WASHINGTON — Veterans who were prescribed an opioid and a benzodiazepine at the same time by the Veterans Health Administration (VHA) faced an increased risk of death, says a new report from the National Academies of Sciences, Engineering, and Medicine that analyzed millions of VHA medical records from 2007 to 2019. The report also finds some evidence that co-prescribing opioids and benzodiazepines increased veterans’ risk of death from suicide.
Death associated with co-prescribing opioids and benzodiazepines has raised concerns among health care providers, federal agencies, veterans, and the public for decades. Opioids are commonly prescribed for pain, and benzodiazepines are often prescribed for anxiety, panic disorders, insomnia, and seizures. The combination of taking both drugs at the same time is known to have potential adverse health effects, including suppressing breathing.
Concerns about prescribing opioids and their interaction with benzodiazepines first appeared in the VA/DOD Clinical Practice Guidelines in 2010. The report notes that in response to adverse outcomes, the VHA changed its clinical guidelines and policies – including during the years that the report examines.
“Our report adds an important point of confirmation to the ongoing conversation on how past opioid and benzodiazepine prescribing practices affected veterans seeking treatment for pain, as well as conditions like post-traumatic stress disorder, anxiety, and depression,” said Brian Strom, chair of the committee that wrote the report, chancellor of Rutgers Biomedical and Health Sciences, and executive vice president for health affairs at Rutgers University.
Each year about 9 million U.S. veterans receive health care services from the VHA. Veterans who receive health care through the VHA have a higher prevalence of both physical and mental health conditions such as post-traumatic stress disorder, anxiety, and depression compared with veterans who are treated elsewhere in the U.S. health care system. Studies have shown that about 19% of all veterans being treated at the VHA in 2004 were receiving an opioid prescription, compared to 33% in 2012, similar to national trends. Between 2004 and 2009, 27% of these veterans were also prescribed benzodiazepines. Opioid prescriptions declined overall at the VHA starting in 2012.
The report concludes that among veterans who received […]
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