Risk of overdose high among young people using benzos for sleep disorders

The use of benzodiazepines to treat common sleep disorders in young people appears to carry a greater risk of drug overdose as compared with alternative pharmacologic treatments, according to a study.

The study used data from a US commercial claims database and identified young people with a sleep disorder diagnosis initiating benzodiazepine (n=23,084; mean age 23 years, 62.6 percent women) or comparator pharmacologic treatments (n=66,706; mean age 22 years, 57.6 percent women). Alternative pharmacologic treatments included trazodone, hydroxyzine, zolpidem, zaleplon, and eszopiclone.

Researchers examined the treatment in relation to the incidence of diagnosed drug overdoses within 6 months of treatment initiation. Data for drug overdoses were obtained from inpatient and emergency department records.

Six months after treatment initiation, 9.7 percent of participants in the benzodiazepine group and 12.3 percent of those in the comparator group were still receiving treatment. Drug overdose at 6 months occurred in 0.9 percent of benzodiazepine users and 0.8 percent of comparator treatment users.

Adjusted analyses showed that the risk of drug overdose was higher among benzodiazepine users than comparator treatment users (intention-to-treat analysis: hazard ratio [HR], 1.25, 95 percent confidence interval [CI], 1.03–1.51; as-treated analysis: HR, 1.44, 95 percent CI, 1.14–1.80). This association was more pronounced among young people with vs without a recent prescription opioid fill (as-treated analysis: adjusted HR, 2.01, 95 percent CI, 1.24–3.25 vs adjusted HR, 1.31, 95 percent CI, 1.00–1.70).

The findings highlight drug overdose as an important safety consideration when using benzodiazepines in the treatment of young people with sleep disorders.