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Research Letter
September 18, 2019

Opioid and Benzodiazepine Coprescribing in the United States Before and After US Food and Drug Administration Boxed Warning

Author Affiliations
  • 1School of Management, Yale University, New Haven, Connecticut
  • 2New York State Psychiatric Institute, Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York
JAMA Psychiatry. 2019;76(11):1208-1210. doi:10.1001/jamapsychiatry.2019.2563

Overdose deaths involving prescription opioids have increased 5-fold in the United States since 1999.1 Benzodiazepines are frequently involved in opioid-related overdoses. Concomitant use of benzodiazepines and opioids increases the risk of overdose and death.2 In response to rising coprescriptions,3 the US Food and Drug Administration issued a boxed warning on August 31, 2016, highlighting the risks of coprescribing opioids and benzodiazepines. Prior research examined trends before the warning3 and found a decrease in opioid prescribing after the March 2016 Centers for Disease Control and Prevention guideline.4 However, it is not known whether coprescriptions further declined significantly after the boxed warning. We provide the first national estimate of opioid and benzodiazepine coprescribing before and after the boxed warning, to our knowledge.

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