The U.S. Food and Drug Administration on Wednesday strengthened warnings about the danger of combining opioid painkillers or cough medicines containing opioids with benzodiazepines, a common class of sedatives.

The agency is requiring that black box warnings, the strongest available, be added to nearly 400 products, alerting doctors and patients that combining opioids and benzodiazepines can cause extreme sleepiness, slowed breathing, coma and death.

Baltimore officials presented a 10-year plan Tuesday that sharply highlights the poor health status of African-Americans and aims to bring black rates of lead poisoning, heart disease, obesity, smoking and overdoses more in line with those of whites.

“We wanted to specifically call out disparities” in racial health, said Dr. Leana Wen, who became the city’s health commissioner early last year. “And we have a moonshot. Our moonshot is we want to cut health disparities by half in the next 10 years.”

In the Food and Drug Administration's latest move to help stem the tide of drug overdoses, it is now requiring "black-box warnings" on nearly 400 products to warn about the dangers of using opioid painkillers in combination with benzodiazepines, drugs commonly used to treat neurological and psychological conditions including seizure, anxiety and insomnia. 

Both opioids, such as hydrocodone and oxycodone, and benzodiazepines, such as diazepam and alprazolam, can slow the central nervous system. Using them together can lead to extreme sleepiness, respiratory depression, coma and death.

 As an emergency room physician in Washington, D.C., it didn’t take long for Leana Wen to notice a pattern: Patients making repeat visits to the ER, wheezing and coughing from asthma exacerbations or suffering from lead poisoning, conditions that most often afflict those living in low-income neighborhoods.

She helped soothe her patients’ immediate needs, but she was acutely aware she was only providing temporary relief, leaving the root causes unchecked — and a gap in the health of residents living in the city’s poorest ZIP codes versus those in the wealthiest. She wanted the opportunity to intervene earlier in those ER patients’ lives.

“If a child is lead poisoned to start with … it’s hurting that child’s chances before they begin,” she says.