ABSTRACT:The number of unintentional deaths involving opioid and/or benzodiazepine use continues to increase in Australia. This study examined patterns of concurrent prescribing of opioids and benzodiazepines/Z‐drugs (BZDs) for long‐term use in Australian general practice. A cross‐sectional analysis was undertaken using MedicineInsight, a national database of de‐identified general practice electronic health records. We estimated the proportion of patients (per 1000, ‰) in 2017 receiving concurrent prescriptions for opioid and BZD medications for long‐term use (≥ 3 prescriptions within 90 days). Poisson regression models were used to estimate the marginal adjusted prevalence (adjP) and adjusted prevalence ratios (adjPR) were used to compare concurrent long‐term prescribing according to sociodemographic characteristics, rurality, smoking status, and diagnosis of mental health or musculoskeletal conditions. The sample included 1,207,671 individuals (41.3% males; mean age 50.6 ± 18.6 years) regularly attending 544 general practices. The prevalence of concurrent long‐term opioid and BZD prescribing was 7.0‰, and the median duration of prescribing overlap was 611 days (p25‐p75 348–952). The prevalence was higher for patients aged over 65 years (adjPR = 3.62 95% CI 3.30, 3.98), females (adjPR = 1.33 95% CI 1.27, 1.39), those living in more disadvantaged (adjPR = 1.70 95% CI 1.49, 1.93) or rural/remote areas (adjPR = 1.13 95% CI 1.00, 1.28), smokers (adjPR = 4.10 95% CI 3.87, 4.35), and those with mental health (adjPR = 3.23; 95% CI 2.83, 3.69) or musculoskeletal conditions (adjPR = 2.74; 95% CI 2.47, 3.04). In patients with both mental health and musculoskeletal conditions, the prevalence was 32.1‰. Interventions to reduce concurrent long‐term prescribing could be targeted to the identified vulnerable groups.