Benzo co-prescribed for MAT for substance abusers BUT NOT FOR CHRONIC PAINERS ?

FDA Okays Benzodiazepines and Medication-Assisted Opioid Addiction Treatment

The FDA has issued a Drug Safety Communication on the use of benzodiazepines and opioid addiction medications. Benzodiazepines and other drugs that can depress the central nervous system do not have to be withheld from patients taking drugs such as buprenorphine or methadone for treatment of opioid addiction. However, careful medication management is needed to reduce the risks of serious side effects.

“The combined use of these drugs increases the risk of serious side effects; however, the harm caused by untreated opioid addiction can outweigh these risks,” the FDA stated in its safety communication. “Careful medication management by health-care professionals can reduce these risks.”

The new information will be added to labeling for buprenorphine and methadone, along with detailed recommendations for minimizing the use of medication-assisted treatment (MAT) drugs and benzodiazepines together. Side effects of combining opioids and benzodiazepines include dizziness or lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness.

Many people who are addicted to or dependent on opioids also take benzodiazepines or other CNS depressants either licitly to treat anxiety and other conditions or illicitly. The FDA recommends that a patient’s treatment plan should include several actions or precautions if buprenorphine or methadone are used in combination with CNS depressants. These include:

  • Educate MAT patients about the serious risks of combined use that can occur with CNS depressants.
  • Develop strategies to manage the use of prescribed or illicit benzodiazepines or other CNS depressants when starting MAT.
  • Taper the benzodiazepine or CNS depressant to discontinuation if possible.
  • Verify the diagnosis if a patient is receiving prescribed benzodiazepines or other CNS depressants for anxiety or insomnia, and considering other treatment options for these conditions.
  • Recognize that patients may require MAT medications indefinitely and their use should continue for as long as patients are benefiting and their use contributes to the intended treatment goals.
  • Coordinate care to ensure other prescribers are aware of the patient’s buprenorphine or methadone treatment.
  • Monitor for illicit drug use, including urine or blood screening.

This safety announcement is based on additional review of the use of these drugs together that caused the agency to update a previous communication. In late August 2016, the FDA had issued a strong warning against combining opioid medicines, including cough medicines, with benzodiazepines. 

13 Responses

  1. I’ve talked about this, til I’m blue in the face!!! Nothing is going to change until the government gets out of medicine. Doctors want stop tapering until the DEA says they won’t invade doctors office for prescribing over the 90mg morphine equivalent. Street addicts are treated better than CPP that take legal prescription. I’m through talking about this problem. A lot of good it does!!!!!!!

  2. 250,000 patients a year killed by medical malpractice not considered a crisis?

  3. Tracie I was just getting ready to say the same thing!

  4. Why did they not put “death”? As that is the clear warning on the actual drug product and every other opioid drug drug label, but for now they are going with “unconscious ” for buprenorphine and methadone? Lol. It’s only death when labeled if used for pain is that it? Or if the addict was using an opioid pain medication /illicit / legal or something not Government funded then it’s just they went “unconscious ” and then what? Blame it on, benadryl?
    legal pain and anxiety patients . again, those that have benefited safely for years, they are not unconscious or dead from safely prescribed medication , rather from being Un-prescribed their safe legal medications. No money there, they are being FORCED to choose what disease to treat, often when these different medications treat different diseases. The common people think Benzos, are simply to treat anxiety, when they have a much broader medical and important medical purpose, such as treating seizures, and patients are actually Being FORCED TO CHOOSE seizures or Pain control.
    just as opioid based medications, they to can treat a entirely different form of diseases such as REstless Syndrome and people are being forced to off even low doses that made sleeping manageable, and if somone was to say replace with a requip or other RLS medication, I give you the option, read the side effects from those mind altering insanity drugs, and MAKE you take the Parkinson drugs over that small dose of opioids, then let’s talk.
    This Gov is commiting genocide, and its choosing addicts as its future and WE ARE the unspeakables.

  5. Opioid & benzodiazepines have been prescribed together as needed for many, many years without overdose. Instead of government calling it like it is…….illicit fentanyl, illegal heroin, illegal street drugs……they have chosen to go after pain sufferers, anxiety disorders & good doctors!!!!! It’s unimaginable suffering placed on our most vulnerable community of afflicted patients!!! Many vets come home with PTSD, many patients suffer pain & anxiety. All afflictions/diagnosis deserve treatment. Ripping patients medications away are compounding the problems already causing havoc on patient systems. Mental health is widely stigmatized & now even more with the discontinuance of much needed anxiety medications

  6. Yes, this is hypocrisy. It is also inhumane. Who are the criminals here? Those taking illegal drugs or the Chronic Pain sufferers who have had their medication taken away from them by their own government? What country are we living in? This is not the country that I grew up in. How are the sick and suffering supposed to fight this atrocity by their own gov’t.? Where are the lawyers who are willing to help? This is genocide by our own country. Save the addicts and take much needed medication away from the sick and suffering. What is wrong with this picture?

  7. Recognize that patients may require MAT medications indefinitely…. $$$ New , lucrative market… Under the bus with the CPP’s wth!

  8. Ppl need to file Civil Rights/ Human Rights complaints as this is discrimination based on disability

    • wanita; do you really think that “people” haven’t tried? I & many of my fellow activists have repeatedly contacted multiple attorneys & civil rights orgs in person, by phone, by email, by snail mail. Nobody will touch anything to do with chronic pain, unless (possibly) we come up with many thousands of dollars up front.

  9. And some people wonder why many CPPs are enraged & feel that addicts get much more compassion & better treatment than people who’ve never abused their legal meds & (formerly, when they could get them) used their pain meds to function & have some QOL, rather than getting high off them. Un-freaking-real.

    • Can’t argue with that. It is insane. Help those who wish to get help but, please help us too!

  10. Hypocrisy … pure hypocrisy

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