The Dangers of Mixing Benzodiazepines and Opioids

Taking benzodiazepines with opioids can be quite dangerous.¹ Benzodiazepines and opioids can both slow vital physiological processes, such as breathing and heart rate.¹ Using both benzos and opioids at the same time can amplify certain adverse effects, resulting in an increased risk of injury, overdose, or death.¹

From 2002 to 2015, overdose deaths involving benzodiazepines increased by 300%; in 2020, 16% of opioid-related overdose deaths also involved benzos.^{2, 6} Accordingly, opioids and benzodiazepines have become the two most common types of prescription drugs involved in overdose deaths.³

Understanding the dangers of mixing substances like benzos and opioids could be lifesaving. This page will explore the dangers of mixing benzodiazepines and opioids and what to do if you or a loved one needs help.

Risks of Mixing Benzos with Opioids

The combination of benzodiazepines and opioids can lead to dangerous over-sedation, profound respiratory depression, and life-threatening overdose.⁶ In 2020, there were nearly 11,000 fatal overdoses involving benzos and opioids; in this same year, deaths from benzodiazepines in combination with synthetic opioids—such as illicitly-manufactured fentanyl—made up a significant portion of the more than 12,000 benzodiazepine-related overdose fatalities.^4,6

Other risks of taking benzodiazepines and opioids together include:^{5, 6}

• Higher risk of emergency room visits
• Higher risk of hospital admission for drug-related emergencies
• Higher risk of overdose
• Polysubstance physical dependence
• Polysubstance addiction
• Over-sedation
• Markedly impaired cognition
• Dangerously slowed breathing
• Coma
• Death

Can You Die from Mixing Opioids and Benzos?

Mixing opioids and benzos can result in deadly overdose due to severe respiratory depression, which may be compounded by using both at the same time.^{1, 3, 10}

In fact, in 2019 and 2020, more than 90% of all benzodiazepine-involved overdose deaths also involved opioids.¹⁰

How to Manage Benzodiazepine and Opioid Withdrawal

Overdose isn’t the only significant risk when combining drugs such as benzos and opioids. With repeated use of opioids or benzodiazepines, people can develop physiological dependence on the drugs, experience withdrawal when use suddenly slows or stops, and ultimately develop compulsive patterns of use characteristic of addiction.^{5, 11}

Dependence develops as a person adapts to a substance and becomes so used to the drug in their system that they experience withdrawal symptoms if they cut back on their use or quit.¹¹ With significant levels of physiological dependence, a person may continue to compulsively use drugs to avoid uncomfortable withdrawal symptoms.¹¹

Opioid and benzodiazepine withdrawal can be extremely unpleasant and difficult to get through, but it may also be associated with dangerous, and sometimes life-threatening withdrawal complications. A period of supervised, medically managed detoxification may be needed to safely treat someone experiencing withdrawal from both substances.^{7, 8, 12}

Benzodiazepine withdrawal symptoms include the following:^{7, 12, 13}

• Anxiety
• Agitation
• Insomnia
• Increased heart rate
• Sweating
• Tremor/shaking
• Being confused or disoriented
• Delirium
• Transient hallucinations
• Seizures

Opioid withdrawal symptoms include the following:^{8, 12, 13}

• Dysphoria
• Insomnia
• Body aches
• Muscle spasm
• Fever and sweating
• Goosebumps
• Runny nose and tearing eyes
• Nausea and vomiting
• Diarrhea and stomach cramps
• Increased breathing, heart rate, and blood pressure

Medical detox can take place in a hospital, treatment center, or another inpatient setting, or on an outpatient basis, when appropriate for adequate clinical management and recovery needs.

Finding Treatment for Benzodiazepine and Opioid Withdrawal

If you or a loved one are struggling with benzo and opioid misuse, getting support can be key in helping you set a solid foundation for ongoing recovery. Withdrawal from both benzos and opioids can be uncomfortable and potentially dangerous. A supervised detox program can provide medication (if needed) and other supportive care to keep you as safe and comfortable as possible during this challenging period of early recovery.

American Addiction Centers (AAC) has several top-rated treatment facilities across the U.S. ready to help you start a new life. Contact our caring admissions team at to learn more about treatment options and to check your insurance. You don’t have to do this alone–we’re here to help!

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