ArticleThe American journal of psychiatry2021
Association Between Benzodiazepine or Z-Drug Prescriptions and Drug-Related Poisonings Among Patients Receiving Buprenorphine Maintenance: A Case-Crossover Analysis.
Article in The American journal of psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Clinical outcomes associated with drug-drug interactions involving buprenorphine: a systematic review.Addiction science & clinical practice · 2026Pooled it
- Reframing Buprenorphine as a Pharmacologic Modifier of Opioid-Induced Respiratory Depression in the Fentanyl Era.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Risk of opioid overdose during buprenorphine treatment for opioid use disorder in the fentanyl era.Addictive behaviors · 2026Article
- Incident benzodiazepine and Z-drug use and subsequent risk of alcohol- and drug-related problems: A nationwide matched cohort study with co-twin comparison.Journal of psychopharmacology (Oxford, England) · 2026Article
- Dose trajectories associated with non-fatal overdose among patients co-prescribed opioids and benzodiazepines: Retrospective cohort study.Drug and alcohol dependence · 2025Article
- A qualitative study of benzodiazepine/z-drug and opioid co-use patterns and overdose risk.Harm reduction journal · 2025Article
- Buprenorphine and postpartum contraception utilization among people with opioid use disorder: a multi-state analysis.Addiction science & clinical practice · 2025Article
- Clinical Outcomes of Benzodiazepine Prescribing for People Receiving Opioid Agonist Treatment: A Systematic Review of the Evidence.Pharmacy (Basel, Switzerland) · 2024Review
- Prescription psychostimulant use, admissions and treatment initiation and retention in pregnant people with opioid use disorder.Nature. Mental health · 2024Article
- Article
- Pregnancy Rates Among Women Treated with Medication for Opioid Use Disorder.Journal of general internal medicine · 2024Article
- Pharmacokinetic-pharmacodynamic analysis of drug liking blockade by buprenorphine subcutaneous depot (CAM2038) in participants with opioid use disorder.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024Article
- Treatment setting and buprenorphine discontinuation: an analysis of multi-state insurance claims.Addiction science & clinical practice · 2024Observational
- Co-occurring psychiatric disorders and disparities in buprenorphine utilization in opioid use disorder: An analysis of insurance claims.Drug and alcohol dependence reports · 2023Article
- Racial and Ethnic Inequities in Buprenorphine and Methadone Utilization Among Reproductive-Age Women with Opioid Use Disorder: an Analysis of Multi-state Medicaid Claims in the USA.Journal of general internal medicine · 2023Article
- Gabapentin Use Among Individuals Initiating Buprenorphine Treatment for Opioid Use Disorder.JAMA psychiatry · 2023Article
- Article
- Prescription characteristics associated with drug overdose risk among adults prescribed benzodiazepines: a cohort study.BMC pharmacology & toxicology · 2023Article
- Initiation and Treatment Discontinuation of Medications for Opioid Use Disorder in Pregnant People Compared With Nonpregnant People.Obstetrics and gynecology · 2023Article
- Benzodiazepine Use and Dependence in Relation to Chronic Pain Intensity and Pain Catastrophizing.The journal of pain · 2023Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectivePersons with opioid use disorder who take benzodiazepines are at high risk for overdose. The objective of this study was to evaluate the association of benzodiazepine and Z-drug use with drug-related poisonings among patients receiving buprenorphine maintenance treatment.
methodsA case-crossover study design was used to analyze prescription claims among persons ages 12-64 with opioid use disorder who had buprenorphine prescriptions and had claims data in the IBM MarketScan databases (2006-2016), encompassing 14,213,075 person-days of observation time for 23,036 individuals who experienced drug-related poisoning. The exposures were buprenorphine prescriptions and benzodiazepine or Z-drug prescriptions, standardized as daily diazepam-equivalent milligram doses and separated by pharmacologic properties (short-acting or long-acting benzodiazepines, Z-drugs). The outcome of interest was nonfatal drug-related poisoning. Conditional logistic regression was used to evaluate variation in benzodiazepine or Z-drug and buprenorphine use between poisoning and nonpoisoning days.
resultsBuprenorphine treatment days were associated with a nearly 40% reduction in the risk of poisoning events (odds ratio=0.63, 95% CI=0.60, 0.66) compared with nontreatment days, whereas benzodiazepine or Z-drug treatment days were associated with an 88% increase in the risk of such events (95% CI=1.78, 1.98). In stratified analyses by dose, we observed a 78% (95% CI=1.67, 1.88) and 122% (95% CI=2.03, 2.43) increase in poisonings associated with low-dose and high-dose benzodiazepine or Z-drug treatment days, respectively. High-dose, but not low-dose, benzodiazepine or Z-drug treatment was associated with increased poisonings in combination with buprenorphine cotreatment (odds ratio=1.64, 95% CI=1.39, 1.93), but this was lower than the odds risk associated with benzodiazepine or Z-drug treatment in the absence of buprenorphine (low-dose: odds ratio=1.69, 95% CI=1.60, 1.79; high-dose: odds ratio=2.23, 95% CI=2.04, 2.45).
conclusionsIncreased risk of nonfatal drug-related poisoning is associated with benzodiazepine or Z-drug treatment in patients with opioid use disorder, but this risk is partially mitigated by buprenorphine treatment. Dose reduction of benzodiazepines or Z-drugs while maintaining buprenorphine treatment may provide the advantage of lowering drug-related poisoning risk.
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