Title: Recommendations

Context:
In addition to benzodiazepines, the addition of other psychoactive medications to LOT must be made with  caution. While the evidence for harm associated with the combination of opioids and Z-drugs (e.g.,  zolpidem, eszopiclone) is not as strong as the evidence for harm associated with the combination of  opioids and benzodiazepines, we suggest not prescribing Z-drugs to patients who are on LOT, as moderate  quality evidence demonstrates that the combination of zolpidem and opioids increases the AOR of  overdose.[66] The evidence reviewed also identifies potential adverse outcomes (e.g., risk of overdose)  with the combined use of antidepressants and opioids in patients who do not have depression.[66] This  particular study did not differentiate between classes of antidepressants, limiting the ability of the Work  Group to recommend for or against prescribing opioids and a specific class of antidepressants. As such,  there is no recommendation in this guideline with respect to using specific classes of antidepressants and  LOT.

Question: What is not as strong as the evidence for harm associated with the combination of  opioids and benzodiazepines?

Answer: the evidence for harm associated with the combination of opioids and Z-drugs (e.g.,  zolpidem, eszopiclone)