Buprenorphine is an effective treatment for opioid use disorder (OUD), contributing to significant reductions in all-cause and opioid-associated mortality amid the current United States (U.S.) opioid epidemic.(1) Among OUD patients taking buprenorphine, benzodiazepine use is highly prevalent; some studies have estimated as many as 30% of OUD patients on opioid maintenance treatment received benzodiazepine prescriptions, (2) with over one-third of these patients endorsing past-month problematic use of benzodiazepines.(3) Although benzodiazepines are frequently prescribed for treatment of comorbid mood and anxiety disorders that are common in the OUD population, recent research has shed light on respiratory depression, overdose risk, and addictive potential associated with benzodiazepine use in patients taking chronic opioids such as buprenorphine.(4–7) It is unclear if risks associated with benzodiazepine use outweigh treatment benefits of buprenorphine.
