A three-state mortality study used benzodiazepines as a comparator and found that declining opioid death rates were not clearly distinct from comparator trends.
The investigators studied extended-release and long-acting opioid mortality before and after a risk-management strategy. Death-certificate text was used to identify drugs involved in poisoning deaths. Population-adjusted rates declined, but benzodiazepine and hydrocodone comparator rates also declined, and differences between trends were generally not statistically distinct.
When changes occur in both a targeted drug group and comparison groups, attributing the whole change to one program becomes difficult. State heterogeneity, prescription-volume adjustment, death-certificate reporting, and concurrent influences also matter. Benzodiazepine involvement on a death certificate is not a laboratory concentration or proof that the benzodiazepine alone caused death. This study helps evaluate a population-level program claim; it does not estimate an individual’s fatal dose or establish that the program had no benefit. Its results leave causal attribution constrained.
Original analysis of the supplied journal article, identified as PMC6953333.