Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Prescription Opioid Use Among Higher-Risk Patients

JAMA Psychiatry; ePub 2018 Apr 12; Ladapo, et al

In 2010, new opioid prescriptions for US adults stopped increasing and began to decrease among higher-risk patients who used benzodiazepines, suggesting that the recent increase in opioid-related deaths may be associated with factors other than physicians writing new opioid prescriptions. Nevertheless, prescribing opioids among higher-risk patients still occurred at rates higher than rates in the general population, a recent study revealed. Data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey were used to identify adults aged ≥20 years receiving new opioid prescriptions and concurrently using a benzodiazepine. 13,146 visits were analyzed, representing 214 million visits nationally, with a new opioid prescription. Researchers found:

  • Rates of new opioid prescriptions among adults using a benzodiazepine increased from 189 to 351 per 1,000 persons between 2005 and 2010 and decreased to 172 per 1,000 persons by 2015.
  • New opioid prescriptions in the general population not using benzodiazepines increased nonsignificantly from 78 to 93 per 1,000 US persons between 2005 and 2010 and decreased nonsignificantly to 79 per 1,000 persons by 2015.


Ladapo JA, Larochelle MR, Chen A, et al. Physician prescribing of opioids to patients at increased risk of overdose from benzodiazepine use in the United States. [Published online ahead of print April 12, 2018]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2018.0544.