Co-Use of Prescribed Benzodiazepines and Opioids is Increasing Among Older Adults

Jan. 8, 2019

Benzodiazepines, such as Xanax and Halcion, are prescribed sedatives to help with anxiety, insomnia and other conditions. Both benzodiazepines and opioids are considered potentially harmful and addictive drugs in older adults because they increase the risk of morbidity and mortality in older adults.

Dr. Greg Rhee, an adjunct assistant professor in the University of Minnesota College of Pharmacy, recently published a study in the Journals of Gerontology, Series A: Biological Sciences and Medical Sciences examining prescribing trends of co-medicating in outpatient settings of opioids and benzodiazepines.

Using a nationally representative sample, Rhee estimated national rates and prescribing trends and found that:

  • the rate of prescription benzodiazepines alone increased from 4.8 percent in 2006-2007 to 6.2 percent in 2014-2015;
  • the rate of prescription opioids alone increased from 5.9 percent in 2006-2007 to 10 percent in 2014-2015;
  • the co-prescribing rate of both benzodiazepines and opioids increased over time from 1.1 percent in 2006-2007 to 2.7 percent in 2014-2015.

Rhee identified demographic and clinical factors associated with co-prescriptions of benzodiazepines and opioids. These correlating independent factors associated with higher co-prescriptions include: being of the female sex, a visit for chronic care, receipt of six or more concomitantly prescribed medications, and clinical diagnoses of anxiety and pain.

“Because both benzodiazepines and opioids carry high-risks for older adults, the increasing use of these medications is concerning,” said Rhee. He makes the following recommendations on how health care providers can reduce co-prescribing opioids and benzodiazepines:

  •  health care providers should be more careful when prescribing these medications in older adults;
  •  health care providers can prescribe safer alternatives (e.g., non-opioid analgesics for opioids) to minimize potentially avoidable adverse drug events;
  •  pharmacists can provide detailed pharmaceutical information and outreach by collaborating with the clinical team.

Rhee added that, since co-use of benzodiazepines and opioids is associated with medication burdens and potential harms in older adults, future research is needed to address medication safety in vulnerable populations.

This study was funded by the National Institute on Aging and the National Institutes of Health.


The College of Pharmacy,