October 22, 2014
Alcohol Plus Opioids or Benzodiazepines: Potentially
Deadly Combination

Atlanta—Prescriptions for opioid pain relievers (OPRs) and benzodiazepines should come with a strong warning to avoid alcohol.

That’s according to a new analysis from the CDC and the FDA. The report was published recently in the Morbidity and Mortality Weekly Report.

Alcohol was commonly involved in hospital emergency department (ED) visits resulting from the abuse of OPRs or benzodiazepines, as well as in deaths related to those drugs, according to the analysis.

In fact, more than a fourth of ED visits related to benzodiazepine abuse—and nearly a fifth of OPR abuse–related ED visits—involved alcohol. Slightly more than 20% of the drug-related deaths from abuse of those medications also involved alcohol.

“Alcohol involvement was higher in single-drug class ED visits for benzodiazepines compared with all ED visits involving benzodiazepines as well as single drug-class deaths for both OPRs and benzodiazepines compared with all deaths involving these drugs,” according to the authors who point out that “this was especially pronounced for the benzodiazepine single-drug class deaths, for which 72.1% involved alcohol.”

Concurrent use of alcohol with the substances increases central nervous system depression and overdose risk, according to the report, which notes that “benzodiazepines and weaker OPRs are less likely to cause such events without the additive effect of alcohol.”

Combining alcohol with the powerful drugs was a bigger problem for men than women, according to the research, possibly because men report higher prevalence, frequency, and intensity of binge drinking.

“The fact that approximately one-fifth of OPR drug abuse–related ED visits and drug-related deaths involve alcohol suggests the need for stronger prevention measures to mitigate this significant public health problem,” the authors write. “OPRs and benzodiazepines are prescribed and dispensed by healthcare providers, and this presents an opportunity to discuss their risks, especially the serious risk of central nervous system depression when combined with alcohol or other depressants.”

Yet, they point out that only 16% of adults in the United States have discussed alcohol consumption with a health professional, while the percentage discussing other substance use is unknown.

The report calls for a range of interventions such as combined prevention programs that target alcohol and prescription drug abuse, systematic provider and patient education, and integration of screening and intervention services into the primary care health system. The authors note that early identification of problematic alcohol and drug use might reduce the number of ED visits and deaths related to drug abuse and alcohol.

U.S. Pharmacist Social Connect