Benzodiazepines Tied to Drug Overdose in Young People With Sleep Disorders

Findings even stronger for young people with a recent opioid prescription

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MONDAY, Nov. 28, 2022 (HealthDay News) -- Benzodiazepines are associated with an increased risk for drug overdose among young people versus alternative pharmacologic treatments for common sleep disorders, according to a study published online Nov. 22 in JAMA Network Open.

Greta A. Bushnell, Ph.D., from Rutgers University in New Brunswick, New Jersey, and colleagues evaluated whether benzodiazepine treatment for sleep disorders is associated with an increased risk for drug overdose for young people (2009 through 2018) compared to alternative pharmacologic treatments (trazodone, hydroxyzine, zolpidem, zaleplon, and eszopiclone). The analysis included 23,084 young people (10 to 29 years of age) with a sleep disorder diagnosis initiating a benzodiazepine and 66,706 initiating a comparator pharmacologic treatment.

The researchers found that the crude incidence of drug overdose at six months was 0.9 percent for benzodiazepine initiators and 0.8 percent for comparator treatment initiators, yielding an increased risk for drug overdose with benzodiazepines versus comparator treatments in an adjusted analysis (intention-to-treat analysis: hazard ratio, 1.25; 95 percent confidence interval, 1.03 to 1.51; as-treated analysis: hazard ratio, 1.44; 95 percent confidence interval, 1.14 to 1.80). This association was even stronger among young people with a recent prescription opioid fill versus those without a recent prescription fill (as-treated analysis: adjusted hazard ratios [95 percent confidence intervals], 2.01 [1.24 to 3.25] versus 1.31 [1.00 to 1.70]).

"The findings of this study suggest that the elevated risk of drug overdose with benzodiazepine treatment compared with alternative pharmacologic treatments for sleep disorders is an important safety consideration when treating young people," the authors write.

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