Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review

While the Food and Drug Administration’s black-box warnings caution against concurrent opioid and benzodiazepine (OPI–BZD) use, there is little guidance on how to deprescribe these medications. This scoping review analyzes the available opioid and/or benzodiazepine deprescribing strategies from the...
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Autor*in:	Yanning Wang [verfasserIn] Debbie L. Wilson [verfasserIn] Deanna Fernandes [verfasserIn] Lauren E. Adkins [verfasserIn] Ashley Bantad [verfasserIn] Clint Copacia [verfasserIn] Nilay Dharma [verfasserIn] Pei-Lin Huang [verfasserIn] Amanda Joseph [verfasserIn] Tae Woo Park [verfasserIn] Jeffrey Budd [verfasserIn] Senthil Meenrajan [verfasserIn] Frank A. Orlando [verfasserIn] John Pennington [verfasserIn] Siegfried Schmidt [verfasserIn] Ronald Shorr [verfasserIn] Constance R. Uphold [verfasserIn] Wei-Hsuan Lo-Ciganic [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	opioid benzodiazepine concurrent use deprescribing tapering

Übergeordnetes Werk:	In: Journal of Clinical Medicine - MDPI AG, 2013, 12(2023), 5, p 1788
Übergeordnetes Werk:	volume:12 ; year:2023 ; number:5, p 1788

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/jcm12051788

Katalog-ID:	DOAJ08799884X

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allfields	10.3390/jcm12051788 doi (DE-627)DOAJ08799884X (DE-599)DOAJ050d08084d9e46abb62a2aaf37462fbd DE-627 ger DE-627 rakwb eng Yanning Wang verfasserin aut Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier While the Food and Drug Administration’s black-box warnings caution against concurrent opioid and benzodiazepine (OPI–BZD) use, there is little guidance on how to deprescribe these medications. This scoping review analyzes the available opioid and/or benzodiazepine deprescribing strategies from the PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases (01/1995–08/2020) and the gray literature. We identified 39 original research studies (opioids: n = 5, benzodiazepines: n = 31, concurrent use: n = 3) and 26 guidelines (opioids: n = 16, benzodiazepines: n = 11, concurrent use: n = 0). Among the three studies deprescribing concurrent use (success rates of 21–100%), two evaluated a 3-week rehabilitation program, and one assessed a 24-week primary care intervention for veterans. Initial opioid dose deprescribing rates ranged from (1) 10–20%/weekday followed by 2.5–10%/weekday over three weeks to (2) 10–25%/1–4 weeks. Initial benzodiazepine dose deprescribing rates ranged from (1) patient-specific reductions over three weeks to (2) 50% dose reduction for 2–4 weeks, followed by 2–8 weeks of dose maintenance and then a 25% reduction biweekly. Among the 26 guidelines identified, 22 highlighted the risks of co-prescribing OPI–BZD, and 4 provided conflicting recommendations on the OPI–BZD deprescribing sequence. Thirty-five states’ websites provided resources for opioid deprescription and three states’ websites had benzodiazepine deprescribing recommendations. Further studies are needed to better guide OPI–BZD deprescription. opioid benzodiazepine concurrent use deprescribing tapering Medicine R Debbie L. Wilson verfasserin aut Deanna Fernandes verfasserin aut Lauren E. Adkins verfasserin aut Ashley Bantad verfasserin aut Clint Copacia verfasserin aut Nilay Dharma verfasserin aut Pei-Lin Huang verfasserin aut Amanda Joseph verfasserin aut Tae Woo Park verfasserin aut Jeffrey Budd verfasserin aut Senthil Meenrajan verfasserin aut Frank A. Orlando verfasserin aut John Pennington verfasserin aut Siegfried Schmidt verfasserin aut Ronald Shorr verfasserin aut Constance R. Uphold verfasserin aut Wei-Hsuan Lo-Ciganic verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 12(2023), 5, p 1788 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:12 year:2023 number:5, p 1788 https://doi.org/10.3390/jcm12051788 kostenfrei https://doaj.org/article/050d08084d9e46abb62a2aaf37462fbd kostenfrei https://www.mdpi.com/2077-0383/12/5/1788 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2023 5, p 1788
spelling	10.3390/jcm12051788 doi (DE-627)DOAJ08799884X (DE-599)DOAJ050d08084d9e46abb62a2aaf37462fbd DE-627 ger DE-627 rakwb eng Yanning Wang verfasserin aut Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier While the Food and Drug Administration’s black-box warnings caution against concurrent opioid and benzodiazepine (OPI–BZD) use, there is little guidance on how to deprescribe these medications. This scoping review analyzes the available opioid and/or benzodiazepine deprescribing strategies from the PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases (01/1995–08/2020) and the gray literature. We identified 39 original research studies (opioids: n = 5, benzodiazepines: n = 31, concurrent use: n = 3) and 26 guidelines (opioids: n = 16, benzodiazepines: n = 11, concurrent