of a deadly overdose.

For the study data was collected on more than 300,000 privately insured patients, aged 18 to 64, who were prescribed a narcotic painkiller between 2001 and 2013.  In 2001, 9 percent of those patients also had prescriptions for benzodiazepines.  By 2013, that had increased to 17 percent which is an 80 percent relative increase. The finding from the data showed that those patients who were prescribed both types of drugs had twice the risk of ending up in hospital emergency rooms as did people who used only used opioids. 

Nearly 30 percent of all fatal overdoses from narcotic medications also involved a person who was using a benzodiazepine at the same time.

This finding is not surprising as over the years, prescriptions for both narcotic painkillers and benzodiazepines have risen.  The researchers with the study were not able to tell from the data whether the overdoses were intentional or accidental.  The symptom that caused the patients to be rushed to an emergency room was due to suppressed breathing. 

The takeaway from this study is that physicians need to assess the need for prescribing both an opioid medication along with a benzodiazepine medication.  There is always the possibility some patients are using two different doctors to prescribe each medication separately in attempts to hide what medications they are taking together at the same time. 

Some ways to help avoid this problem is for patients to always be completely truthful in informing their doctors as to what medications they are using.  Another intervention that can be done is by having insurance companies help to monitor medications patients are using. In addition, electronic health records could be designed to flash a warning when a potentially dangerous drug combination is being prescribed. 

It should be noted that this study was observational and does not prove that using both medications increases the risk of overdose.