VA investigates impact of opioids, sedatives on veterans.

Byline: Anthony Vecchione

Veterans who simultaneously take opioids for chronic pain and benzodiazepines for anxiety and insomnia are at an increased risk of unintentional overdose and death as well as suicide, according to the results of a study by National Academies of Sciences, Engineering and Medicine.

Nearly 20 veterans kill themselves each day in the United States, a statistic that has led the Department of Veterans Affairs to make suicide prevention its highest priority, and it is looking to recognize the risks from the simultaneous use of opioids and benzodiazepines.To address the issue, the VA asked the National Academies of Sciences, Engineering and Medicine to develop protocols for a study that would use existing records to evaluate the best approaches to opioid treatment in veterans taking benzodiazepines.

"These records might reveal important insights that could inform the use of opioid treatment as part of chronic pain management," said Brian Strom, chancellor of Rutgers Biomedical and Health Sciences and chair of the committee that developed the study protocol."The committee's report gives the VA guidelines on how to research the effects of starting veterans on an opioid for chronic pain while they are taking benzodiazepines and the effects of tapering patients off opioids and the relationship to any subsequent death by suicide or other causes," said Strom.

In response to the question: Why are veterans at a higher risk of overdose and death? Storm said that compared to civilians, veterans have higher rates of chronic pain, traumatic brain injury, post-traumatic stress disorder, depression and other mental health conditions.

"This makes it more likely they will be on concurrent opioid and benzodiazepine treatment, a combination that has been linked to potentially fatal health risks, such as respiratory depression and suicide," said Strom.

Strom said that investigations using existing data are an excellent opportunity to use VA medical records to clarify the connections between important clinical conditions, changes in opioid and benzodiazepine prescribing practices over the years 2010 to 2017, and outcomes.

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