Benzodiazepines: America's Lesser Known Drug Problem

Benzodiazepines: America's Lesser Known Drug Problem
Posted on 04/04/2018
HARRIS COUNTY/HOUSTON, TEXAS — As the national spotlight exposes the opioid crisis, another threat looms. Year after year, benzodiazepines such as Xanax and Valium are killing more and more people; yet this issue receives little attention.

Nationwide, benzodiazepine-related overdose deaths increased nearly eight-fold from 1999 to 2015.1 Between 1996 and 2013, the number of benzodiazepine prescriptions increased from 8.1 million to 13.5 million.2 Similarly, the amount of benzodiazepine received by each patient more than tripled in those 17 years.2 So, more people are legally getting the drug, and in higher amounts than ever before.

Benzodiazepines (also called benzos) act on the central nervous system to decrease excitability of neurons, which results in overall calming effects.3 Benzos are commonly used to treat anxiety, insomnia, seizures, and muscle spasms. Anxiety is a common problem, and benzodiazepines are the most commonly prescribed medication to treat it.

“20% of the population suffers from anxiety,” said Dr. Joy Alonzo, Clinical Assistant Professor of Pharmacy Practice at Texas A&M. “Xanax is far and away the most prescribed benzodiazepine. Xanax is one of the most prescribed drugs in the United States.”

The Journal of the American Medical Association published in 2015 that 59% of Americans report taking at least one prescription medication, and most reported taking more than one medication.4

Medications have become such a normal part of our society that nobody stops to think about the potential downside. Many people falsely assume that if a medication is prescribed by a doctor, then it is safe to use. However, all medications have side effects. Common benzodiazepine side effects include sleepiness, confusion, forgetfulness, and decreased coordination. More serious side effects, include slowed heart rate, lowered blood pressure, and even reduced instinct to breathe.3

It’s not that benzodiazepines should never be taken. Doctors prescribe them because they work, and they work fast. They decrease anxiety, make people worry less, and overall make people feel better. When taken as prescribed for short periods, they are proven to be effective and relatively safe. When taken for longer periods of time, the benefits start to disappear and the risks increase dramatically. The body gets used to the medicine. People need to take more to get the same results. Many people do not realize that these drugs can be highly addictive and cause fatal overdose.5

What can you do? Most importantly, recognize that drug abuse is a serious problem. Understand that nobody chooses to become an addict and that addiction can happen to anyone. Inform your family, friends, and co-workers about the dangers of benzos. Lastly, speak with your doctor about the risk for addiction and/or overdose from any medication that you are taking.

Please read part II to learn about how benzodiazepines are fueling the national opioid epidemic.

References:

1 National Institute on Drug Abuse. 2017. Trends & Statistics Series: Overdose Death Rates. https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

2 Bachhuber MA, Hennessy S, Cunningham CO, Starrels JL. Increasing benzodiazepine prescriptions and overdose mortality in the United States, 1996-2013. Am J Public Health 2016;106;686-8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816010/

3 Griffin, C. E., Kaye, A. M., Bueno, F. R., & Kaye, A. D. (2013). Benzodiazepine Pharmacology and Central Nervous System–Mediated Effects. The Ochsner Journal, 13(2), 214–223. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/

4 Kantor ED, Rehm CD, Haas JS, Chan AT, Giovannucci EL. Trends in prescription drug use among adults in the United States from 1999-2012. JAMA. 2015;314(17):1818-1831. https://www.ncbi.nlm.nih.gov/pubmed/26529160

5 Lembke, A., Papac, J., & Humphreys, K. (2018). Our Other Prescription Drug Problem. New England Journal of Medicine, 378(8), 693-695. http://www.nejm.org/doi/full/10.1056/NEJMp1715050


About the author:

Rhett Lacey served as Coalition Intern from February – March 2018 in the Nutrition and Chronic Disease Prevention Division at Harris County Public Health. He will receive a Master of Science in Physician Assistant Studies, and a Master of Public Health from Touro University California in May 2018. He holds a Bachelor of Science in Human Physiology and a Bachelor of Arts in Biology from The University of Iowa, as well as an Associate of Science in Paramedicine from Kirkwood Community College. Throughout his career, Rhett has focused on researching the topics of treatment and prevention in medicine. To learn more about the North Harris County Substance Abuse Prevention Coalition, please visit our About page.

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