Teens and young adults treated for sleep disorders with benzodiazepines such as Xanax — a drug commonly prescribed to treat anxiety and insomnia — may be at greater risk of overdose, Rutgers researchers said.
The study, published in JAMA network openedexamined how often adolescents with sleep disorders had a drug overdose in the months after starting a prescription sleep medication.
According to the National Institute on Drug Abuse, benzodiazepines were implicated in 12,290 overdose deaths in 2020, up from 6,872 in 2011 and 1,135 in 1999. However, Rutgers researchers said the risks of drug overdose in youth prescribed benzodiazepine treatment for insomnia, were unclear. .
Researchers found that young people taking benzodiazepines for common sleep disorders had an increased risk of overdose during the six months after starting treatment compared to other prescription sleep medications, including trazodone, hydroxyzine and z-hypnotics.
The risk of drug overdose with benzodiazepine treatment is an important safety consideration in the treatment of adolescents and young adults. We hope that these results can help guide prescribing decisions and encourage close monitoring in this young patient population.”
Greta Bushnell, study author and faculty member at the Center for Pharmacoepidemiology and Treatment Sciences at the Rutgers Institute for Health, Health Care Policy and Aging Research (IFH)
Using a commercial claims database involving privately insured youth ages 10 to 29, researchers identified nearly 90,000 people who had recently received benzodiazepine or an alternative prescription treatment for a sleep disorder. Researchers then examined the drug overdoses in this group in the six months after starting treatment.
Researchers also found that the risk of overdose was highest in young people who started treatment with benzodiazepines and who were recently prescribed an opioid.
“Given the frequent concomitant use of benzodiazepines with other substances, it is important to discuss with youth the potential associated harms,” says Bushnell, an assistant professor at the Rutgers School of Public Health. “Because the use of other agents may be unknown to the prescriber, adolescents and young adults should be screened for substance use and a history of overdoses prior to treatment.”
Bushnell said further research is needed to determine how specific benzodiazepine treatment details, such as dosage, change the risks of overdose.
Study co-authors are Tobias Gerhard of the Center for Pharmacoepidemiology and Treatment Sciences at IFH and the Ernest Mario School of Pharmacy at Rutgers and collaborating faculty at Columbia University Mailman School of Public Health, Columbia University Irving Medical Center and New York University School ofMedicine. Research was supported by the National Institute on Drug Abuse (5K01DA050769).
Bushnell, GA, et al. (2022) Association of benzodiazepine treatment for sleep disorders at risk of drug overdose in youth. JAMA network opened. doi.org/10.1001/jamanetworkopen.2022.43215.