{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T18:06:54Z","timestamp":1758823614035},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T00:00:00Z","timestamp":1552867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Benzodiazepines have been identified as a concurrent factor in opioid\u2010related deaths. Although the dangers of concomitant administration of opioids and benzodiazepines are well documented, implementation of this knowledge into practice may be lagging behind.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the concomitant use of opioids and benzodiazepines in the outpatient setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic outpatient multispecialty practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Over 2000 outpatient clinic visits from January 2018 to April 2018 among four physiatrists were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients were reviewed in the Prescription Drug Monitoring Program (PDMP) website to identify whether they have filled either opioid or benzodiazepine prescription(s) in the last 12\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measurements<\/jats:title><jats:p>Number of opioid and benzodiazepine prescriptions, discrepancies in reporting of medications, providers prescribing medications, and cigarette\/alcohol use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 353 patients were identified to have filled either opioid or benzodiazepine prescription(s) in last 12\u2009months. 49.4% of patients prescribed opioids were found to be taking benzodiazepines concurrently. Reporting discrepancies were noted between the outpatient electronic medical record and PDMP in 17.2% of patients. Among patients taking both opioids and benzodiazepines, 38.9% had multiple providers prescribing these medications, 41.9% were over 65\u2009years old, and 11.9% were daily cigarette\/alcohol users. Patients taking both types of drugs (opioids and benzodiazepines) were significantly more likely to use different providers (38.9%) compared to patients taking one type of drug (9.8%, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). The former group was also noted to fill significantly more prescriptions than the latter group (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study results emphasize that clinicians may not be aware that some of their patients are concurrently taking opioids and benzodiazepines. These results highlight the importance of routinely checking the PDMP and using that information to make fully informed decisions to minimize risks in use of these controlled substances.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>III<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2018.09.026","type":"journal-article","created":{"date-parts":[[2018,9,20]],"date-time":"2018-09-20T05:32:59Z","timestamp":1537421579000},"page":"337-343","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Concomitant Use of Opioids and Benzodiazepines in the Outpatient Setting"],"prefix":"10.1002","volume":"11","author":[{"given":"Jeremy","family":"Simon","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Rothman Institute\/Thomas Jefferson University Hospital  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Gehret","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Rothman Institute\/Thomas Jefferson University Hospital  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Stolzenberg","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Rothman Institute\/Thomas Jefferson University Hospital  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro K.","family":"Beredjiklian","sequence":"additional","affiliation":[{"name":"Department of Hand and Wrist Surgery Rothman Institute\/Thomas Jefferson University Hospital  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathon","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Sidney Kimmel Medical College at Thomas Jefferson University  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor","family":"Paskey","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Sidney Kimmel Medical College at Thomas Jefferson University  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Raju","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Rothman Institute\/Thomas Jefferson University Hospital, 925 Chestnut Street  Philadelphia PA 19107"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,18]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Center for Disease Control and Prevention (CDC).National Vital Statistics System CDC WONDER Online Database 2017.https:\/\/wonder.cdc.gov. Accessed April 30 2018."},{"key":"e_1_2_7_3_1","unstructured":"Center for Disease Control and Prevention (CDC).Annual Surveillance Report of Drug\u2010Related Risks and Outcomes \u2014 United States. Surveillance Special Report. 2017.https:\/\/www.cdc.gov\/drugoverdose\/pdf\/pubs\/2017\u2010cdc\u2010drug\u2010surveillance\u2010report.pdf. Accessed April 20 2018."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2017.12.010"},{"key":"e_1_2_7_5_1","unstructured":"Drugs of abuse: Benzodiazepines and opioids. NIH\/NIDA Web site.https:\/\/www.drugabuse.gov\/drugs-abuse\/opioids\/benzodiazepines-opioids. Accesed April 30 2018."},{"issue":"1","key":"e_1_2_7_6_1","first-page":"85","article-title":"Cohort study of the impact of high\u2010dose opioid analgesics on overdose mortality","volume":"17","author":"Dasgupta N","year":"2016","journal-title":"Pain Med"},{"key":"e_1_2_7_7_1","unstructured":"Executive Office of Health and Human Services Massachusetts Department of Public Health Current Statistics.Data Brief: Opioid Related Overdose Deaths Among Massachusetts Residents 2017.https:\/\/www.mass.gov\/files\/documents\/2017\/12\/04\/Opioid\u2010related%20Overdose%20Deaths%20among%20MA%20Residents%20\u2010%20Revised%20December%202017.pdfhttps:\/\/www.mass.gov\/files\/documents\/2017\/12\/04\/Opioid\u2010related%20Overdose%20Deaths%20among%20MA%20Residents%20\u2010%20Revised%20December%202017.pdf. 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Accessed May 5 2018."},{"key":"e_1_2_7_17_1","unstructured":"Monograph. Tramadol.Micromedex May 10 2018.http:\/\/www.micromedexsolutions.com. Accessed May 10 2018."},{"key":"e_1_2_7_18_1","unstructured":"Tramadol.Palliative Care Formulary. May 10 2018.http:\/\/www.palliativedrugs.com\/palliative\u2010care\u2010formulary.html. Accessed May 10 2018."},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h2698"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2008.00477.x"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148218309262?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148218309262?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.pmrj.2018.09.026","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.pmrj.2018.09.026","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.pmrj.2018.09.026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T18:34:52Z","timestamp":1694370892000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1016\/j.pmrj.2018.09.026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,18]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1016\/j.pmrj.2018.09.026"],"URL":"https:\/\/doi.org\/10.1016\/j.pmrj.2018.09.026","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,18]]},"assertion":[{"value":"2018-06-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}