Benzodiazepine Use Among Low Back Pain Patients Concurrently Prescribed Opioids in the Military Health System Between 2012 and 2013

Abstract : Dramatic increases in the amount of opioids prescribed for chronic non-cancer pain, particularly low back pain, exist among those served by the military health care system. The combination of opioids and benzodiazepines poses numerous safety risks for the patient including respiratory suppression, oversediation, and overdose. There is scant evidence regarding opioid and benzodiazepines prescribing practices among active duty service members with low back pain. It is important to understand factors associated with benzodiazepine use in this population to identify those most vulnerable to safety issues. To this end, we investigated factors associate with concurrent opioid and benzodiazepine prescribing among active duty service members with nonmalignant low back pain who started their first opioid episode in 2012 or 2013. Our findings suggest that differences in patient characteristics across a variety of domains may raise safety concerns and quality of care issues. The results are consistent with previous findings among both US veterans and civilian populations.