Risk of Combining Certain Medications

The combination of certain sedatives and prescription pain medications is especially risky if multiple doctors prescribe two different types of drugs to the same patient rather than the same doctor.

The two classes of drugs, called benzodiazepines and opioids, both act on the brain. Benzodiazepines are prescribed for anxiety, insomnia, and panic attacks, while opioids are prescribed for pain.

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‘A risky combination of medicines gets riskier when a patient’s prescriptions come from two doctors.’

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Both drugs suppress the drive to breathe and past studies have shown a higher risk of overdose among patients who take opioids and benzodiazepines at the same time.

A new study shows that the risk of overdose is 20% greater for patients who filled current prescriptions written by two different providers.

The finding comes from an analysis of private insurance and Medicare Advantage claims among more than 529,000 people over the age of 12 who had overlapping benzodiazepine and opioid prescriptions between late 2016 and the end of 2018.

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The study is published in JAMA Network Open by a team from Michigan Medicine, the University of Michigan’s academic medical center.

“We know that having overlapping opioid and benzodiazepine prescriptions is one of the strongest risk factors for overdose. Our findings suggest that the circumstances that lead to these overlapping prescriptions matter”, said Kao-Ping Chua, M.D., Ph.D., lead author of the new study.

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The reason for the increased risk is speculated that it involves lack of coordination, a known risk factor for overdose.

As health record software differs, a doctor in one system might prescribe a benzodiazepine without being aware that the patient is being prescribed an opioid by a doctor in another system.

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This results in missed opportunities to co-prescribe naloxone and educate patients about the risk of overlapping opioid and benzodiazepine prescriptions.

The solution would be to create an alert to co-prescribe naloxone in electronic health records anytime a doctor tries to prescribe an opioid to a patient who is prescribed a benzodiazepine by another doctor in the same system.

Many states require prescribers to check a Prescription Drug Monitoring Program before prescribing controlled substances, which allows them to see if their patient is taking a medication that could clash with the one, they’re prescribing.

These high-tech solutions would not be needed if doctors did a better job of taking a complete medical history. This includes a list of all medication’s patients are taking.

Source-Medindia