The People's Perspective on Medicine

What Is the Other Drug Epidemic?

Researchers say there is another drug epidemic in addition to opioids. Doctors are prescribing more benzodiazepines than ever for longer periods of time.
Worried senior man can not sleep. He is sitting on his bed with headache.

Much has been written about the epidemic of opioid drug misuse, overdose and death. With more than 130 people dying every day in this country as a result of opioid overdose, we all have a right to be alarmed. Within six years, the annual death toll is expected to rise to almost 82,000 (Chen et al, JAMA Network Open, Feb. 1, 2019). But another drug epidemic is flying under the radar, according to a different report in JAMA Network Open (Jan 25, 2019).

Benzodiazepines Are the Silent Drug Epidemic:

Prescriptions for benzodiazepine drugs such as alprazolam (Xanax), lorazepam (Ativan) and diazepam (Valium) have risen dramatically over the last dozen years (Agarwal & Landon, JAMA Network Open, Jan. 25, 2019). These medications are usually prescribed for anxiety or insomnia. However, the data show that primary care physicians are increasingly prescribing these drugs for back pain or other chronic pain. We have not seen evidence that benzos are effective for pain, however.

The Benzo Drug Epidemic–Not Only More But Longer:

These findings are worrisome. Not only are more people taking benzodiazepines, but patients are taking them for longer periods of time. Older people are especially susceptible to side effects. In particular, we worry that older individuals who take benzodiazepines for long periods of time may be more likely to develop dementia.

In general, benzos are best used for short periods of time. Over weeks or months, they tend to lose their effectiveness. In addition, people develop dependence which can make it very difficult to stop taking them. In fact, sudden withdrawal can sometimes be fatal. Overdose deaths related to benzodiazepines have also risen–almost eight-fold in the 21st century. That is another reason to be alarmed about the benzodiazepine drug epidemic.

The authors conclude:

“As we have seen with the opioid epidemic and in light of increasing death rates related to benzodiazepine overdose, addressing prescribing patterns may help curb the growing use of benzodiazepines.”

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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First of all, I think it is important to differentiate between addiction and dependence. These words are not interchangeable. Addiction refers to an individual centering their life around obtaining and using their drug of choice. They will go to any lengths to obtain it – stealing, cheating, lying, etc. Dependence merely refers to being unable to abruptly discontinue a particular medication.

Yes, it is likely that one will become dependent upon benzodiazepines if one uses them long-term. This does not mean that one will become an addict, however.

Secondly, many people are able to use benzodiazepines successfully for years without raising the dosage. Jean from IL in this thread talks about using 15 mg of temazepam for over a decade with positive results.

What we do not need is the federal government getting on another kick about some category of drug’s use being an “epidemic,” therefore justifying all sorts of restrictions on and interference with that use. Many people use controlled substances responsibly. (Benzodiazepines are Schedule IV drugs.) Let’s not penalize them because of those who do not.

I know that these medications that are abused are very effective and probably are the most effective for insomnia and anxiety. It seems difficult to obtain them if they even suspect you might abuse them. A lot of times those suspicions are just that–

My wife was put on Clonazepam more than 20 years ago. As it became less effective, the dosage quickly climbed from 1 to 5 mg per day. It has taken her the last 7 years to taper down to 1 mg per day. This has not been easy, to put it mildly. This last milligram will likely take another 3 years to wean off this highly addictive drug.

I have taken 1/2 to one .25 mg Xanax at bedtime for about 10 years. It helps me fall asleep. I don’t take it all the time and certainly have not abused it, but I would not like to be without it as I have life issues that cause me great anxiety. Is that addiction? I don’t think so. One doctor I saw refused to prescribe it, even though I explained my usage history. She acted like it was the worst drug in the world, but wanted to prescribe clonazepam instead!!! I quickly changed doctors, again!

I have recurring vertigo. Nothing but Diazepam (Valium) helps. 5 Mg twice a day for a few days ends it. Then I’m all right for a month or so. Those of us that need the meds, and aren’t addicts, should not be paying the unhealthy price of doing without because of addicts.

