Considering the risks of benzodiazepines and opioids together.

Using a cohort of more than 17,000 men and women followed for 4 to 7 years, Norwegian investigators Skurtveit and colleagues looked at recent opioid prescriptions for subjects who had earlier reported using benzodiazepines but no opioids. They came to the intriguing conclusion that benzodiazepine use contributes to later opioid use among subjects who had reported no opioid use to start. In fact, benzodiazepine users were more than seven times as likely to have at least 12 prescriptions for opioids than non-benzodiazepine users during the follow-up period. Controlling for pain and other potentially confounding factors reduced the benzodiazepine effect, yet users were still three times more likely to later user opioids than were nonusers.