Posted on February 24, 2016 by
Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996–2013
Marcus A. Bachhuber, MD, MSHP, Sean Hennessy, PharmD, PhD, Chinazo O. Cunningham, MD, MS, and Joanna L. Starrels, MD, MS
Marcus A. Bachhuber, Chinazo O. Cunningham, and Joanna L. Starrels are with Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. Sean Hennessy is with Center for Clinical Epidemiology and Biostatistics and Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
Objectives. To describe trends in benzodiazepine prescriptions and overdose mortality involving benzodiazepines among US adults.
Methods. We examined data from the Medical Expenditure Panel Survey and multiple-cause-of-death data from the Centers for Disease Control and Prevention.
Results. Between 1996 and 2013, the percentage of adults filling a benzodiazepine prescription increased from 4.1% (95% confidence interval [CI] = 3.8%, 4.5%) to 5.6% (95% CI = 5.2%, 6.1%), with an annual percent change of 2.5% (95% CI = 2.1%, 3.0%). The quantity of benzodiazepines filled increased from 1.1 (95% CI = 0.9, 1.2) to 3.6 (95% CI = 3.0, 4.2) kilogram lorazepam equivalents per 100 000 adults (annual percent change = 9.0%; 95% CI = 7.6%, 10.3%). The overdose death rate increased from 0.58 (95% CI = 0.55, 0.62) to 3.07 (95% CI = 2.99, 3.14) per 100 000 adults, with a plateau seen after 2010.
Conclusions. Benzodiazepine prescriptions and overdose mortality have increased considerably. Fatal overdoses involving benzodiazepines have plateaued overall; however, no evidence of decreases was found in any group. Interventions to reduce the use of benzodiazepines or improve their safety are needed. (Am J Public Health. Published online ahead of print February 18, 2016: e1–e3. doi:10.2105/AJPH.2016.303061)