use: n = 0). Among the three studies deprescribing concurrent use (success rates of 21–100%), two evaluated a 3-week rehabilitation program, and one assessed a 24-week primary care intervention for veterans. Initial opioid dose deprescribing rates ranged from (1) 10–20%/weekday followed by 2.5–10%/weekday over three weeks to (2) 10–25%/1–4 weeks. Initial benzodiazepine dose deprescribing rates ranged from (1) patient-specific reductions over three weeks to (2) 50% dose reduction for 2–4 weeks, followed by 2–8 weeks of dose maintenance and then a 25% reduction biweekly. Among the 26 guidelines identified, 22 highlighted the risks of co-prescribing OPI–BZD, and 4 provided conflicting recommendations on the OPI–BZD deprescribing sequence. Thirty-five states’ websites provided resources for opioid deprescription and three states’ websites had benzodiazepine deprescribing recommendations. Further studies are needed to better guide OPI–BZD deprescription. opioid benzodiazepine concurrent use deprescribing tapering Medicine R Debbie L. Wilson verfasserin aut Deanna Fernandes verfasserin aut Lauren E. Adkins verfasserin aut Ashley Bantad verfasserin aut Clint Copacia verfasserin aut Nilay Dharma verfasserin aut Pei-Lin Huang verfasserin aut Amanda Joseph verfasserin aut Tae Woo Park verfasserin aut Jeffrey Budd verfasserin aut Senthil Meenrajan verfasserin aut Frank A. Orlando verfasserin aut John Pennington verfasserin aut Siegfried Schmidt verfasserin aut Ronald Shorr verfasserin aut Constance R. Uphold verfasserin aut Wei-Hsuan Lo-Ciganic verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 12(2023), 5, p 1788 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:12 year:2023 number:5, p 1788 https://doi.org/10.3390/jcm12051788 kostenfrei https://doaj.org/article/050d08084d9e46abb62a2aaf37462fbd kostenfrei https://www.mdpi.com/2077-0383/12/5/1788 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2023 5, p 1788
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allfieldsGer	10.3390/jcm12051788 doi (DE-627)DOAJ08799884X (DE-599)DOAJ050d08084d9e46abb62a2aaf37462fbd DE-627 ger DE-627 rakwb eng Yanning Wang verfasserin aut Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier While the Food and Drug Administration’s black-box warnings caution against concurrent opioid and benzodiazepine (OPI–BZD) use, there is little guidance on how to deprescribe these medications. This scoping review analyzes the available opioid and/or benzodiazepine deprescribing strategies from the PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases (01/1995–08/2020) and the gray literature. We identified 39 original research studies (opioids: n = 5, benzodiazepines: n = 31, concurrent use: n = 3) and 26 guidelines (opioids: n = 16, benzodiazepines: n = 11, concurrent use: n = 0). Among the three studies deprescribing concurrent use (success rates of 21–100%), two evaluated a 3-week rehabilitation program, and one assessed a 24-week primary care intervention for veterans. Initial opioid dose deprescribing rates ranged from (1) 10–20%/weekday followed by 2.5–10%/weekday over three weeks to (2) 10–25%/1–4 weeks. Initial benzodiazepine dose deprescribing rates ranged from (1) patient-specific reductions over three weeks to (2) 50% dose reduction for 2–4 weeks, followed by 2–8 weeks of dose maintenance and then a 25% reduction biweekly. Among the 26 guidelines identified, 22 highlighted the risks of co-prescribing OPI–BZD, and 4 provided conflicting recommendations on the OPI–BZD deprescribing sequence. Thirty-five states’ websites provided resources for opioid deprescription and three states’ websites had benzodiazepine deprescribing recommendations. Further studies are needed to better guide OPI–BZD deprescription. opioid benzodiazepine concurrent use deprescribing tapering Medicine R Debbie L. Wilson verfasserin aut Deanna Fernandes verfasserin aut Lauren E. Adkins verfasserin aut Ashley Bantad verfasserin aut Clint Copacia verfasserin aut Nilay Dharma verfasserin aut Pei-Lin Huang verfasserin aut Amanda Joseph verfasserin aut Tae Woo Park verfasserin aut Jeffrey Budd verfasserin aut Senthil Meenrajan verfasserin aut Frank A. Orlando verfasserin aut John Pennington verfasserin aut Siegfried Schmidt verfasserin aut Ronald Shorr verfasserin aut Constance R. Uphold verfasserin aut Wei-Hsuan Lo-Ciganic verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 12(2023), 5, p 1788 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:12 year:2023 number:5, p 1788 https://doi.org/10.3390/jcm12051788 kostenfrei https://doaj.org/article/050d08084d9e46abb62a2aaf37462fbd kostenfrei https://www.mdpi.com/2077-0383/12/5/1788 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2023 5, p 1788