If I may ask to Jow in NC, why is it taking so long? My grandmother tapered off ten milligrams of Xanax in a year. Could the time be making it more difficult? I by no means mean this as judgmental – quite the opposite. There is hope!

I used to have pain and panic attacks. At one time I took Xanax. My goal is to not be on any pharmaceuticals. I did some research and as a result I got off the Xanax. I now take about 800mg of Magnesium daily. When I am really stressed or anxious I take GABA 750 mg x 2. 5-HTP is also good.

Our food is sorely deficient in nutrients that we all need to function, and often many “diseases” are because of this. Do your own research, and get the best brands as well. Not all supplements are equal. Most Americans are sorely deficient in basic minerals. The Magnesium also fixed my atrial fibrillation. There is a good book on this written a while back called The Mood Cure by Julia Ross.

For me and many others benzos are a complete nightmare. I took them briefly (approx. 4 weeks) in 2002 for severe insomnia and anxiety. They did not help much, and when I attempted to stop all hell broke loose. I could not get off. I found support with an online benzo group and switched to longer acting valium. With the help of the support group I was able to taper off over a period of 2 years. What I went through was living hell, and I do not recommend these drugs unless they are absolutely necessary and saving a life. They are one of the most addictive substances on the planet.

Not all people are alike, and not all become addicted. Perhaps dependent, but not addicted to Benzo’s. I liken it to having diabetes and becoming dependent on insulin – one is dependent, but not addicted, and Benzos can be used for conditions that can be life-threatening if not used, not suicide, but diseases, such as users of Insulin. The government is systematically eliminating medications that have worked well for many, and in my opinion usage needs to be evaluated on an individual basis, not the collective whole of the population. Some abuse, many do not. I am tired of government/medical interference with medications that work for people, and it is the job of MDs and others to cull out those who are abusers.

My doctor, having read of the evils of benzos, determined to wean me off the Temazepam 15mg for sleep. I’d taken it for more than a decade with no side effects. After trials with eight mostly (minimal dose) antidepressants, I had a massive reaction to half tablets of Mirtazapine 7.5mg. The rash that covered all but my face and chest turned into a massive painful, oozing skin infection after five days of no sleep. I was bedridden for a month and have been off my feet for nearly two more. It is still painful to stand.

Myself included, with anxiety/panic. From a very young age, I mean 6-8 yr old onset, I had genetic markers for anxiety and panic attacks and didn’t know the cause. So after childhood, as soon as I had control of my life, off to the drug store and doctor I went. Thanks to genetic testing I found I was severely deficient in critical nutrients to assist in my getting anxiety under control. Also, after such a prolonged anxious state I had to relearn to self-talk, because I would get anxious before any situation ever occured. Hope this helps someone. Thanks, everyone, for sharing.

Male,nearly 75, have been on benzos for 54 years. Began with Valium 15 mgs daily in three doses of 5 mg each and up to 25 mgs in 5 doses of 5 mg each. At 28 yrs of age was put on Ativan, total daily 8 mgs in 4 daily doses of 2 mg each. Now have been on 10 mgs of Ativan daily in 5 divided doses of 2 mg each. I hate being on them but my ODC was controlled till tolerance set in 10 years ago. Now am also on 40 to 60 mgs of Prozac daily,to keep my otherwise-crippling OCD in check. The Ativan is now POSSIBLY ONLY SERVING MY ADDICTIVE NEED. In addition to my OCD,I ALSO HAVE REAL-PROBLEMS WHICH WOULD CAUSE ANGUISH TO ANY HUMAN-BEING OF FLESH AND BLOOD WITH A HEART THAT FEELS.

The Benzodiazepine Information Coalition. W-Bad; World Benzodiazepine Day. the benzo buddies.
Education. Facts. Knowledge.

Jean, mental health professionals view Dr. Peter Breggin as a very controversial figure. It seems he never met a psychotropic he didn’t hate. I encourage you to seek out more balanced views.

