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Don’t Withhold Medication-assisted Therapy from Benzodiazepine Users, FDA says

The US Food and Drug Administration has updated its recommendationson co-prescribing benzodiazepines with medication-assisted therapy treatment, stating that buprenorphine and methadone “should not be withheld from patients taking benzodiazepines or other drugs that depress the central nervous system.” While the combination of benzodiazepines or other CNS depressants with opioids presents risks, they say, “the harm caused by untreated opioid addiction can outweigh these risks. Careful medication management by health care professionals can reduce these risks.”

The FDA recommends a group of actions for physicians to take when managing a patient taking both classes of drugs, including:

  • Educating patients about the serious risks of combined use
  • Tapering the benzodiazepine or CNS depressant to discontinuation if possible
  • Verifying the diagnosis if a patient is receiving prescribed benzodiazepines or other CNS depressants for anxiety or insomnia, and considering other treatment options for these conditions
  • Recognizing that patients may require MAT medications indefinitely and their use should continue for as long as patients are benefiting,and their use contributes to the intended treatment goals
  • Coordinating care to ensure other prescribers are aware of the patient’s buprenorphine or methadone treatment
  • Monitoring for illicit drug use, including urine or blood screening