When people think about the opioid crisis, they 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 like 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 people 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 risky. 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 people taking both medications were up to 10 times more likely to die from overdose compared to those taking opioids alone.
Even people 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 U.S., more than 30% of opioid overdoses now involve a benzodiazepine (Am J Public Health, Vol. 109, Art. 4).
Many people 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 people 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 these substances:
- People 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).
- Polysubstance 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 like a crushing burden or a hole that’s too deep to dig out of. It is critical to understand that both of these addictions can be treated, and recovery is possible.
While it’s true that polysubstance addiction can be complex, there are a few key steps to take if you’re ready to move towards recovery and sobriety:
1. Seek Professional Medical Help Right Away
Stopping opioids or benzodiazepines suddenly can be dangerous, especially benzos, which can cause life-threatening withdrawal symptoms if stopped abruptly. Always talk to a qualified addiction specialist or medical provider first.
2. Consider Medically Supervised Detox
A medical detox program can safely manage withdrawal symptoms and reduce health risks as you stop using. For opioids, medications like methadone or buprenorphine (Suboxone) can ease withdrawal and cravings. For benzos, a gradual taper is essential — quitting “cold turkey” can cause seizures or severe anxiety. Silver Pines Detox + Addiction Treatment Center provides specialized tapering protocols for benzodiazepines, allowing our clients to safely manage their detox while they navigate rehab.
3. Enter an Integrated Treatment Program
Look for a treatment center experienced with polysubstance use. The best programs combine medical care, behavioral therapy (like CBT or DBT), peer support, and mental health counseling to address why you rely on both drugs.
4. Build a Strong Support System
Recovery is hard to do alone. Support groups like Narcotics Anonymous (NA) or SMART Recovery, trusted friends, family members, or a trusted therapist or counselor can help you stay accountable and supported.
5. Have Naloxone on Hand
Until you’re stable, keep naloxone (Narcan) available. This lifesaving medication can reverse opioid overdoses. Share it with loved ones and teach them how to use it.
Addiction Treatment That Helps You Recover What Matters
Are you ready to take your life back? At Silver Pines Detox and Residential Treatment, you’ll get caring, around-the-clock support to safely detox, heal, and build a strong foundation for lasting recovery. Here, you’re not alone — our team will guide you every step of the way with compassion and wisdom, in a peaceful, welcoming setting. Reach out today to start your journey to recovery.
Contact our admissions team today to learn more about our addiction treatment program and how we support both clients and their families.
Sources
- 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