allfieldsSound	10.3390/jcm12051788 doi (DE-627)DOAJ08799884X (DE-599)DOAJ050d08084d9e46abb62a2aaf37462fbd DE-627 ger DE-627 rakwb eng Yanning Wang verfasserin aut Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier While the Food and Drug Administration’s black-box warnings caution against concurrent opioid and benzodiazepine (OPI–BZD) use, there is little guidance on how to deprescribe these medications. This scoping review analyzes the available opioid and/or benzodiazepine deprescribing strategies from the PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases (01/1995–08/2020) and the gray literature. We identified 39 original research studies (opioids: n = 5, benzodiazepines: n = 31, concurrent use: n = 3) and 26 guidelines (opioids: n = 16, benzodiazepines: n = 11, concurrent use: n = 0). Among the three studies deprescribing concurrent use (success rates of 21–100%), two evaluated a 3-week rehabilitation program, and one assessed a 24-week primary care intervention for veterans. Initial opioid dose deprescribing rates ranged from (1) 10–20%/weekday followed by 2.5–10%/weekday over three weeks to (2) 10–25%/1–4 weeks. Initial benzodiazepine dose deprescribing rates ranged from (1) patient-specific reductions over three weeks to (2) 50% dose reduction for 2–4 weeks, followed by 2–8 weeks of dose maintenance and then a 25% reduction biweekly. Among the 26 guidelines identified, 22 highlighted the risks of co-prescribing OPI–BZD, and 4 provided conflicting recommendations on the OPI–BZD deprescribing sequence. Thirty-five states’ websites provided resources for opioid deprescription and three states’ websites had benzodiazepine deprescribing recommendations. Further studies are needed to better guide OPI–BZD deprescription. opioid benzodiazepine concurrent use deprescribing tapering Medicine R Debbie L. Wilson verfasserin aut Deanna Fernandes verfasserin aut Lauren E. Adkins verfasserin aut Ashley Bantad verfasserin aut Clint Copacia verfasserin aut Nilay Dharma verfasserin aut Pei-Lin Huang verfasserin aut Amanda Joseph verfasserin aut Tae Woo Park verfasserin aut Jeffrey Budd verfasserin aut Senthil Meenrajan verfasserin aut Frank A. Orlando verfasserin aut John Pennington verfasserin aut Siegfried Schmidt verfasserin aut Ronald Shorr verfasserin aut Constance R. Uphold verfasserin aut Wei-Hsuan Lo-Ciganic verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 12(2023), 5, p 1788 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:12 year:2023 number:5, p 1788 https://doi.org/10.3390/jcm12051788 kostenfrei https://doaj.org/article/050d08084d9e46abb62a2aaf37462fbd kostenfrei https://www.mdpi.com/2077-0383/12/5/1788 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2023 5, p 1788
language	English
source	In Journal of Clinical Medicine 12(2023), 5, p 1788 volume:12 year:2023 number:5, p 1788
sourceStr	In Journal of Clinical Medicine 12(2023), 5, p 1788 volume:12 year:2023 number:5, p 1788
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	opioid benzodiazepine concurrent use deprescribing tapering Medicine R
isfreeaccess_bool	true
container_title	Journal of Clinical Medicine
authorswithroles_txt_mv	Yanning Wang @@aut@@ Debbie L. Wilson @@aut@@ Deanna Fernandes @@aut@@ Lauren E. Adkins @@aut@@ Ashley Bantad @@aut@@ Clint Copacia @@aut@@ Nilay Dharma @@aut@@ Pei-Lin Huang @@aut@@ Amanda Joseph @@aut@@ Tae Woo Park @@aut@@ Jeffrey Budd @@aut@@ Senthil Meenrajan @@aut@@ Frank A. Orlando @@aut@@ John Pennington @@aut@@ Siegfried Schmidt @@aut@@ Ronald Shorr @@aut@@ Constance R. Uphold @@aut@@ Wei-Hsuan Lo-Ciganic @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
hierarchy_top_id	718632478
id	DOAJ08799884X
language_de	englisch
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author	Yanning Wang
spellingShingle	Yanning Wang misc opioid misc benzodiazepine misc concurrent use misc deprescribing misc tapering misc Medicine misc R Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review
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topic_title	Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review opioid benzodiazepine concurrent use deprescribing tapering
topic	misc opioid misc benzodiazepine misc concurrent use misc deprescribing misc tapering misc Medicine misc R
topic_unstemmed	misc opioid misc benzodiazepine misc concurrent use misc deprescribing misc tapering misc Medicine misc R
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title	Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review
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title_full	Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review
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author_browse	Yanning Wang Debbie L. Wilson Deanna Fernandes Lauren E. Adkins Ashley Bantad Clint Copacia Nilay Dharma Pei-Lin Huang Amanda Joseph Tae Woo Park Jeffrey Budd Senthil Meenrajan Frank A. Orlando John Pennington Siegfried Schmidt Ronald Shorr Constance R. Uphold Wei-Hsuan Lo-Ciganic
