Opioids and Benzos not a good combination, health directors say

Be careful when combining benzos and opioids

Baltimore Health Commissioner Leana Wen will join other health directors across the country today in asking the federal government to require a "black box warning" when prescribing opioids with a class of drugs called benzodiazepines.

The health directors believe the combination of drugs are helping to drive the epidemic of prescription drug overdoses. They will deliver a petition to the U.S. Food and Drug Administration Monday.

Black box warnings appear on the labels of prescription drugs and call attention to serious or life-threatening risks.  

In Maryland, benzodiazepines were associated with 18.5 percent of prescription deaths in 2014, the latest numbers available.  Severnty-four percent of Maryland’s benzodiazepine associated deaths in 2012 involved prescription opioids.

In 2013, 22,767 people in the United States died of drug overdoses that involved prescription drugs. Approximately 1 in 3 unintentional overdose deaths from prescription opioids also involve benzodiazepines.

Benzodiazepines are drugs that work in the central nervous system to treat medical conditions such as anxiety and panic attacks. They are also used as sedatives and muscle relaxtants and to treat alcohol withdrawal and prevent seizures. Opioids are a pain medication.

City Health Commissioners who have signed the petition are:
• Baltimore: Leana Wen, M.D. MSc,
• Boston, MA: Monica Valdes Lupi, J.D., M.P.H.
• Chicago, IL: Julie Morita, M.D.,
• Dallas, TX: Zachary Thompson
• Denver, CO: Robert McDonald
• Detroit, MI: Abdul El-Sayed, M.D., DPhil
• Houston, TX: Stephen L. Williams, M.Ed., M.P.A.
• Long Beach, CA: Kelly Colopy
• Minneapolis, MN: Gretchen Musicant
• New York City, NY: Mary T. Bassett, M.D., M.P.H.
• Philadelphia, PA: Caroline C. Johnson, M.D., Acting Medical Director,
• Sacramento, CA: Olivia Kasirye, M.D., M.S.
• San Francisco, CA: Tomás J. Aragón, M.D., DrPH

State and Territorial Health Directors who signed the petition include:
• Alaska: Jay C. Butler, MD
• Arizona: Cara Christ, MD, MS
• Arkansas: Nathaniel Smith, MD, MPH
• Connecticut: Raul Pino MD, MPH
• Delaware: Karyl Thomas Rattay MD, MS
• Guam: James W. Gillan, MS, HSA
• Maine: Kenneth Albert R.N., Esq.
• Maryland: Howard M. Haft, M.D.
• Massachusetts: Monica Bharel, MD, MPH
• Minnesota: Edward P. Ehlinger, MD, MSPH
• Montana: Richard H. Opper
• Pennsylvania: Karen M. Murphy, PhD RN
• Rhode Island: Nicole Alexander-Scott, MD, MPH
• South Carolina: Catherine Heigel
• Vermont: Harry Chen, MD
• West Virginia: Rahul Gupta, MD, MPH, FACP
• Commonwealth of the Northern Mariana Islands: Esther Muna, MHA, CPC

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