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Concomitant Use of Buprenorphine for Medication-Assisted Treatment of Opioid Use Disorder and Benzodiazepines: Using the Prescription Behavior Surveillance System

NCJ Number
Drug and Alcohol Dependence Volume: 187 Dated: June 2018 Pages: 121-126
Yanmin M. Zhu; D. Tyler Coyle; Mohamed Mohamoud; Esther Zhou; Efe Eworuke; Catherine Dormitzer; Judy Staffa
Date Published
June 2018
6 pages
This study describes real-world drug dispensing patterns for the concomitant use of buprenorphine products approved for medication-assisted treatment (MAT) and benzodiazepines.
Despite clinical guidelines discouraging the practice, it is well-documented that the concomitant use of benzodiazepines and opioid analgesics occurs regularly. Information on concomitant use of buprenorphine for medication-assisted treatment (MAT) of opioid use disorder (OUD) and benzodiazepines, however, is limited. The current study examined concomitant use of buprenorphine for MAT and benzodiazepines using the 2013 Prescription Behavior Surveillance System data from eight states. For prescription-level analysis, the study estimated the proportion of concomitant buprenorphine and benzodiazepine prescriptions and the proportions of concomitant prescriptions prescribed by the same provider (co-prescribing) and dispensed by the same pharmacy (co-dispensing) for each state. For patient-level analysis, the study calculated the proportion of patients with ¡Ý1 buprenorphine therapy episode overlapping with a benzodiazepine episode, i.e., concomitant users, and the proportion of concomitant users who experienced co-prescribing or co-dispensing. In 2013, 1,925,072 prescriptions of buprenorphine products for MAT were dispensed to 190,907 patients in eight states. Approximately 1 in 8 buprenorphine prescriptions was used concomitantly with ¡Ý1 benzodiazepine prescription(s). Co-prescribing proportions ranged from 22.2 to 64.6 percent across states, while co-dispensing proportions ranged from 54.7 to 91.0 percent. Approximately 17.7 percent of patients had >1 buprenorphine episode overlapping a benzodiazepine episode for ¡Ý7 cumulative days¡¯ supply. Among these patients, 33.1¨C65.2 percent experienced co-prescribing, and 65.1¨C93.3 percent experienced co-dispensing. The study concludes that the concomitant use of buprenorphine for MAT and benzodiazepines occurs frequently, with variations by state in co-prescribing and co-dispensing. (publisher abstract modified)