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Substance use Adults

Opioids and benzodiazepines together

An opioid and a benzodiazepine should not be prescribed together unless there is a clear, discussed reason - the combination raises overdose risk.

14% of the time this step is missed
0% missed at the best-performing clinics
3.7x higher risk of harm when missed
Safety first: Do not stop either medicine abruptly on your own - ask your prescriber to review the combination safely.

Across de-identified U.S. psychiatric records, we found this step was missed about 14% of the time it should have happened. At the best-performing clinics it almost never gets missed, so this is a gap that can be closed. Whether it happens usually comes down to how a clinic is set up, not anything about you.

In our analysis, taking a benzodiazepine and an opioid together was linked to a 3.7x higher rate of overdose compared with an opioid alone.

This page is here to help you know what to ask about. It is not medical advice, and you should never start, stop, or change a medication on your own. Bring these questions to a doctor who knows you.

Questions to ask your doctor

Copy a line and ask it at your next visit. These are questions to start a conversation, not instructions to change your treatment.

  • I'm prescribed both an opioid and a benzodiazepine - is that combination safe for me?
  • Can we review whether I still need both, and can I have naloxone on hand?

The evidence

In our analysis, taking a benzodiazepine and an opioid together was linked to a 3.7x higher rate of overdose compared with an opioid alone.

Guideline — read the guideline →

This page is information, not medical advice. It describes care patterns across many people and can't speak to your own situation. Bring these questions to a clinician who knows you.

Build a checklist for your own care →