The opioid epidemic has grown increasingly deadly, yet it is possible that an important component has been overlooked. It has been estimated that concurrent use of benzodiazepine and opioids may occur in as many as 50% of opioid overdose deaths.1 Yet, more and more patients leave their doctors’ offices with prescriptions for benzodiazepine medications. Across the medical profession, the percentage of outpatient visits resulting in a benzodiazepine prescription has increased from 3.8% in 2003 to 7.4% in 2015.2 This startling statistic suggests that more cautious and conservative use and prescription of benzodiazepines has the potential to save thousands of lives per year.
During the time period studied by Agarwal et al,2 outpatient psychiatrists manifested a stable pattern of benzodiazepine prescribing, delivering benzodiazepine prescriptions to the patient in 30% of psychiatric visits. Overall, prescriptions written by psychiatrists account for approximately one-sixth of the more than 25 million prescriptions that are written each year.3 In 2015 and 2016, 30.6 million US adults reported benzodiazepine use in the past year; of these, 5.3 million were deemed to be misusing them.3 The most common type of misuse occurs when prescribed medications are diverted and utilized by individuals who did not receive them for a legitimate medical indication.