Efemena Diejomaoh, MD, DTMH, MPH, a PGY 4 Psychiatry Resident, has been featured in the October Issue of Pain Medicine News for his analysis on the growing dangers of polypharmacy, the concurrent use of multiple medications, among patients treated for chronic pain, particularly when sedating drugs are combined.
Dr. Diejomaoh, who is originally from Warri, Delta State, Nigeria, collaborated with researchers at UTHealth Houston and Johns Hopkins Medicine and found that patients prescribed opioids often also receive other sedating medications, such as benzodiazepines, muscle relaxants, and sleep aids, creating a heightened risk for respiratory depression, excessive sedation, cognitive impairment, falls, and overdose. This additive effect poses serious safety concerns, especially for older adults or those with underlying health conditions.
Dr. Diejomaoh emphasized that these medication combinations are not rare. Many patients with chronic pain also experience anxiety, insomnia, or musculoskeletal disorders, leading clinicians to prescribe additional sedating drugs without always accounting for their cumulative effects on the central nervous system.
He said that clinicians may underestimate the interactive dangers of layering multiple sedating medications on top of opioids. The findings highlight the need for routine medication reviews, deprescribing efforts, and patient education about the risks of combining sedatives.
The researchers recommended that health systems and prescribers take proactive steps to:
- Evaluate all medications in a patient’s regimen for overlapping sedative effects.
- Avoid or limit concurrent prescriptions of opioids and other central nervous system depressants whenever possible.
- Educate patients about recognizing early warning signs of excessive sedation or slowed breathing.
- Use prescription monitoring tools to identify high-risk combinations.
Dr. Diejomaoh completed his medical school at Ambrose Alli University, Ekpoma, Edo State Nigeria.
Written by: Brandon Marshall, Communications Director Meharry School of Medicine
