Although benzodiazepines without opioids were associated with an overall increase in all-cause mortality in weighted analyses, these hazards of death were negligible among those with shorter as opposed to longer amounts of follow-up time. This finding may be consistent with existing literature20 suggesting that benzodiazepine use without opioids is more of a proxy for elevated short-term mortality risk than a factor directly associated with death. Furthermore, recent findings—focusing largely on acute as opposed to chronic benzodiazepine and opioid exposures—have suggested that fatalities associated with pure benzodiazepine overdose are rare and that the combination of sedative-hypnotic agents with opioids may be an important and understudied factor associated with mortality.34