Psychotropics are not panaceas. But they do help many people live a functional existence. Like any medication, there are pros and cons.

I am so very thankful for the small amount of Xanax that I take as needed for panic attacks (0.25 mg). maybe 3 times a week. I have to go to a psychiatrist and pay the copay because my doctor will not give them to me because she says I am benzo dependent! Such a shame I have this on my medical record just because I requested a prescription for Xanax. After going to the hospital for a panic attack I was given a prescription, and it has been such a wonderful blessing!

I have been on benzodiazepines for over 25 years to control my panic disorder. The stories I have read about people trying to get off them is worse to me than potential dementia. The behavorial center I went to over the years kept prescribing them over and over without telling me of the potential problems and now because of that it’s too late to get off them. They told me at my scheduled med check that they were not going to prescribe Benzos anymore. I tried to reason with them because I never abused them and did everything right, but to no avail. Fortunately my PCP prescribed them for me, but it is always in the back of my mind that one day they won’t prescribe them any longer.

I would rather be on a benzo than the antidepressants that are consistently shoved in patients faces & which I refuse to take.

in my years of non-stop panic 1982-87 that only 7 daily 1mg xanax could restrain, i was grateful for that miraculous drug. once i learned how to manage my bipolar nature after both my beloved parents died, only one 1mg xanax quieted the thoughts that kept me from sleep. i’ve tried several times to wean off xanax, but cannot sleep without my faithful 1mg nightly. i’m blessed that it works for me. and i just turned 76.

Patricia: I so agree with you! About 35 years years ago, in the midst of a terrible depression, I was prescribed many anti-depressants. Most made me feel worse; some made me so nervous that I could not relax or sleep. Finally, I was put on Pamelar. It seemed OK, but I gained 30 pounds on it. It also caused severe dry eyes and dry mouth. When I wanted to stop it the PCP told me to “just quit.” That was terrible! I had to wean myself off slowly.

Ten years ago, I was going through severe financial stress and was given very low dose Xanax for sleep, when needed. It helped without any side effects. Then I was changed to Atenolol and it, too, was OK. I still take a very low dose for sleep, when needed, and occasionally when traveling. My PCP told me to stop, that it was “addictive and would cause dementia.” I am 80 years old. My cardiologist says its better to stay on it and get some sleep. Also, it helps to offset the side effects of the Beta Blocker that I take to lower my BP.

Well, yes, benzodiazepines can help with pain by helping you to forget about the pain or not be quite as aware of it. This is the nature of “hypnotics”. But on a whole, they are very addictive and can be very hard to get off of depending upon how long you’ve been on them. Furthermore, doctors don’t have a clue as to how to take people off of them.

The Benzodiazepine Epidemic hasn’t gotten the attention its severity deserves, but hopefully that’s changing. Patients aren’t told, and don’t realize that their multiple health issues such as cardiac, liver, thyroid, digestive, nerve and muscle pain, among many other issues, are actually being CAUSED by the use of these dangerous meds. This can happen while taking them exactly as prescribed when the PT develops a tolerance to them, or when they build up in the body with long-term use. Please note that ‘long-term’ is over 2 -4 WEEKS. The benefits vs. the huge risks of these Central Nervous System damaging drugs has been skewed and downplayed for way too long, and it must stop. The CNS runs just about everything in the body, it shouldn’t be a big surprise that messing with this vital system can cause catastrophic problems. They cause physical dependence in a very short time, and PTs are bombarded with tortuous mental, emotional, and physical symptoms when trying to stop taking them. Uneducated doctors then prescribe more drugs to ‘cure the consequences’ of the 1st drug, solving nothing and creating ever more damage. The very idea of “talk to your Doctor” is ludicrous when said Dr. has no education on these drugs, and doesn’t attribute the health issues to them. There are tens of 1000s of these Drs.’ patients in online support groups desperately trying to keep each other alive through the often years-long, hellish withdrawals from prescribed benzos. No one told them they were signing up for a trip to hell and possibly permanent brain damage when agreeing to take these so-called meds. These drugs started causing big problems in the 1960s, which are well-documented in medical literature. WAY past time to end this trainwreck.

