Benzodiazepines and Opioids for Breathlessness Caused by Severe Lung Disease

In patients with severe respiratory disease, morphine relieves breathlessness, and benzodiazepines often are used to relieve anxiety. But whether using these drugs, alone or in combination, results in excess hospitalization or death is unclear. In a nationwide prospective study, Swedish investigators determined the safety of these drugs in 2250 patients (age, ≥45) with very severe chronic obstructive pulmonary disease (COPD) who required oxygen treatment. Twenty-four percent of participants used benzodiazepines, 23% used opioids, and 9% used both.

After a median 76 days, 76% of the participants had been admitted to a hospital; after a median 1.1 years, 50% had died. Adjusted for multiple variables, treatment with benzodiazepines or opioids w…