Opioids & Benzodiazepines…a Bad Mix?

Opioids are used to manage pain and benzodiazepines are prescribed to treat a variety of different conditions including anxiety, muscle spasm, insomnia, and seizures.

There are certainly risks associated with combined use of an opioid and a benzodiazepine. Taking an opioid pain medication with other opioid medicines, benzodiazepines, alcohol, or other Central Nervous System (CNS) depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death. These risks occur because opioids and benzodiazepines affect the CNS, which controls most of the functions of the brain and body.

Some general recommendations for the use of opioids and benzodiazepines or other CNS depressants are as follows:

  • Use of opioid medication with benzodiazepines or other CNS depressants should be avoided
  • If opioids and benzodiazepines must be used together:
  • Alternative treatment options should have been tried first
  • Limit dose and time period for use to a minimum
  • Do not drink alcohol while taking these medications
  • Monitor for signs and symptoms of extreme sleepiness, breathing difficulty, or unresponsiveness (i.e., person is responding strangely or cannot be woken up), and seek immediate medical attention if any of these occur

Patients should be encouraged to speak with their health care provider if they have questions or concerns about taking opioids or benzodiazepines. These medications should not be stopped abruptly, and it is best to work with a health care professional to discuss options for discontinuing opioids and/or benzodiazepines in a controlled, gradual manner.


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