I’m a 78year old lady, having had untreatable sleep disorders for nearly 40 years. I’ve taken lorazepam for 25 years. I guess there isn’t a way to get off it and still get any sleep. Other sleep drugs have never helped. So am I risking dementia? “So be it” seems to be the case. No doctor ever told me about it’s dependent properties. This was pre-google, though.

I’m 68 andI have long standing treatment resistant bipolar illness, along with associated sleep problems for which I was prescribed clonazepam(Klonopin) by a psychiatrist 12 years ago. My dosage has varied from as high as 4 mg, daily, to my current dose of .5 mg. I know I’m addicted and I suspect some of my physical health issues are connected to its use. I got off it, once,several years ago, after going through a slow taper. I’ve embarked on another slow taper with my doctor’s knowledge and it likely will take 4 to 6 months or longer, but I do not want to envision myself on this drug for the rest of my life.

I am a retired RN who worked 20 of her 47 years practice in Mental Health. My observations of people on Benzodiazapines are: 1) Alprazolam (Ativan) excellent for SHORT TERM and EMERGENCY relief of extreme anxiety. Benzos given with anti-psychotics for SHORT TERM emergency relapses gives anti-cholinergic relief. Diazepam used as ONLY a sleeping aide in Elderly very effective with no cognitive deficits. Otherwise in cases of extreme mania and drug related psychoses benzos only exacerbated symptoms and disinhibited people causing danger to themselves and others. 2) LONG TERM administration of Benzos resulted in addiction to substances within 2 weeks and the longer the time given the more difficult to withdraw. 3) I have seen the withdrawal symptoms of persons having been on long term benzodiazapines (over 10 yrs). (Often this was the cold turkey rather than a long tapered withdrawal but also short term tapers.) Patients suffered complete cognitive disintegration, neurological tics and delusions, screaming and crying for hours on end etc:. This can go on for months if it doesn’t kill the person. 4) Conclusion: My personal and professional opinion is that continuing a patient new to Benzodiazepines on regular basis beyond 2 weeks offers no benefit to patient…only addiction. I think it is inhumane to discontinue benzos for a patient who has been taking them for long term without a long term tapered withdrawal plan. I was aware of the dangers of Benzodiazepines in the 1970’s why was this knowledge not transmitted to new nursing and medical students? A readable book on the subject “I’m Dancing as Fast as I Can” by Barbara Gordon…also a film made of the book.

I had a life characterized by several family suicides, child abuse, and alcoholism. Two of my four children died: one in an auto accident and the other during surgery. Growing up sober and sane in my family was a difficult task. I have been in therapy life-long. I have been lucky to have found 3 solid therapists.

Naturally, I was prescribed “benzos.” I have been taking them for over 40 years. I continue to take them because I cannot stop at this point. I would not live to an age where I would be free from these drugs through normal detox procedures. My life would end before the detox did. So today I take benzodiazepines just to avoid withdrawal. My levels are so high that I need to take only 1 pill a week. I am still seeing a therapist.

The best has been saved for last. I am deeply grateful for that. What has also helped is a deep and abiding faith in our Lord Jesus Christ. My husband and I are orthodox Catholic Christians. Hope is found and grounded in a life guided by faith. That is why 12 Step programs work. God is present in these programs: AA, AlaNon, etc.

As a senior I would prefer not to have these drugs in my system but they are here to stay. In current times there are more options. In my lifetime benzodiazepines were an easy out. I am comfortable, in touch with myself, grateful for friends and for a wonderful husband and a gifted therapist. I will be working on myself until the very end of this worldly life. After that I will have a new beginning with Christ.

As a nurse clinician who specialized in psychiatric nursing I feel that drug therapy is needed to allay anxiety. One cannot attend to issues under discussion if you are constantly anxious. Quiet the mind so it can focus but remember that the danger of addiction is always on the horizon.

