Coprescribing of benzodiazepines or gabapentinoids (e.g., gabapentin, pregabalin) with opioids is increasingly used in the multimodal treatment of acute and chronic pain, despite limited evidence to support the effectiveness of this practice. Population studies have demonstrated that these combinations are associated with an increased risk of serious adverse outcomes such as excessive sedation, overdose events, and death. In 2019, the U.S. Food and Drug Administration required new warnings about the risk of serious breathing difficulties that can lead to death in patients who use gabapentinoids with opioid pain medicines or other drugs that depress the central nervous system or in patients who have underlying respiratory impairment, such as those with chronic obstructive pulmonary disease, or the elderly. Older adults may be particularly vulnerable because of age-related changes in pharmacokinetics, pharmacodynamics, and medical comorbidity. Initiation of combination therapy should be avoided whenever possible; older patients who require chronic concurrent use of these medication classes should be closely monitored and periodically evaluated for deprescribing. Choosing Wisely Canada (Canadian Pharmacists Association) spells out an important consideration for prescribing benzodiazepines that includes discontinuation strategies, except for patients with valid indications requiring long-term use of these medications.