Medication treatment for opioid addiction (e.g., “medication-assisted treatment” with methadone and buprenorphine) shouldn’t be withheld from patients who take benzodiazepines or other central nervous system depressants even though this combination can lead to serious adverse events, the FDA said on Wednesday. The agency said the benefit of stopping opioid misuse usually outweighs these risks.
In one study the FDA reviewed, medication therapy plus benzodiazepines or other CNS depressants was associated with increased mortality risk. This information will be added to the existing boxed warning on the methadone products.
The agency recommends that clinicians:
- educate patients about the potential risks (e.g., overdose, death) of combining benzodiazepines or other CNS depressants with methadone or buprenorphine;
- attempt to taper patients off of benzodiazepines or CNS depressants;
- consider treatments other than benzodiazepines or CNS depressants for anxiety or insomnia;
- monitor for illicit drug use regularly;
- understand that patients may need medication treatment of addiction indefinitely.