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Adverse outcomes associated with concurrent gabapentin, opioid, and benzodiazepine utilization: A nested case-control
Abisola Olopoenia1, Wendy Camelo-Castillo1, Danya M Qato1,2
1Department of Pharmaceutical Health Services Research, University of Maryland Baltimore, Baltimore, MD, USA.
Lancet Regional Health. Americas
|February 13, 2023
Summary
Concurrent use of gabapentin, opioids, and benzodiazepines significantly increases the risk of respiratory depression and overdose. This study highlights the critical need to evaluate the combined risks of these commonly prescribed medications.
Area of Science:
- Pharmacology
- Public Health
- Clinical Medicine
Background:
- Gabapentin, opioids, and benzodiazepines are frequently prescribed for pain and psychiatric conditions.
- Co-prescription of these medications is common, yet their combined use and associated public health outcomes are not well understood.
Purpose of the Study:
- To examine the association between concurrent use of gabapentin (GABA), opioids (OP), and benzodiazepines (BZD) and adverse health outcomes.
- To investigate risks of respiratory depression, opioid-related overdose, and substance-related overdose among Medicare beneficiaries.
Main Methods:
- A nested case-control study using Medicare CCW Data (2013-2016).
- Examined Fee-for-service disabled beneficiaries with acute pain, chronic pain, or mental health conditions receiving GABA, OP, or BZD.
- Concurrent medication use was defined as at least one day overlap in prescriptions.
Main Results:
- Concurrent GABA+OP+BZD use was linked to increased odds of respiratory depression, opioid-related overdose, and substance-related overdose.
- GABA+OP and GABA+BZD use were associated with significantly higher odds of substance-related overdose across all clinical cohorts.
- Specific increased odds ratios were reported for different pain and mental health cohorts compared to single-drug use.
Conclusions:
- Concurrent utilization of gabapentin, opioids, and benzodiazepines is associated with multiple adverse outcomes in Medicare disabled beneficiaries.
- Comprehensive examination of the benefits and risks of co-prescribing these medications is imperative.
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