11
Patients Co-prescribed Benzodiazepines and Opioids
16. Because patients co-prescribed BZDs and opioids are at increased
risk of respiratory depression, clinicians should assess the risks
and benefits of continued BZD prescribing at least every 3 months
or with every related clinical encounter or prescription renewal,
whichever is more frequent (CC-S).
17. Clinicians should offer to provide or prescribe opioid overdose
reversal medication (e.g., naloxone) for all patients co-prescribed
BZDs and opioids (CC-S).
18. Clinicians should consider additional strategies for mitigating
risk, including using the lowest effective doses of BZD and opioid
medications and optimizing non-opioid interventions (CC-S).
Patients with Benzodiazepine and Other Substance Use
Disorders
19. Clinicians should consider more frequent assessments of the
risks and benefits of continued BZD prescribing for patients with
co-occurring SUDs and/or other co-occurring addictions (e.g.,
behavioral addictions) compared with the general guidance in
Recommendation 1 (CC-S).
20. When tapering BZD medication in patients with SUD, clinicians should
manage the underlying SUD concurrently with the BZD taper (CC-S).
21. Clinicians should not use BZD prescribing or tapering considerations
as a reason to discontinue or disrupt a patient's medications for SUD
treatment, including buprenorphine and methadone (CC-S).
22. Following the taper, clinicians should continue to monitor and treat
any underlying SUDs or refer patients to an appropriate level of care
for continuing care (CC-S).
23. Clinicians should offer patients harm reduction services or provide
them with referrals to access these services (CC-S).
a. Clinicians should offer to provide or prescribe opioid overdose reversal medication
(e.g., naloxone) and provide or refer patients for related education (CC-S);
b. Clinicians can consider providing or referring patients to community services
for drug checking or other safe use supplies (e.g., fentanyl test strips, xylazine
test strips, sterile syringes) and related education (CC-C).