Your comment is truly a reflection of mine only I suffer from chronic pancreatitis and have been on maintaince opiates for pain for over 20 years. I’ve always trusted my doctors, and now I’m too old to think about going through detox etc. I’m involved in several 12-Step programs, and the Lord Jesus Christ guides and directs my life. I do see a therapist and have a weekly group session with my peers. Thank you, Patty, again for talking about your very great program and with GOD in the lead!

In 2004, when I was first diagnosed with Lymphoma, I had the worst panic attack I ever had. It started the minute my PCP spoke the word cancer and lasted non-stop until after my appointment with the oncologist the following day. The oncologist gave me an Rx for Xanax. Xanax helped me control the panic attacks throughout the testing and treatment that followed as well as all of the follow-up tests afterwards.

In 2008, after a hysterectomy for endometrial cancer, the xanax was losing its effectiveness so I started seeing a therapist for help dealing with my panic disorder. She helped me wean off the daily Xanax dose and taught me a technique to stop the majority of my panic attacks. However, because some panic attacks still occur, she still gave me an Rx for Xanax with the instruction to take it ONLY when I am having a panic attack.

I still have a current Rx for Xanax and, even though I have learned many other techniques over the years, I still get an occasional panic attack that I cannot control with any of those techniques and, as a LAST RESORT ONLY, I will take a Xanax. Over the past six months, I have used it a total of 10 times.

It is sad that people who need and use drugs like Xanax and/or pain medications responsibly are too often now facing problems obtaining them because some doctors over-prescribe, and some people misuse them. I am grateful to the oncologist who first gave me help for my panic disorder and for the therapist who helped me reduce my need for a drug and taught me how to use it most effectively.

EDUCATION for both doctors and patients is the best way to solve the problem of misuse of all drugs without denying help to those who need it.

I so agree with you. I too have them for emergencies and have used them responsibly for many years, and I am not addicted. Sometimes just knowing that I have them is enough, and I don’t have to take one. I am the same with Vicodin. I use them only for break-through pain and have for over 20 years, usually only when I am traveling and cannot manage my pain like I can at home. But now with all the furor over these drugs it is getting harder. Fortunately, I have a dr who knows how long a prescription lasts for me but if I ever lose her I don’t know what will happen.

I have been taking Vicodin for years with great results for my back pain (numerous surgeries have not helped). NOW, due to the bureaucrats in D.C., I have not been able to fill my prescription for over a month, with no relief in sight. I have checked all the pharmacies, and they all say the drug is backordered, and they have no idea when they will get it. I asked my pain doctor about an alternative, and she had no ideas. Vicodin (hydrocodone-ibuprofen) was selected as a result of a DNA test several years ago. Other formulations (drugs) were useless.

Now, I am thrown on the trash heap of the uncaring in Congress, the DEA, and FDA. My quality of life has diminished and is getting worse by the day, as any residual effect of the drug over the years totally runs its course.

I understand the need to control opioids due to their abuse, addictions, deaths, etc. BUT for those of us who do not abuse and seriously need these drugs, the over-control is affecting us in totally unacceptable ways. I know I am among millions suffering this injustice. We don’t know where to turn. Is there any sort of organization or lobbying firm that has taken up our cause? I would like to join them!

Jim go to Facebook and look up DPPPR It is a large group that arranges rally’s protesting the torture chronic pain patients that are collateral damage due to addicts. correct use is not abuse.Yes there is a drug abuse problem that needs to be addressed but compliant patients are suffering and the addicts are getting help or their drugs off the street..

Been on benzos 30 yrs. Have never abused them. At one time I took up to 15 mgs a day, at my highest. Now take 1/4 to 1/2 in 24 hrs. This drug is demonized. What next? aspirin?? Look at the success stories not just the downside. I turned 70 this month.