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title_sort	deprescribing strategies for opioids and benzodiazepines with emphasis on concurrent use: a scoping review
title_auth	Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review
abstract	While the Food and Drug Administration’s black-box warnings caution against concurrent opioid and benzodiazepine (OPI–BZD) use, there is little guidance on how to deprescribe these medications. This scoping review analyzes the available opioid and/or benzodiazepine deprescribing strategies from the PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases (01/1995–08/2020) and the gray literature. We identified 39 original research studies (opioids: n = 5, benzodiazepines: n = 31, concurrent use: n = 3) and 26 guidelines (opioids: n = 16, benzodiazepines: n = 11, concurrent use: n = 0). Among the three studies deprescribing concurrent use (success rates of 21–100%), two evaluated a 3-week rehabilitation program, and one assessed a 24-week primary care intervention for veterans. Initial opioid dose deprescribing rates ranged from (1) 10–20%/weekday followed by 2.5–10%/weekday over three weeks to (2) 10–25%/1–4 weeks. Initial benzodiazepine dose deprescribing rates ranged from (1) patient-specific reductions over three weeks to (2) 50% dose reduction for 2–4 weeks, followed by 2–8 weeks of dose maintenance and then a 25% reduction biweekly. Among the 26 guidelines identified, 22 highlighted the risks of co-prescribing OPI–BZD, and 4 provided conflicting recommendations on the OPI–BZD deprescribing sequence. Thirty-five states’ websites provided resources for opioid deprescription and three states’ websites had benzodiazepine deprescribing recommendations. Further studies are needed to better guide OPI–BZD deprescription.
abstractGer	While the Food and Drug Administration’s black-box warnings caution against concurrent opioid and benzodiazepine (OPI–BZD) use, there is little guidance on how to deprescribe these medications. This scoping review analyzes the available opioid and/or benzodiazepine deprescribing strategies from the PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases (01/1995–08/2020) and the gray literature. We identified 39 original research studies (opioids: n = 5, benzodiazepines: n = 31, concurrent use: n = 3) and 26 guidelines (opioids: n = 16, benzodiazepines: n = 11, concurrent use: n = 0). Among the three studies deprescribing concurrent use (success rates of 21–100%), two evaluated a 3-week rehabilitation program, and one assessed a 24-week primary care intervention for veterans. Initial opioid dose deprescribing rates ranged from (1) 10–20%/weekday followed by 2.5–10%/weekday over three weeks to (2) 10–25%/1–4 weeks. Initial benzodiazepine dose deprescribing rates ranged from (1) patient-specific reductions over three weeks to (2) 50% dose reduction for 2–4 weeks, followed by 2–8 weeks of dose maintenance and then a 25% reduction biweekly. Among the 26 guidelines identified, 22 highlighted the risks of co-prescribing OPI–BZD, and 4 provided conflicting recommendations on the OPI–BZD deprescribing sequence. Thirty-five states’ websites provided resources for opioid deprescription and three states’ websites had benzodiazepine deprescribing recommendations. Further studies are needed to better guide OPI–BZD deprescription.
abstract_unstemmed	While the Food and Drug Administration’s black-box warnings caution against concurrent opioid and benzodiazepine (OPI–BZD) use, there is little guidance on how to deprescribe these medications. This scoping review analyzes the available opioid and/or benzodiazepine deprescribing strategies from the PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases (01/1995–08/2020) and the gray literature. We identified 39 original research studies (opioids: n = 5, benzodiazepines: n = 31, concurrent use: n = 3) and 26 guidelines (opioids: n = 16, benzodiazepines: n = 11, concurrent use: n = 0). Among the three studies deprescribing concurrent use (success rates of 21–100%), two evaluated a 3-week rehabilitation program, and one assessed a 24-week primary care intervention for veterans. Initial opioid dose deprescribing rates ranged from (1) 10–20%/weekday followed by 2.5–10%/weekday over three weeks to (2) 10–25%/1–4 weeks. Initial benzodiazepine dose deprescribing rates ranged from (1) patient-specific reductions over three weeks to (2) 50% dose reduction for 2–4 weeks, followed by 2–8 weeks of dose maintenance and then a 25% reduction biweekly. Among the 26 guidelines identified, 22 highlighted the risks of co-prescribing OPI–BZD, and 4 provided conflicting recommendations on the OPI–BZD deprescribing sequence. Thirty-five states’ websites provided resources for opioid deprescription and three states’ websites had benzodiazepine deprescribing recommendations. Further studies are needed to better guide OPI–BZD deprescription.
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