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Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j760 (Published 14 March 2017) Cite this as: BMJ 2017;356:j760

Rapid Response:

Re: Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis

Rather than being entirely causal, there is likely an association with benzodiazepine use as a marker for those at higher risk of escalating dosage. Part of such a higher risk would likely be because of the anxiety-abating signal of the early peak opioid sensations. These likely operantly condition those suffering from anxiety, either constitutionally or as a result of difficult life circumstances and learned avoidance, to be the relief that they seek. Either an assurance that their physical pain will diminish allowing them to stop focussing or worrying about it or, simply because it is generally anxiety reducing and helps in escaping from the intolerable feelings associated with facing the realities of life.

As we know the actual sustained pain reducing effect when used regulalry is about 30%..... rather than getting high, most people who get into trouble are just trying to get by; and this whether it is more apparently about hopelessness or physical pain which also often becomes the substitute focus. We are in a "lost" time at the end of this indutsrialized age. The fabric which humans are adapted to is torn. This issue is but one more signal.

Competing interests: No competing interests

16 March 2017
Andre C. Piver
Physician
Nelson, B.C., Canada