ArticleBMJ (Clinical research ed.)2015
Benzodiazepine prescribing patterns and deaths from drug overdose among US veterans receiving opioid analgesics: case-cohort study.
Article in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 299 papers, 6 of them syntheses that pooled it.
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Who cites it
299 citing papers in PubMed, 6 syntheses or guidelines pooled it, 571 citations in OpenAlex.
- Clinical outcomes associated with drug-drug interactions involving buprenorphine: a systematic review.Addiction science & clinical practice · 2026Pooled it
- Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations When Risks Outweigh Benefits.Journal of general internal medicine · 2025Guideline
- Predictors of fatal and nonfatal overdose after prescription of opioids for chronic pain: a systematic review and meta-analysis of observational studies.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Pooled it
- CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2022Guideline
- Application of a diazepam milligram equivalency algorithm to assess benzodiazepine dose intensity in Rhode Island in 2018.Journal of managed care & specialty pharmacy · 2022Pooled it
- [Recommendations of the second update of the LONTS guidelines : Long-term opioid therapy for chronic noncancer pain].Schmerz (Berlin, Germany) · 2020Pooled it
- Effect of Paroxetine or Escitalopram Coadministered with Oxycodone versus Oxycodone Alone on Ventilation during Hypercapnia: A Randomized Clinical Trial.Anesthesiology · 2026Trial
- Effect of midazolam co-administered with oxycodone on ventilation: a randomised clinical trial in healthy volunteers.British journal of anaesthesia · 2025Trial
- Augmenting the efficacy of benzodiazepine taper with telehealth-delivered cognitive behavioral therapy for anxiety disorders in patients using prescription opioids: A pilot randomized controlled trial.Contemporary clinical trials · 2023Trial
- Effect of Pharmacist Email Alerts on Concurrent Prescribing of Opioids and Benzodiazepines by Prescribers and Primary Care Managers: A Randomized Clinical Trial.JAMA health forum · 2022Trial
- Accidental and Intentional Drug Poisoning Mortality in Older Adults in Spain: Nationwide Trends, 2001-2022.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026Article
- Higher prevalence of non-fatal overdose with opioid and stimulant use compared to use of opioids alone.Drug and alcohol dependence · 2026Article
- Prescription Patterns of Benzodiazepines and Opioid Analgesics in Adults with and without Major Psychiatric Disorders: A Nationwide Cohort Study.Yonsei medical journal · 2026Article
- Hospital Drug Burden and Post-Discharge Health Care Utilization in Older Adults Prescribed Central Nervous System-Active Medications.Journal of the American Geriatrics Society · 2026Article
- Distinct Patterns of Intentional and Unintentional Overdose Among Psychiatric Patients With Bipolar and Substance Use Disorders.Rhode Island medical journal (2013) · 2026Article
- A population-based study exploring racial and gender inequities in polysubstance-related deaths across the United States from 2004 to 2022.Addiction (Abingdon, England) · 2026Article
- Opioid-specific risk of respiratory depression in non-cancer pain: a retrospective cohort study.BMC medicine · 2026Article
- Characterizing treatment initiation with central nervous system-active polypharmacy among adults with dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Article
- Machine Learning Prediction and Reducing Overdoses With Electronic Health Record Nudges (mPROVEN) in the Primary Care Setting: Protocol for a Cluster Randomized Controlled Trial.JMIR research protocols · 2026Article
239 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo study the association between benzodiazepine prescribing patterns including dose, type, and dosing schedule and the risk of death from drug overdose among US veterans receiving opioid analgesics.
designCase-cohort study.
settingVeterans Health Administration (VHA), 2004-09.
participantsUS veterans, primarily male, who received opioid analgesics in 2004-09. All veterans who died from a drug overdose (n=2400) while receiving opioid analgesics and a random sample of veterans (n=420,386) who received VHA medical services and opioid analgesics.
main outcome measureDeath from drug overdose, defined as any intentional, unintentional, or indeterminate death from poisoning caused by any drug, determined by information on cause of death from the National Death Index.
resultsDuring the study period 27% (n=112,069) of veterans who received opioid analgesics also received benzodiazepines. About half of the deaths from drug overdose (n=1185) occurred when veterans were concurrently prescribed benzodiazepines and opioids. Risk of death from drug overdose increased with history of benzodiazepine prescription: adjusted hazard ratios were 2.33 (95% confidence interval 2.05 to 2.64) for former prescriptions versus no prescription and 3.86 (3.49 to 4.26) for current prescriptions versus no prescription. Risk of death from drug overdose increased as daily benzodiazepine dose increased. Compared with clonazepam, temazepam was associated with a decreased risk of death from drug overdose (0.63, 0.48 to 0.82). Benzodiazepine dosing schedule was not associated with risk of death from drug overdose.
conclusionsAmong veterans receiving opioid analgesics, receipt of benzodiazepines was associated with an increased risk of death from drug overdose in a dose-response fashion.
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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.