Opioid and Benzodiazepine Co-Prescribing Trends from the Emergency Department from 2012 to 2019: A National Analysis

Opioid and Benzodiazepine Co-Prescribing Trends from the Emergency Department from 2012 to 2019: A National Analysis

Authors: Christine Ramdin, George Mina, Lewis S Nelson, Maryann Mazer-Amirshahi

Published in: Journal of Emergency Medicine, 2023 September 5

Conclusions:

• The study observed no significant change in the overall trend of co-prescribing opioids and benzodiazepines from 2012 to 2019 in EDs nationwide.
• However, there was a notable decline in such prescriptions following the 2016 FDA Black Box Warning.

Methods:

• Conducted a retrospective review of the National Hospital Ambulatory Medical Care Survey data from 2012 to 2019.
• The primary outcome was to identify the trend in ED visits where opioids and benzodiazepines were co-prescribed at discharge.
• The study examined co-prescribing rates before (2012-2015) and after (2017-2019) the FDA warning, identified commonly co-prescribed medications, and reviewed the rate of naloxone co-prescribing.
• Descriptive statistics and bivariate tests were utilized for data analysis.

Results:

• Out of all ED visits from 2012 to 2019, 4,489,613 visits (0.41%) involved co-prescribing of opioids and benzodiazepines.
• No overall trend was seen in co-prescribing rates; however, there was a significant decrease post-FDA warning (from an average of 0.49% to 0.29%, p < 0.0001).
• There were 7980 ED visits (0.18%) where naloxone was co-prescribed, with an increasing trend over the years (p < 0.001).