Are Anti-Anxiety Drugs the Next Epidemic? 

Are Anti-Anxiety Drugs the Next Epidemic? 

If you've been following the news about the opioid epidemic, you might have seen a recent CNBC article declaring that anti-anxiety medications - primarily benzodiazepines - are "fueling the next drug crisis" of widespread addictions and overdoses.

Before we get too excited about a deadly new epidemic looming on the horizon, let's take a closer look at the situation.

How addictive are benzodiazepines, and how life-threatening?

The answer is, they are addictive, but not nearly as addictive as opioids, cocaine, methamphetamine, or even alcohol and tobacco.

As for overdoses, benzodiazepines on their own are not nearly as likely as opioids to cause sudden overdose and death.

But benzodiazepines are involved in over 30 percent of multidrug opioid overdose deaths. And their use and abuse have become alarmingly widespread.

Benzodiazepines may not be "the next drug crisis." But they are already a cause for grave concern.

Overdoses involving benzodiazepines

Over 30 percent of overdoses involving prescription drugs involve benzodiazepines, says the CDC. And 30 percent of overdoses involving only opioids, including heroin, also involve benzodiazepines. And those numbers are rising.

The major problem here is that opioids and benzodiazepines both depress the central nervous system and hence the ability to think and to breathe, greatly adding to the risk of overdose. Mixing two or more CNS depressants is an invitation to disaster.

"Overdose deaths involving benzodiazepines - such as Xanax, Librium, Valium and Ativan, drugs commonly used to treat anxiety, phobias, panic attacks, seizures and insomnia - have quadrupled between 2002 and 2015, according to the National Institute on Drug Abuse (NIDA)," the CNN article said.

It's suggested that the rising number of prescriptions is a red flag signaling more overdose deaths in the future. This is especially so, says NIDA, because so many people are being prescribed both drugs simultaneously.

"In a study of over 300,000 continuously insured patients receiving opioid prescriptions between 2001 and 2013, the percentage of persons also prescribed benzodiazepines rose to 17 percent in 2013 from nine percent in 2001," NIDA says. "The study showed that people concurrently using both drugs are at higher risk of visiting the emergency department or being admitted to a hospital for a drug-related emergency."

Prescriptions soared

More or less paralleling the opioid crisis from 1996 to 2013, the number of adults who filled a benzodiazepine prescription increased by 67 percent - from 8.1 million to 13.5 million. And those prescriptions contain more benzos than they did, even 10 years ago, says the CDC.

Since then, prescriptions have slightly dropped. It's been suggested that prescribers have become more cautious, as they learned that opioid death autopsies were finding more and more benzodiazepines in the mix.

The CNN article also reminds us that close to 40 million adult Americans are said to be suffering from anxiety. Perhaps as many as 30 percent of them fill benzodiazepine prescriptions. With so many benzos out there, the field remains ripe for continued overdoses, even if only accidental combinations with other CNN depressants, such as alcohol or prescription painkillers.

What about benzo overdose?

On their own, benzodiazepines are seldom the "primary" drug treated in emergency wards - perhaps 1 percent of all drug overdose-type admissions. This is basically true for the dozen or so different benzodiazepines commonly prescribed.

It's the same for the other two classes of drugs most associated with anxiety and insomnia. The barbiturates, like Seconal, Nembutal and Amytal, and the "Z-drugs," like Ambien, Sonata and Lunesta (technically not benzodiazepines but they act in a similar way) are also only 1 percent of all ER admissions.

So it's not like anti-anxiety drugs, on their own, are loading up the ERs with overdoses.

But they are addictive, and dangerous to discontinue without medical supervision even after taking them for just a week or so.

Some people also experience worsening anxiety symptoms, called the "rebound" effect, and mistakenly consume even more of the drug, placing themselves at greater risk of overdose.

Fake benzos laced with fentanyl

The DEA tells us that the illegal, deadly fentanyl that's being mixed into heroin across the country also has been found in "counterfeit" benzodiazepine pills. This has contributed to the increases in overdoses - heroin with fentanyl and then a fentanyl-laced fake benzo - a deadly combination.

So bottom line, benzodiazepines and other anti-anxiety meds cause and contribute to overdoses and deaths, and we need to get better organized to deal with the situation.

Meanwhile, Americans are subjecting themselves to mind-altering, risky and dangerous drugs by taking a pill when they feel stressed or depressed when there are so many alternatives such as exercise, a healthy diet, nutritional supplements, limiting caffeine, talking to a friend, listening to music, getting a massage, and improving quality of sleep.

But on the flip side, we're making progress. Prescribers are taking greater care, people are becoming better informed about the risks, and the numbers have been coming down.

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