# Benzodiazepine restrictions and the prevention of overdoses and other harms

> **NIH NIH K01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2022 · $171,834

## Abstract

PROJECT SUMMARY/ABSTRACT
The use of benzodiazepines, an addictive yet commonly prescribed class of drugs in the US, is independently
linked to serious health outcomes, including falls and fractures. Benzodiazepines are also frequently involved
in opioid-related overdoses, underscoring their relevance in the ongoing US opioid epidemic. Benzodiazepine
coverage restrictions and other regulatory actions have been implemented in the past to reduce
benzodiazepine use and related harms, though the intended and unintended impact of these actions remains
unclear. One such restriction with national implications was the exclusion of benzodiazepines coverage for
Medicare enrollees during the implementation of Medicare Part D in 2006. At the same time, the Tennessee
Medicaid (TennCare) program instituted a restriction on benzodiazepine coverage for all enrollees. TennCare
was the only State Medicaid program in the country to do so. Thus, TennCare enrollees (including dual-
eligibles) did not have benzodiazepine coverage from either Medicaid or Medicare from 2006 through 2013,
when the restriction was partially removed, and then completely removed in 2014. This intermittent restriction
and subsequent reintroduction of benzodiazepine coverage is unique to TennCare enrollees and provides the
setting for a natural experiment to determine the impact of benzodiazepine restrictions on benzodiazepine-
related harms and the use of other psychotropic medications. The proposed work will use retrospective
longitudinal TennCare data linked to Medicare Part D, Vital Records, and State hospitalization data to examine
three specific aims: Aim 1: To test the hypothesis that benzodiazepine restrictions in 2006 led to a lower rate
of falls, fractures and opioid-related overdoses among TennCare patients with indications for benzodiazepines
use compared to patients without indications for benzodiazepines. Aim 2: To test the hypothesis that the
implementation and subsequent removal of benzodiazepine restrictions in 2006 and 2014 led to compensatory
changes in the rates of filled prescriptions for other similarly indicated psychotropic medications among
TennCare patients with indications for benzodiazepine use. Aim 3: To test the hypothesis that the removal of
benzodiazepine restrictions in 2014 led to a higher rate of falls, fractures and opioid-related overdoses among
patients with indications for benzodiazepine use compared to patients without indications for benzodiazepine
use. To inform the proposed work and the development of an independent research program focused on drug
safety research, the candidate has identified mentors with relevant expertise to oversee additional training
opportunities in (1) the application of advanced difference-in-difference designs for the evaluation of state
policy changes, (2) the clinical needs and barriers to care among patients that use benzodiazepines and other
psychotropic drugs, and (3) the large-scale linkage of claims data with other cli...

## Key facts

- **NIH application ID:** 10434150
- **Project number:** 5K01DA051683-02
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Andrew David Wiese
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $171,834
- **Award type:** 5
- **Project period:** 2021-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10434150

## Citation

> US National Institutes of Health, RePORTER application 10434150, Benzodiazepine restrictions and the prevention of overdoses and other harms (5K01DA051683-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10434150. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*
