In the case of benzodiazepine use without opioids, data on its long-term mortality risks are marked by inconsistent findings. Although some studies have found substantial mortality associated with benzodiazepine use without opioids,17 such that the hazards of taking benzodiazepines more than 30 times per month were akin to smoking 1 to 2 packs of cigarettes per day,18,19 other studies have not supported these findings,20 with several analyses suggesting that benzodiazepine-associated mortality may vary based on age or follow-up time.17,20 Furthermore, these studies have often been limited to employed, middle-aged populations in commercial insurance databases,20 which may exclude individuals with a heavier comorbidity burden who initiate benzodiazepines.20,21
