Late last month the Food and Drug Administration, the government agency that oversees the efficacy and safety of medications prescribed to Americans, issued a new warning, which might complicate treatment for people addicted to opioids.
Medications used in the treatment of opioid addiction, such as methadone or buprenorphine, also known as Suboxone, can pose a serious risk when combined with anti-anxiety or sleep medications, says the FDA. Both prescriptions can relax or depress breathing, which compounds the danger when mixing the medications.
“Careful medication management by health care professionals can reduce these risks,” FDA Commissioner Scott Gottlieb said in a statement.
“We are requiring this information to be added to the buprenorphine and methadone drug labels along with detailed recommendations for minimizing the use of medication-assisted treatment (MAT) drugs and benzodiazepines together.”
What Medications are on the FDA Watch List?
According to the agency’s official warning, the combination of these drugs is not limited to just difficulty breathing, but can also lead to coma and death. Some of the benzodiazepines and central nervous system depressants on the “watch list” include:
- Valium and Xanax, which are prescribed for anxiety
- Ambien and Lunesta, prescribed for insomnia
- Soma and Zanaflex, which are muscle relaxers
- Abilify, Invega and Saphris, which are all antipsychotic prescriptions
Complicating the FDA’s warning is that the U.S. is in the midst of opioid an epidemic. According to the Centers for Disease Control and Prevention, an estimated 64,000 overdose deaths last year were attributable to heroin or prescription painkiller addiction.
One of the most effective methods for helping people addicted to opioids, especially those with the co-occurring disorders of addiction and mental health conditions, like depression, anxiety or post-traumatic stress disorder, is medication-assisted treatment.
Drugs like methadone and buprenorphine bind to the same receptors in the brain as opioids and, as a result, reduce withdrawal and cravings without getting a person in recovery “high.”
On the other end of that, benzodiazepines are effective in treating mental health issues that sometimes lead to drug seeking behavior and relapse.
The general population, even those who don’t suffer from addiction, often take unnecessary risks with drug interactions that in most cases never occur to them.
For example, 71 percent of adults in the U.S. enjoy an alcoholic beverage from time to time. That’s a somewhat benign statistic until it’s paired with a study out of the Mayo Clinic, which found a near equal number of adults – 70 percent – take at least one prescription medication. There is any number of serious interactions when prescription medication and alcohol are mixed.
What Does the FDA Recommend?
It’s the FDA’s recommendation that physicians develop treatment plans that consider the risks of combining several medications that slow or depress respiratory and brain activity.
Qualified addiction treatment facilities that employ medication assisted treatment should always let patients know ahead of time if there are potential side effects from drug combinations.
Always take the necessary precautions before mixing drugs; ask your physician if a prescription is safe with any other medications, confirm it with the pharmacist; avoid alcohol while taking prescription drugs and make sure the pharmacy hasn’t inadvertently mixed-up a prescription order.
Common sense goes a long way in avoiding serious drug interactions. Don’t be afraid to ask questions and research potential interactions or side effects.
For those on the front lines of the opioid crisis, taking extra caution in the medical treatment of opioid addiction is and always has been mandatory. Addiction is a serious chronic disease of the brain and people’s lives are at stake.
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