ArticleThe Journal of clinical psychiatry2019
New Coprescription of Opioids and Benzodiazepines and Mortality Among Veterans Affairs Patients With Posttraumatic Stress Disorder.
Article in The Journal of clinical psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis 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
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and acceptability of mindfulness-based interventions for military veterans: A systematic review and meta-analysis.Journal of psychosomatic research · 2020Pooled it
- A pilot randomized clinical trial evaluating the feasibility, acceptability, and preliminary efficacy of a cognitive-behavioral therapy adjunct to support benzodiazepine tapering among primary care patients coprescribed benzodiazepines and opioids.Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors · 2026Trial
- 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
- Risk of all-cause and cause-specific mortality, and suicide attempt in people with anxiety and stress-related disorders: a systematic review, meta-analysis and meta-regression analysis of 165 studies.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- Chronic prescription opioid use in MS: Associations with adverse outcomes and acute medical service utilization.medRxiv : the preprint server for health sciences · 2025Article
- Chronic opioid prescription in veterans with spinal cord injury: Prevalence and associated factors.The journal of spinal cord medicine · 2025Article
- Substance use and use disorders among Veterans on long-term opioid therapy.Drug and alcohol dependence reports · 2025Article
- Drug Safety and Suicidality Risk of Chronic Pain Medications.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Post-traumatic stress disorder and risky opioid use among persons living with HIV and chronic pain.AIDS care · 2023Observational
- Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review.Journal of clinical medicine · 2023Article
- Association Between Hypnotic Use and All-Cause Mortality in Patients with Chronic Obstructive Pulmonary Disease and Insomnia.International journal of chronic obstructive pulmonary disease · 2023Article
- Medication Use Evaluation of High-Dose Long-Term Opioid De-prescribing in Multiple Veterans Affairs Medical Centers.Journal of general internal medicine · 2022Article
- Latent Class Analysis of Prescribing Behavior of Primary Care Physicians in the Veterans Health Administration.Journal of general internal medicine · 2022Article
- Five-year incidence of substance use and mental health diagnoses following exposure to opioids or opioids with benzodiazepines during an emergency department encounter for traumatic injury.Drug and alcohol dependence · 2022Observational
- Concomitant opioid and benzodiazepine use and risk of suicide attempt and intentional self-harm: Pharmacoepidemiologic study.Drug and alcohol dependence · 2021Article
- Assessing opioid overdose risk: a review of clinical prediction models utilizing patient-level data.Translational research : the journal of laboratory and clinical medicine · 2021Review
- Association Between Benzodiazepine Use With or Without Opioid Use and All-Cause Mortality in the United States, 1999-2015.JAMA network open · 2020Article
- Potentially inappropriate prescribing in older adults with advanced chronic kidney disease.PloS one · 2020Article
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.
Funding
Abstract
backgroundOpioids and benzodiazepines are commonly coprescribed medications. The mortality risk associated with their concurrent use is unknown.
objectiveTo estimate the all-cause mortality risk for patients newly prescribed opioids and benzodiazepines concurrently relative to patients prescribed benzodiazepines only, opioids only, or neither medication.
methodsThis propensity score-matched, retrospective, cohort study included 17,476 patients receiving Veterans Affairs (VA) health care between October 1, 2009, and September 30, 2011, and diagnosed with posttraumatic stress disorder identified using ICD-9-CM code 309.81. One-year total and cause-specific mortality was assessed by hazard ratios and subhazard ratios, adjusted for propensity score, age, baseline psychiatric and medical comorbidity, and daily medication dose.
resultsConcurrent users (n = 4,369) were propensity score matched 1:1 with benzodiazepine-only users, opioid-only users, and nonusers. One year after medication start, the concurrent cohort had higher rates of all-cause mortality (116 deaths) relative to benzodiazepine-only (75 deaths; adjusted hazard ratio = 1.52; 95% CI, 1.14-2.03), opioid-only (67 deaths; 1.76; 95% CI, 1.32-2.35), and nonuser (60 deaths; 1.85; 95% CI, 1.30-2.64) cohorts. Risk of overdose death was greater among patients in the concurrent cohort relative to patients in the benzodiazepine-only (adjusted subhazard ratio = 2.59; 95% CI, 1.00-6.66), opioid-only (2.58; 95% CI, 1.09-6.11), and nonuser (9.16; 95% CI, 2.27-37.02) cohorts. For circulatory disease-related deaths, the adjusted subhazard ratio for concurrent medication users was 1.81 (95% CI, 1.01-3.24) relative to nonusers.
conclusionsNew coprescription of opioids and benzodiazepines was associated with increased all-cause mortality and overdose death compared with new prescription of benzodiazepines only, opioids only, or neither medication and increased circulatory disease-related death relative to neither medication.
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.