Retrospective study of impact of perioperative benzodiazepine exposure on risk of new persistent benzodiazepine use among cancer patients

Benzodiazepines are among the most misused medications, with many patients having their first exposure during a surgical episode. Analysis of the IBM-MarketScan database identied 34,637 patients who underwent cancer surgery between 2013 and 2021, most commonly for cancer of colon (31.3%), prostate (26.0%), or breast (15.8%). Overall, 8.8% of patients had perioperative benzodiazepine use, and 7.5% of patients developed new persistent benzodiazepine use (NPBU) with 180 days after surgery. On multivariable analysis, perioperative benzodiazepine exposure (versus no exposure OR 2.00; 95% CI 1.68-2.38) and perioperative dose of > 32.0 lorazepam milligram equivalents (versus < 10 LME OR 2.42; 95% CI 2.01-2.92) were independently associated with hhigher odds of NPBU. Male patients had lower odds of NPBU versus female patients (OR 0.80; 95% CI 0.68-0.94). The authors conclude that roughly 1 in 13 commercially insured patients developed NPBU following surgery for cancer.