benzodiazepine

Long-Term Benzodiazepine Prescribing in Massachusetts: A 10-Year Longitudinal Study.

Dalvi Netrali N, DeNufrio Valerio Danielle D, Young Leonard D LD

Benzodiazepines are one of the most widely prescribed classes of medications in the United States. However, long-term benzodiazepine (LTB) prescribing may result in potential misuse and dependency. While standard definitions of LTB use are not uniformly applied in clinical settings, we examined LTB prescribing patterns in Massachusetts using a definition based on a review of the literature. We conducted a descriptive analysis of Massachusetts Prescription Monitoring Program data from 2013 through 2023. We identified people with LTB use as any benzodiazepine-naïve individual (no prescription for 365 d prior) whose days' supply of benzodiazepines was ≥30% (109 d) during a full 365-day period, beginning from their initial prescription. We followed people with LTB use for subsequent 365-day cycles (follow-up years 1-10) through 2023. We reported and stratified the prevalence of LTB use by age and gender. The baseline group of benzodiazepine-naïve Massachusetts residents included 339 481 people. Females across all age groups comprised a larger part of the baseline group (63.8%; n = 216 751) than males. Overlap of benzodiazepine and opioid agonist days' supply among people with LTB use declined slightly from 32.8% in follow-up year 1 to 29.1% in follow-up year 10. In Massachusetts, 4.4% (n = 14 905) and 2.0% (n = 6621) of the baseline group continued to meet LTB criteria at 5 and 10 years, respectively. In Massachusetts, 2% of the baseline continued to receive benzodiazepines after 10 years. Defining LTB use and benzodiazepine equivalence could promote safer benzodiazepine prescribing.

Persistence of Benzodiazepines After Initiation in Patients Prescribed Long-term Opioids: Retrospective Cohort Study.

Fenton Joshua J JJ, Fang Shao-You SY, Stewart Susan S, Tseregounis Iraklis Erik IE et al.

Patients prescribed long-term opioids are often co-prescribed benzodiazepines, which heighten overdose risk. To assess the persistence of new opioid-benzodiazepine co-prescriptions and identify patient characteristics associated with persistent co-prescription. Retrospective cohort study. Data from the Optum Labs Data Warehouse, which includes de-identified medical and pharmacy claims and enrollment records for commercial and Medicare Advantage enrollees across the United States. U.S. adults with a new benzodiazepine prescription (≥ 3 days' supply) from July 1, 2016 to December 31, 2021, who were prescribed opioids for ≥ 80% of days during a 6-month baseline period and no benzodiazepines in the prior year. Days of overlapping opioid and benzodiazepine prescriptions during 30-day periods for up to 1 year of follow-up, classified as 0, 1-10, 11-24, and ≥ 25 days. The study included 32,815 patients with mean follow-up of 9.9 months. Initial benzodiazepine prescriptions were written by primary care physicians (47.9%), psychiatrists (5.2%), or other specialties (46.9%). At month 12, 25.7% had persistent opioid-benzodiazepine overlap. Compared to patients with 1-10 days of overlap in month 1, those with 11-24 days had significantly increased odds of higher overlap at month 12 [adjusted odds ratio (aOR) for 11-24-day overlap at month 12: 3.58 (95% CI: 3.03-4.22); aOR for ≥ 25-day overlap: 3.65 (3.07-4.33)]; those with ≥ 25 days of month 1 overlap had even greater risk [aOR for 11-24 day overlap at month 12: 4.48 (3.85-5.22); aOR for ≥ 25 day overlap: 9.73 (8.37-11.32)]. Patients whose initial benzodiazepine prescriber was a psychiatrist were significantly more likely to have ≥ 25 days' overlap in month 1 (aOR vs. primary care physician: 2.45 [2.10-2.85]). Persistent opioid-benzodiazepine co-prescription is common following benzodiazepine initiation in patients prescribed long-term opioids, and greater days of initial overlap increases risk of long-term co-prescription.

From Lipoabdominoplasty to Lipedema Surgery: New Perspectives on Reducing Benzodiazepine Use.

Albanese Roberta R, Tomaselli Federica F, Tambasco Damiano D

Early benzodiazepine treatment and electrographic seizures after febrile status epilepticus.

Inui Takehiko T, Togashi Noriko N, Haginoya Kazuhiro K