ArticleBMJ open2019
Characterisation of concurrent use of prescription opioids and benzodiazepine/Z-drugs in Alberta, Canada: a population-based study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Inappropriate use of clinical practices in Canada: a systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Pooled it
- Concurrent Prescribing of Opioids and Sedative-Hypnotic Drugs for Long-Term Use in Australian General Practice: A Cross-Sectional Analysis Using MedicineInsight.Pharmacology research & perspectives · 2025Article
- Psychiatric and racial/ethnic differences in incident and long-term benzodiazepine use: A commercial healthcare claims study.Journal of psychiatric research · 2025Article
- Comparison of opioid use among long-term care residents in Ontario and Alberta, Canada: A multi-jurisdictional, repeated cross-sectional study.Canadian journal of pain = Revue canadienne de la douleur · 2025Article
- Article
- Association Between Concurrent Use of Benzodiazepines and Opioids and Health Care Utilization Among Patients With Cancer in Puerto Rico.JCO global oncology · 2023Article
- Co-prescribing of Central Nervous System-Active Medications for COPD Patients: Impact on Emergency Room Visits and Hospitalization.The Annals of pharmacotherapy · 2023Article
- A method for generating synthetic longitudinal health data.BMC medical research methodology · 2023Article
- Concurrent Use of Prescription Opioids and Gabapentinoids in Older Adults.American journal of preventive medicine · 2022Article
- Risk Prescriptions of Strong Opioids in the Treatment of Chronic Non-Cancer Pain by Primary Care Physicians in Catalonia: Opicat Padris Project.International journal of environmental research and public health · 2022Article
- Article
- Acute Care Use by Breast Cancer Patients on Adjuvant Chemotherapy in Alberta: Demonstrating the Importance of Measurement to Improving Quality.Current oncology (Toronto, Ont.) · 2021Article
- 'Z-trip'? A Comprehensive Overview and a Case-series of Zolpidem Misuse.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2021Article
- Opioid use in medical cannabis authorization adult patients from 2013 to 2018: Alberta, Canada.BMC public health · 2021Article
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Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe objective of this study is to characterise concurrent use of benzodiazepine receptor modulators and opioids among prescription opioid users in Alberta in 2017.
designA population based retrospective study.
settingAlberta, Canada, in the year 2017.
participantsAll individuals in Alberta, Canada, with at least one dispensation record from a community pharmacy for an opioid in the year 2017. EXPOSURE: Concurrent use of a benzodiazepine receptor modulator and opioid, defined as overlap of supply for both drugs for at least 1 day.
main outcome measuresPrevalence of concurrency was estimated among subgroups of patient characteristics that were considered clinically relevant or associated with inappropriate medication use.
resultsAmong the 547 709 Albertans who were dispensed opioid prescriptions in 2017, 132 156 (24%) also received prescriptions for benzodiazepine receptor modulators. There were 96 581 (17.6%) prescription opioid users who concurrently used benzodiazepine receptor modulators with an average of 98 days (SD=114, 95% CI 97 to 99) of total cumulative concurrency and a median of 37 days (IQR 10 to 171). The average longest duration of consecutive days of concurrency was 45 (SD=60, 95% CI 44.6 to 45.4) with a median of 24 days (IQR 8 to 59). Concurrency was more prevalent in females, patients using an average daily oral morphine equivalent >90 mg, opioid dependence therapy patients, chronic opioid users, patients utilising a high number of unique providers, lower median household incomes and those older than 65 (p value<0.001 for all comparisons).
conclusionsConcurrent prescribing of opioids and benzodiazepine receptor modulators is common in Alberta despite the ongoing guidance of many clinical resources. Older patients, those taking higher doses of opioids, and for longer durations may be at particular risk of adverse outcomes and may be worthy of closer follow-up for assessment for dose tapering or discontinuations. As well, those with higher healthcare utilisation (seeking multiple providers) should also be closely monitored. Continued surveillance of concurrent use of these medications is warranted to ensure that safe drug use recommendations are being followed by health providers.
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