Reducing Concurrent Opioid and Benzodiazepine Prescribing

Substance use disorders, including opioid and benzodiazepine misuse, are prevalent and growing concerns across all age groups. The HEDIS measures for Diagnosed Substance Use Disorders (DSU), Deprescribing of Benzodiazepines in Older Adults (DBO), and Concurrent Use of Opioids and Benzodiazepines (COB) highlight the importance of identifying, educating, and supporting patients who may be at risk.

Proactive education and documentation can help reduce misuse, improve patient safety, and support better health outcomes—especially in older adults who are more vulnerable to adverse effects. In 2021, nearly 14% of overdose deaths involving opioids also involved benzodiazepines.¹ Concurrent overlaps can cause increased patient risk if not modified or discontinued where clinically appropriate.

Best Practices for Identifying & Educating at Risk Patients

• Update your patients’ lists of medications regularly to include medications prescribed by other clinicians.
• Educate patients on the risks of opioid and benzodiazepine use, including dependency, cognitive impairment, and overdose. Tailor education to age and risk level.
• Use EMR alerts to flag patients who are prescribed opioids or benzodiazepines, especially those 67+ years old, to assess for deprescribing opportunities.
• Check the state PDMP to avoid duplicate prescribing or unintentional co-prescribing of high-risk medications with other providers.
• Consider outreaches to patients diagnosed with substance use disorders (SUDs), especially those with opioid or alcohol use disorders, to offer support and resources.
• Document opioid education and addiction prevention efforts in the EMR, including discussions, handouts provided, and referrals to behavioral health or pain management.

Resources

• Deprescribing.org
• Intermountain Health Pain Management

References

1. CDC WONDER. Multiple Cause of Death 1999-2021. Centers for Disease Control and Prevention, National Center on Health Statistics. Released January 2023. Accessed January 2023.

Contact a Select Health Quality Consultant RN or Pharmacist:

• Sarah Olsen, RN  (sarah.olsen@selecthealth.org)
• Amber Wray, RN (amber.wray@selecthealth.org)
• Nakisa Mirrafie, PharmD, MBA (Nakisa.mirrafie@selecthealth.org)