One of the reasons that opioid addiction can be so stealthy is that the signs of opioid addiction may not be obvious the way signs of, for example, alcohol abuse can be. Signs like track marks will not be present unless a prescription opioid user turns to heroin to try to replicate a prescription high. Often the signs of opioid abuse begin with behaviors, like “losing” prescriptions in an attempt to get more prescriptions written.

As devastating as opioids can be when a person is addicted, they can be even more dangerous when mixed with other drugs. In particular, mixing opioids with anti-anxiety drugs that slow down the respiratory system can cause serious problems, including death. The US Food and Drug Administration (FDA) has recently issued strong warnings about the dangers of mixing opioids with certain other drugs.

What Are Opioids?

Opioids are a drug class that includes synthetic opioids like fentanyl, oxycodone, codeine, and morphine, as well as the illegal drug, heroin. What they have in common is that they interact with opioid receptors on the brain’s nerve cell receptors. When taken as directed, for a brief period of time, they can be outstanding for the relief of pain. The problem is that opioids can produce feelings of euphoria, and developing an addiction can happen relatively quickly. While drugs like naloxone can reverse opioid overdoses, addiction treatment is necessary once a person becomes dependent on opioids.

What Are Benzodiazepines?

Benzodiazepines are another drug class, and they are mostly used for treating anxiety. Exactly how they work is not known, but they apparently affect neurotransmitters in the brain, one of which is gamma-aminobutyric acid (GABA), a neurotransmitter that suppresses nerve activity. Benzodiazepines may work by enhancing the effects of GABA and reducing nerve activity in the brain and spinal cord. In addition to being used to treat anxiety, they may also be used for pre-surgical sedation, muscle relaxation, and to treat the symptoms of acute alcohol withdrawal.

The Dangers of Mixing the Two

Misuse of either opioids or benzodiazepines can be dangerous or deadly, and mixing the two can be especially hazardous. Mixing these two types of drugs can cause breathing difficulty, coma, or even death. The new FDA warning spells out some of the dangers of combining opioids and benzodiazepines and requires new information to be added to drug labels of methadone and buprenorphine, two addiction treatment drugs used by many people with opioid abuse disorders.

The FDA strongly advises that doctors treating patients who take both kinds of drugs manage medication instructions and follow-up carefully to minimize risk. For some people taking both kinds of drugs, including those taking benzodiazepines for insomnia or anxiety, doctors are urged to consider other treatment options that present less danger.

Other Drugs That Are Dangerous Combined with Opioids

Benzodiazepines are not the only drugs that are particularly dangerous when combined with opioids. Insomnia drugs like Lunesta and Ambien, as well as muscle relaxers like Zanaflex and Soma,  slow the action of the central nervous system too and must be managed with care. In addition, antipsychotic drugs including Saphris, Invega, Abilify, and others can be dangerous when used in combination with opioids. These dangers highlight the importance of people being forthright with all healthcare providers about the medications they take so that all necessary safety precautions can be taken.

Opioids can be abused, and so can benzodiazepines, yet both classes of drugs have legitimate medical uses for some conditions. When these drugs are combined, it should only be done under the guidance of a physician, and if any signs of dependence develop, the physician should be notified at once. Addiction treatment is usually easier when the addiction has not gone on for a long period of time.

Developing a substance abuse disorder is not a character flaw, and it does not mean a person is “bad.” It can happen to anyone, and opioid addiction is particularly insidious because it can happen quickly, and to people who take care to follow physician instructions. With addiction treatment, however, opioid dependence can be overcome. If you are worried about addiction to opioids, benzodiazepines, alcohol, or any other substance, help is available to you 24/7. We encourage you to contact us at any time if you need to talk.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.