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    Prescribing practices that increase risk of opioid overdose

    Concurrent opioid and benzodiazepine use is prevalent and needs to be addressed, according to two recent studies.

    study published in the British Medical Journal (BMJ), found that the simultaneous use of opioids and benzodiazepines, primarily used to treat anxiety and insomnia, has been increasing over the past decade, despite well known risks of this combination.  

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    Researchers at the Stanford University used a dataset of healthcare claims for more than 300,000 privately insured patients. Using these data, they tracked the simultaneous use of benzodiazepines and opioids between 2001 and 2013, as well as the incidence of emergency room visits and hospital admissions for opioid overdose during this time

    “We found that, in our study population, the simultaneous use of both drugs accounted for about 15% of ER visits/hospital admissions for opioid overdose,” according to lead author Eric Sun, MD, PhD, assistant professor, department of anesthesiology, perioperative and pain medicine, Department of Health Research and Policy, Stanford University.

    “This study is important for managed care executives because one reason why the growth in the use of both drugs may have increased—despite widespread knowledge of the risks—is that information on a given patient's prescriptions is quite fragmented,” Sun says. “Typically, it is difficult for one physician to know what another [physician] is prescribing; the only way to figure this out is to rely on the patient. However, insurers are in a position to know all the medications a patient has been prescribed. Indeed, our study used healthcare claims data." 

    Thus, according to Sun, managed care executives may be uniquely positioned to reduce the incidence of this and other potentially dangerous drug combinations by utilizing claims-based surveillance and monitoring systems and alerting physicians and patients of the concern. The BMJ published an editorial on Stanford’s research, which echoes this point.

    Next: Another study

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