The Journal of Pain Summary

Highlight from The Journal of Pain (Volume 20, No. 4, April 2019)

---

Influence of Abuse History on Concurrent Benzodiazepine and Opioid Use in Chronic Pain Patients

Jennifer Pierce, Stephanie Moser, Afton L. Hassett, Chad M. Brummett, Julie A. Christianson, Jenna Goesling

In 2016, more than 42,200 deaths in the United States involved opioids. The rate of opioid-related deaths has risen steadily and drastically since 1999. Although public policy has focused on curbing these high rates, the epidemic remains a public health crisis.

An important predictor of opioid overdose is the co-use of benzodiazepines. Benzodiazepines are frequently prescribed to patients with chronic pain because of their broad clinical applications, including treatment of anxiety, sleep disorders, and seizures. Coping with anxiety may be particularly difficult among individuals with a history of abuse victimization because such victimization is often linked to heightened sensitivity to psychological or physical distress and poorer coping skills. However, when Benzodiazepines are combined with opioids, the consequence can be deadly because both medications can induce respiratory depression.

This study’s population included adult patients reporting current opioid use. Approximately 16 percent reported co-use of benzodiazepines and 17 percent reported a history of abuse. Co-use of benzodiazepines and opioids was reported more often among patients reporting cumulative abuse or child abuse only than in those who denied abuse or reported adult abuse only.

The authors concluded that the association between abuse victimization and benzodiazepine and opioid co-use should be considered in future research. Providers should be aware of life history factors, including abuse, that may drive the need for medication.