Health Officials Push FDA to Add ‘Black Box’ Warnings About Using Opioids, Benzodiazepines Together


Dozens of public health officials and academics across the country are pushing the Food and Drug Administration to warn people about the potential dangers of taking powerful prescription painkillers alongside common anti-anxiety drugs known as benzodiazepines.

In a petition submitted to the agency Monday, 41 officials from various state and municipal health departments, as well as from some universities, urged the agency to add so-called “black box” warnings to both types of medications, given evidence that using them together increases the chance of deadly overdoses.

“The science clearly demonstrates that this is a potentially fatal combination, when opioids and benzodiazepines are prescribed together,” said Nicole Alexander-Scott, director of Rhode Island’s Department of Health, saying doctors and public health officials have a moral and professional obligation to be transparent about the risks and be cautious when prescribing the drugs to patients.

Opioids, which include narcotic painkillers such as Oxycodone and Hydrocodone, are at the heart of a deadly nationwide epidemic of abuse and addiction. The Centers for Disease Control and Prevention recently reported that overdose deaths from legal opioids grew to nearly 19,000 in the United States in 2014, the most recent year on record. The drugs also have played a role in a surge of overdoses in recent years of heroin, which is cheaper and more widely available than prescription opioids.

At the same time, according to a study last week in the American Journal of Public Health, overdose deaths also have been soaring among Americans who use benzodiazepines, a class of sedatives that includes medications such as Valium and Xanax. Researchers found that the death rate from overdoses involving benzodiazepines — commonly referred to as “benzos” — had increased more than four-fold since 1996. In 2013, they noted, deaths from benzodiazepine overdoses accounted for nearly a third of the 23,000 deaths attributed to prescription drug overdoses in the United States.

In Monday’s petition, health officials detailed data suggesting that both types of medication become only more risky when used together — and they are used together frequently. Often, for example, doctors will prescribe opioids to a patient with acute pain, along with a benzodiazepine to treat muscle spasms. Or benzodiazepines for a patient with an anxiety disorder, along with an opioid to treat chronic pain.

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