Physicians advised to use caution in prescribing sedatives for patients taking opioids

Adverse events associated with taking opioid pain medications increase in patients who concurrently use sedatives and alcohol. A study in The Journal of Pain, published by the American Pain Society, www.ampainsoc.org, advises physicians to use caution in prescribing sedatives for patients taking opioids, even if there is no history of substance abuse.

Concurrent use of sedatives and alcohol with opioid analgesic medications can exacerbate respiratory depression and sedation. In most death cases associated with prescription opioids, other drugs are identified in the blood stream, such as sedatives, alcohol and illicit drugs. In this study, the authors sought to assess the prevalence and predictors of concurrent use of opioids with sedatives and alcohol among patients receiving chronic opioid therapy for non-cancer pain.

Data for the study was generated from individuals in health plans participating in the Consortium to Study Opioid Risks and Trends (CONSORT). Health plan enrollees were eligible for the study if they filled an opioid prescription within 30 days of the sample selection date. Phone interviews took place from June to November 2008.

Overall, 2,163 patients were interviewed, 31 percent had a history of substance use disorder, and concurrent sedative use was common - about 32 percent. Alcohol use was less common, as 12 percent of patients said they had two or more drinks within two hours of taking an opioid. Male subjects showed the highest rate of concurrent alcohol use.

The key finding was younger, depressed women taking opioid pain medications at higher doses for multiple pain problems have the highest risk for concurrent sedative use. The authors concluded that "the widespread practice of prescribing opioids and sedatives, particularly among patients receiving COT at high opioid dosages, deserves increased scrutiny."

Source American Pain Society