When we think about the opioid crisis, we often picture powerful painkillers like oxycodone or illicit fentanyl. But the opioid crisis today isn’t just about dependence on painkillers — it’s about deadly drug combinations. Many overdoses now involve opioids mixed with other drugs such as benzodiazepines or stimulants, amplifying dangerous effects on the body in unpredictable ways.
According to the National Institute on Drug Abuse, in 2023, 70% of overdose deaths involving benzodiazepines also involved illicit fentanyl, highlighting both the deadly synergy between these substances and the lack of awareness that much of the public has about potentially deadly drug combinations. Let’s explore how benzodiazepines and opioids work, why they’re often taken together, and why they pose such a profound risk to individuals struggling with substance abuse.
Are Benzodiazepines Opioids?
First, a quick myth-buster: benzodiazepines (often called “benzos”) are not opioids.
Opioids — like oxycodone, morphine, heroin, and fentanyl — work by binding to opioid receptors in the brain and spinal cord to block pain and create feelings of euphoria.
Benzodiazepines — like Xanax (alprazolam), Valium (diazepam), Ativan (lorazepam), or Klonopin (clonazepam) — are sedatives that act on a different system, called the GABA (gamma-aminobutyric acid) pathway. Benzos calm excessive brain activity, so they’re prescribed for anxiety, panic attacks, insomnia, and sometimes muscle spasms.
Why Do People Combine Opioids + Benzos?
Many people take opioids and benzodiazepines together for medical reasons — often to manage different symptoms like pain, anxiety, or trouble sleeping. Sometimes doctors prescribe both to address co-occurring conditions, such as chronic pain alongside anxiety or insomnia.
However, even when taken as directed, combining these drugs can quickly become dangerous. Both opioids and benzodiazepines slow the body’s breathing, and together, their effects multiply — sometimes unexpectedly.
A large study in the BMJ (Vol. 356, Art. j760) found that individuals taking both medications were up to 10 times more likely to die from overdose compared to those taking opioids alone.
Even those who are prescribed these medications by their doctor can be at risk, especially if they:
- Mix their pills with alcohol (which also slows breathing)
- Take extra doses for pain or anxiety
- Have underlying conditions like sleep apnea or lung disease
The Reality of Opioid-Benzodiazepine Overdoses
Today, mixing opioids and benzodiazepines is one of the deadliest trends fueling overdose deaths. In the US, more than 30% of opioid overdoses now involve a benzodiazepine (Am J Public Health, Vol. 109, Art. 4).
Many individuals don’t realize that taking slightly more of their medications or using a benzodiazepine to help them “come down” from opioids — or vice versa — actually puts them at risk of severe sedation, unconsciousness, and respiratory arrest.
Tragically, the risk is especially high for those who use street drugs, where counterfeit pills may contain hidden opioids like fentanyl or fake benzos with unpredictable doses.
What Science Says About the Risks
Here’s what decades of peer-reviewed research show about combining opioids and benzos:
- Individuals prescribed both meds long-term have a significantly higher overdose risk than those on opioids alone (BMJ, Vol. 356, Art. j760).
- Emergency room visits for benzo-opioid overdose have surged over the last decade (Drug Alcohol Depend., Vol. 178, Art. 350).
- Co-occurring substance use — especially combining opioids with sedatives or alcohol — is driving the current “fourth wave” of the overdose crisis (Am J Public Health, Vol. 109, Art. 4).
Navigating Polysubstance Use Disorder: Getting Treatment for Benzo + Opioid Addictions
Struggling with both benzodiazepine addiction and opioid dependence can feel overwhelming, like an impossible burden to overcome. It’s important to know that both addictions are treatable — and recovery is within reach.
While it’s true that co-occurring substance use disorders can be complex, here are a few key steps to take when you or your loved one is ready to move towards recovery and sobriety:
1. Seek professional medical help immediately
Stopping opioids or benzodiazepines suddenly can be dangerous — especially benzos, which can cause life-threatening withdrawal symptoms if stopped abruptly. Always consult a qualified medical provider or addiction specialist, like the team at STR Silver Pines, first.
2. Consider medically supervised detox
A medical detox program helps manage withdrawal symptoms safely while reducing health risks. At STR Silver Pines, we offer carefully monitored tapering protocols to support a safe, effective detox process as clients prepare for the next phase of recovery.
3. Enter an integrated treatment program
Choose a treatment center with expertise in co-occurring disorders, also known as dual diagnosis. The most effective programs combine medical support, evidence-based therapies like CBT or DBT, peer connection, and mental health assessments to uncover and treat the underlying reasons behind dual drug use.
4. Build a strong support system
Recovery is hard, but you don’t have to do it alone. At STR Silver Pines, our family support program and lifelong alum network ensure that every step — from detox to long-term recovery — is backed by a community that understands, encourages, and helps you stay on track every step of the way.
Recovering What Matters Through Compassionate Addiction Care
Ready to take your life back? At STR Silver Pines Detox + Residential Treatment, you’ll receive compassionate, 24/7 support to detox safely, heal deeply, and build a strong foundation for lasting recovery. You’re never alone — our dedicated team will guide you every step of the way with expertise and care in a peaceful, welcoming environment.
Contact our admissions team today to learn how we support both clients and their families on the path to lasting healing.
References
- Sun et al., BMJ, Vol. 356, Art. j760
- Jones et al., Am J Public Health, Vol. 109, Art. 4
- Hasegawa et al., Drug Alcohol Depend., Vol. 178, Art. 350
