ReviewPostgraduate medicine2013
Risks, management, and monitoring of combination opioid, benzodiazepines, and/or alcohol use.
Review in Postgraduate medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
104 citing papers in PubMed, 2 syntheses or guidelines pooled it, 247 citations in OpenAlex.
- Beyond benzodiazepines: a meta-analysis and narrative synthesis of the efficacy and safety of alternative options for alcohol withdrawal syndrome management.European journal of clinical pharmacology · 2023Pooled it
- Harmonizing post-market surveillance of prescription drug misuse: a systematic review of observational studies using routinely collected data (2000-2013).Drug safety · 2015Pooled it
- Effects of the neuroactive steroid precursor pregnenolone on stress- and alcohol cue-provoked pain responses in individuals with alcohol use disorder.Experimental and clinical psychopharmacology · 2026Trial
- Remifentanil enhances the sedative effect of remimazolam during anesthesia induction in patients undergoing hysteroscopy: a randomized controlled trial.Annals of medicine · 2025Trial
- Need and utility of a polyethylene glycol marker to ensure against urine falsification among heroin users.Drug and alcohol dependence · 2015Trial
- Use of sedative drugs among adults reporting illicit opioid use or prescription opioid use in the United States, 2017-2024.Drug and alcohol dependence · 2026Article
- Sex Differences in Older Adults with Risky Alcohol Consumption: Medication Use, Comorbidities, and Hepatic Biomarkers.Nutrients · 2026Article
- Questions on Medicines, Alcohol, and Illicit Drug Interactions in the Finnish AddictionLink Online Service: A Descriptive Analysis.Nordisk alkohol- & narkotikatidskrift : NAT · 2026Article
- Bromazolam Tablet Quantification and Analysis of Post-Mortem Cases From the National Programme on Substance Use Mortality (NPSUM).Drug testing and analysis · 2026Article
- Pharmacological topics of interest for young people: misinformation on TikTok is common.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Clinical Characteristics and Prognostic Factors of Patients with Acute Poisoning: A Retrospective Observational Cohort Study of Diquat, Single-Drug and Mixed-Drug Exposures.Risk management and healthcare policy · 2026Article
- Risk factors for morphine-associated sedation in intravenous patient-controlled analgesia for postoperative pain.BMC anesthesiology · 2025Article
- Harm reduction approaches for the use of benzodiazepines: a scoping review.Harm reduction journal · 2025Article
- Benzodiazepines and Opioid co-use Among Rural People Who Use Drugs: Findings From the Rural Opioid Initiative.Substance use & addiction journal · 2025Article
- Recent advances in alcohol metabolism: from the gut to the brain.Physiological reviews · 2025Review
- Spatial associations between alcohol detection in opioid overdose deaths and alcohol outlets.Drug and alcohol dependence · 2025Article
- Advancement in Opioid Abuse-deterrent Formulation Technologies and Regulatory Expectation.Current drug research reviews · 2025Review
- Impact of 'street' benzodiazepines on drug-related deaths in England, Wales and Northern Ireland.Drug and alcohol review · 2025Article
- A Mixed-Methods Study of Motives for Benzodiazepine Misuse Among Adults Receiving Substance Use Disorder Treatment.Substance use & misuse · 2025Article
- Benzodiazepine Use Among Individuals with Opioid Use Disorder: A Narrative Review.Substance abuse and rehabilitation · 2025Review
44 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
The concurrent use of opioids, benzodiazepines (BZDs), and/or alcohol poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs and/or alcohol are at higher risk for fatal/nonfatal overdose and have more aberrant behaviors. Few practice guidelines for BZD treatment are readily available, especially when they are combined clinically with opioid analgesics and other central nervous system-depressant agents. However, coadministration of these agents produces a defined increase in rates of adverse events, overdose, and death, warranting close monitoring and consideration when treating patients with pain. To improve patient outcomes, ongoing screening for aberrant behavior, monitoring of treatment compliance, documentation of medical necessity, and the adjustment of treatment to clinical changes are essential. In this article, we review the prevalence and pharmacologic consequences of BZDs and/or alcohol use among patients with pain on chronic opioid therapy, as well as the importance of urine drug testing, an indispensable tool for therapeutic drug monitoring, which helps to ensure the continued safety of patients. Regardless of risk or known aberrant drug-related behaviors, patients on chronic opioid therapy should periodically undergo urine drug testing to confirm adherence to the treatment plan.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.