Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 24:10:100190.
doi: 10.1016/j.lana.2022.100190. eCollection 2022 Jun.

Overdose deaths involving non-BZD hypnotic/sedatives in the USA: Trends analyses

Vitor S Tardelli  1   2 , Marina C M Bianco  1 , Rashmika Prakash  3 , Luis E Segura  3 , João M Castaldelli-Maia  3   4   5 , Thiago M Fidalgo  1 , Silvia S Martins  3
Affiliations

Overdose deaths involving non-BZD hypnotic/sedatives in the USA: Trends analyses

Vitor S Tardelli et al. Lancet Reg Health Am. .

Abstract

Background: There is sparse knowledge on overdose deaths resulting from non-benzodiazepines and gabapentinoids usage. We examined overdose death rate across demographics categories and the overdose death trends over time.

Methods: Using data from the National Center for Health Statistics (USA), we identified 21,167 persons that died with an overdose ICD code as the underlying cause of death and had a T42.6/T42.7 ICD code, which include gabapentinoids and z-drugs, among their multiple causes of death. The overdose death rate was calculated per 100,000 persons for every year between 2000 and 2018. We used joinpoint regression analyses to assess trends over time.

Results: We identified a rise in the proportion of deaths with a T42.6/T42.7 ICD code between 2000 and 2006 (yearly change: +0.06) and between 2006 and 2015 (yearly change: +0.32). From 2000 to 2008, the proportion of deaths with any other T code rose significantly (yearly change: +3.56). Between 2008 and 2018, there was also a significant rise (yearly change: +1.31). From 2000 to 2015, the proportion of deaths with a T42.6/T42.7 ICD code with any other T code rose (yearly change: +2.58). From 2000 to 2015, the proportion of deaths with a T42.6/T42.7 ICD code with a concurrent benzodiazepine T code rose (yearly change: +1.98). From 2000 to 2005, the proportion of alcohol T codes rose non-significantly (yearly change: +0.35). Finally, the proportion of alcohol T codes fell significantly between 2008 and 2018 (yearly change: - 0.74).

Interpretation: Deaths due to non-benzodiazepine hypnotics and gabapentinoids increased significantly over the last two decades. Clinicians should not assume that replacing benzodiazepines and opioids with these medications necessarily lowers risk to the patient.

Funding: This study was funded by an internal grant from the Columbia University President's Global Innovation Fund (PI: Martins).

PubMed Disclaimer

Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Fig 1
Figure 1
Joinpoint regression model with trends of the percentage of deaths involving a T42.6/T42.7 ICD code among all overdose deaths with a T code from 2000 to 2018 in the USA (Y-axis truncated for best visualization).
Fig. 2.
Figure 2
Joinpoint regression model with proportion of deaths involving any other concurrent T code among deaths involving a T42.6/T42.7 ICD code deaths from 2000 to 2018 in the USA(Y-axis truncated for best visualization).
Fig. 3.
Figure 3
Joinpoint regression model with proportion of deaths involving a concurrent opioid T code among deaths involving a T42.6/T42.7 ICD code deaths from 2000 to 2018 in the USA (Y-axis truncated for best visualization).
Fig. 4.
Figure 4
Joinpoint regression model with proportion of deaths involving a concurrent benzodiazepine T code among deaths involving a T42.6/T42.7 ICD code deaths from 2000 to 2018 in the USA (Y-axis truncated for best visualization).
Fig. 5.
Figure 5
Joinpoint regression model with proportion of deaths involving a concurrent alcohol T code among deaths involving a T42.6/T42.7 ICD code deaths from 2000 to 2018 in the USA (Y-axis truncated for best visualization).
See this image and copyright information in PMC

References

    1. Jones C.M., McAninch J.K. Emergency department visits and overdose deaths from combined use of opioids and benzodiazepines. Am J Prev Med. 2015;49(4):493–501. - PubMed
    1. Jones C.M., Mack K.A., Paulozzi L.J. Pharmaceutical overdose deaths, United States, 2010. JAMA. 2013;309(7):657–659. - PubMed
    1. Hirschtritt M.E., Delucchi K.L., Olfson M. Outpatient, combined use of opioid and benzodiazepine medications in the United States, 1993-2014. Prev Med Rep. 2018;9:49–54. - PMC - PubMed
    1. Chua K.P., Brummett C.M., Ng S., Bohnert A.S.B. Association between receipt of overlapping opioid and benzodiazepine prescriptions from multiple prescribers and overdose risk. JAMA Netw Open. 2021;4(8) - PMC - PubMed
    1. Gladden R.M., O'Donnell J., Mattson C.L., Seth P. Changes in opioid-involved overdose deaths by opioid type and presence of benzodiazepines, cocaine, and methamphetamine - 25 states, July-December 2017 to January-June 2018. MMWR Morb Mortal Wkly Rep. 2019;68(34):737–744. - PMC - PubMed