Cheryl I so agree w/ you: Xanax has been demonized! It’s my opinion that for over 20 years now, I’ve observed that when a woman goes to a Doctor & says anything describing her symptoms using words like, ‘Panic Attack’, ‘PMS’, ‘Nobody loves me’, ‘Oh I’m so lonely’, ‘I’m insomniac, I can’t sleep’ etc etc., immediately their doctor gave them ‘antidepressants’! There are probably hundreds of complaints. I heard the same story over & over again from my neighbors, my friends, with my family, my coworkers, the same story!! I was saying ‘What the hell is going on!?!’.

Aren’t antidepressants much more dangerous than anxiety meds like Xanax!!? I’m confused!

In 2015 when I had to go through 2 surgeries, one on my back & one hip replaced, I was anxious, kept putting off the surgery. My daughter said, ‘Mom you’re anxious, I’m going w/ you to your next appointment! I want you talk to the doctor about some anxiety med.’ I went off on her!! She explained to me that an anxiety med, is not the same as taking the antidepressants like all my friends were doing! Between her & my doctor they convinced me that Xanax was great!. Well still I didn’t want to become addicted. So even though the bottle says to take it when anxious, several times a day, but at least 6 hours in between. I thought ‘Hell No’!

So, he gave me the lowest possible strength, or so he said, a .25MG! I have never taken any w/ a stronger dose! I only take it at night before I go to sleep. AND I only take it 3-4 time a week like when I have to work. I work 3 days a week, and I need to make sure I sleep well. I only take one pill. I cut it in half because it works faster, &amp. What’s funny is that several times I went to sleep before I took the Xanax! I went to sleep watching tv! Go figure!

Now it’s 2019. My doctor moved away! So no big deal. That particular clinic I go to had many doctors. So the new doctor, told me about the horrible see effects of Xanax, that people are dying from it!! OMG!!!! So he gives me a written prescription for a different med to treat my insomnia! “Trazadone!” I researched it & found out that it was an antidepressant! After I read a lot about it, it was obvious it would be much more dangerous!!

Somebody talk to me!! I’m not a doctor, or even a nurse. And there is a nurse in my family who defends it! ANTIDEPRESSANTS! That’s the real Demon! I’m sorry, I’m beginning to smell a RAT, & his name is GREED! To be addicted to an anxiety med, not abusing it: isn’t it better than becoming addicted to an antidepressant!!?!! Don’t get me wrong, its still addiction!

Well, I live in Colorado, so I know I can replace it w/ something else. But my Health Insurance wouldn’t cover it! While I was off work for the surgeries, someone gave me a ‘Candy’ made from Cannabis that DOES NOT get you high (I don’t like the high marijuana gives when people smoke it). This ‘Candy’ is for fighting panic attacks, insomnia, anxiety! etc. It worked better that Xanax! Some of the best sleep I got was because of that ‘med’!

However, I know someone who was fired from their job because it was in her bloodstream. That’s right! Even though it is legal in this state, you cannot go to work while it’s in your bloodstream, which is of course ‘All the Time’! It looked like a Tootsie roll & about the same size! I would only eat a ¼ of the piece of Candy, & I slept great! But I let go of it when I went back to work. I didn’t want to lose my job in case I was tested! But meanwhile I take my .25mg of Xanax, 3 or 4 times a week, & I’m doing ok. Now I have to find a doctor that won’t mind prescribing Xanax, since my doctor moved away. We’ll see!

The problem with that approach is that panic attacks are so disabling and if you take a Xanax it takes about 45 minutes before it is fully i your bloodstream and working. 45 minutes of panic attack is an eternity as you know, I’ve been on Benzo for over fifty years.

I take Xanax and hate it. I think if North Carolina had medical marijuana I could get off of it.

Full spectrum CBD oil is legal in all 50 states. It helped me immensely prior to my strokes. I still take it, but it’s not as effective as it was pre-stroke, and a diagnosis of early onset dementia. I did cut my dose and half though. I also have neuropathy and other chronic pain. I find it helps for that as well. They give Ativan and tramadol in the hospital 4 pain at times. Ativan is a benzo as well I think that’s why it works on my pain, not as well as I would like it to, but it does work. I would definitely give that a try.

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