Is It Safe to Combine Methadone and Benzodiazepines?

Combining methadone and benzodiazepines is generally not safe, because the drugs can fatally interact. They both have sedating effects on the central nervous system, which can lead to difficulty breathing as well as cognitive impairment. In some cases, this can be deadly if the patient does not receive appropriate treatment. Patients in drug treatment using methadone as part of their recovery who also experience anxiety may need to pursue alternatives to benzodiazepines in order to stay safe. Medical professionals may consider benzodiazepine therapy if other treatment options are not effective, in which case the patient needs to be carefully supervised.

Methadone is an opioid medication used in pain management and drug treatment programs. Benzodiazepines act on the central nervous system to address symptoms of anxiety and stress, and are very widely recommended in many regions of the world. The combination of methadone and benzodiazepines is recommended against in many clinical practice guidelines, backed by numerous scientific studies showing an increased risk of severe and fatal complications for patients on both medications.

Concerns about bad interactions in patients who take methadone and benzodiazepines stem from the fact that the dual depression of the central nervous system can pose a serious risk. Benzodiazepine use is more likely to result in airway obstruction, which can be a problem when a patient starts breathing more slowly and irregularly as a result of severe central nervous system depression. Patients can also develop symptoms like slurred speech, confusion, dizziness, and unconsciousness. This can be an especially high risk for patients on big doses of either or both medications.

Analysis on deaths among patients using methadone indicates that benzodiazepines can be a significant factor. For this reason, providers may be reluctant to recommend methadone and benzodiazepines together. People using these medications without medical supervision should make sure providers are aware of it if they are seeking medical treatment for symptoms like neurological impairment. Medical providers need this information so they can identify an interaction and treat the patient properly.

Some patients taking methadone may discuss anxiety and stress with the medical providers supervising their care. Treatments like therapy, other medications, and meditation are available. If these are not effective and the patient continues to experience distress that interferes with tasks of daily living, the provider may consider benzodiazepines. Concerns about complications may lead the provider to recommend a very low dose along with constant monitoring, which can include blood tests, regular checkin appointments, and other measures to catch complications caused by methadone and benzodiazepines early.