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Although opioid replacement therapy (ORT) reduces risks for all-cause and overdose death in individuals with opioid use disorder, mortality in individuals on ORT is still elevated. Benzodiazepines, pregabalin, and z-drugs (e.g., zolpidem, zopiclone) are misused by and prescribed for individuals on ORT, but only benzodiazepines have been linked to overdose risk. To learn more about the safety of these medications, researchers examined Swedish registry data on 4501 individuals dispensed methadone or buprenorphine.
During 7 years, 32% of the patients were prescribed a benzodiazepine, 41% a z-drug, and 22% pregabalin; 356 individuals died, more than half from overdose. The investigators compared risks during periods in which patients were prescr…