Unintentional injury is a significant burden and source of premature mortality for aging Americans: in 2016, there were 53,141 deaths due to unintentional injury among adults 65 and older (“older adults”) and an additional 5.1 million non-fatal injuries. Falls are the leading cause of injury for older adults, accounting for 56% of injury deaths and 63% of non-fatal injuries. Prescription drug overdose is another leading cause of injury among older adults, which is unsurprising given older adults consume the most prescription medications, have the highest rates of polypharmacy overall, and have growing use of potentially harmful polypharmacy of opioids and psychotropic medications. With the population of older adults in the U.S. expected to double to 83.7 million by 2050, identifying older adults at highest risk of unintentional injury has high public health significance, and benzodiazepine (BZD) use is a key factor underlying both of these causes of unintentional injury among older adults.
Benzodiazepines (BZDs) are the medication class most strongly associated with fall and fracture risk in older adults. In addition to their association with falls, BZDs are the second-most common cause of prescription drug overdose (OD) after opioids, as well as the medication most commonly combined with opioids. Compared to fall risk, there have been no studies of how OD risk varies with short- or long-term use.