Third, we are unable to deduce if medication use and medical comorbidities in NHANES precisely preceded exposure to benzodiazepines, which is generally an assumption of propensity score approaches.39 Despite our inability to infer such temporal precedence, we contend that NHANES medication data serve as a good proxy for unmeasured comorbidities that likely preceded benzodiazepine exposure. To assess the possibility of overcorrection via inclusion of mediating variables, we developed an alternative propensity score that excluded more than 650 non–CNS-acting medications that yielded largely similar results to those from our main models.
