Drug overdose deaths from nonbenzodiazepine sleeping pills and anti-epilepsy gabapentinoids rises

A new study in The Lancet Regional Health Americas found that the proportion of overdose deaths involving nonbenzodiazepine sleeping drugs (also called z-drugs) and anti-epilepsy gabapentinoids increased more than threefold between 2000 and 2018, coinciding with exponential prescription increases since their introduction into the market.

“These drug classes were introduced as less dangerous alternatives to opioids and benzodiazepines, creating perceptions among physicians and patients of their supposed increased safety, even without guidelines or data to back up such perceptions and leading to increases in prescribing,” said Silvia Martins, MD, PhD, senior author of the study, in a news release. “Approved for short-term treatment of insomnia, they were touted as safe alternatives to the popular benzodiazepines when introduced to the market as less prone to abuse or dependence. Yet, recent evidence suggests that this alternative may also be as harmful as the product it intended to replace.”

The research team wanted to further explore and determine the dangers of co-usage of the drugs.

According to the research, more than 67% of those who died from overdoses with nonbenzodiazepine sleeping drugs and anti-epilepsy gabapentinoids between 2000 and 2018 also had opioids in their system.

Prescription opioids and benzodiazepines are the most common medication classes involved in drug-related emergency department visits and drug overdose deaths in the United States. When taken in excess, both benzodiazepines and prescription opioids promote respiratory decline.

According to the research, which was based on data from the National Center for Health Statistics, there were more unintentional overdoses and a greater proportion of women, whites, and those with higher educational background who died from an overdose.

“The rise in gabapentin prescriptions roughly accompanies the involvement of z-drugs and gabapentinoids in overdose deaths, which suggests they can be playing a role in those deaths. The literature also has shown increasing deaths with gabapentin co-using with other substances including alcohol,” said Martins, who is also a professor of epidemiology at Columbia University Mailman School of Public Health.