A recent study found that one in six adults in the United States take psychiatric drugs for the treatment of mental health conditions. Among the most commonly used medications are benzodiazepines. These sedative drugs, used for the treatment of clinical anxiety and other conditions, have become one of the most commonly prescribed and misused classes of drugs in the U.S. You might be familiar with brands like Xanax (alprazolam), Valium (diazepam), or Klonopin (clonazepam).
While these drugs are widely used for the management of medical conditions, they’re also increasingly diverted, illicitly sold, and abused recreationally. These medications carry a risk of dependence, life-threatening overdoses, and even fatalities, particularly when used illicitly. Further, the extent of benzodiazepine overprescription and misuse has continued to climb in recent years.
Continue reading to learn more about how benzodiazepines are used, their role in medicine, and their addictive potential and possible dangers to health.
Overview of Benzodiazepines
Benzodiazepines are a class of drugs that operate on the body’s GABA receptors to produce sedation and relaxation. This is, in some ways, akin to the effects of alcohol. While benzodiazepines vary – along with their sedative activity and the strength of their effects – these drugs are typically used for clinical anxiety, panic attacks, insomnia, and seizures.
Benzodiazepines can be habit-forming and continued regular use of benzodiazepines, or abuse of high doses recreationally, can produce physical dependence and addiction. Those who become dependent on these medications might continue taking them to avoid unpleasant withdrawal effects and may need to take greater doses over time to achieve the same effects due to the development of tolerance. Even those who begin taking benzodiazepines for serious conditions can be at risk for developing dependence over time.
Benzodiazepines for Poison Treatment
While misuse of benzodiazepines can be life threatening, their medical use can play an important role in the emergency treatment of poisoning. For instance, benzodiazepines may be used in the treatment of rapid or irregular heartbeat that can result from some forms of poisoning.
Some benzodiazepines have anticonvulsant activity as well and are used in the acute treatment of seizures, which can be due to poisonings. A report by the American Association of Poison Control Centers indicated that use of benzodiazepines in poisoning cases is quite common, and they are the fourth most frequently administered treatment in poisoning cases.
Benzodiazepine-Related ER Visits
It’s clear that benzodiazepines have important medical uses; however benzodiazepines also carry significant risks – these dangers are clearly visible in statistics on emergency room visits related to benzodiazepines. From 2005 to 2011, national data showed a steady rise in visits due to benzodiazepine use, as well as the use of these drugs in combination with alcohol or opioids.
While a staggering 46,966 ER visits were due to benzodiazepines in 2005, this number skyrocketed to 89,310 visits by 2011. Overdoses can occur when a person takes more than the recommended dose; however, combining the sedative with another central nervous system depressant such as alcohol, opioid painkillers or barbiturates can also increase the risk of overdose. This is reflected in the statistics: Nearly 4,000 ER visits in 2005 were due to the combined use of benzodiazepines, alcohol, and opioids. This number rose to more than 8,000 by 2011.
Most Abused Popular Benzodiazepines
While there are many benzodiazepines available with a prescription or obtained through illegal means, not all are abused at similar rates. Data on ER visits due to nonmedical use and misuse of different benzodiazepines show that Xanax was most frequently seen in ER visits in 2011 (the most recent year data are available). Specifically, 123,744 ER visits were associated with the nonmedical use of Xanax. This eclipsed Klonopin, which was linked to 61,219 ER visits in 2011. Ativan was linked to 42,874 cases, while Valium was seen in 24,118 visits.
Why are some of these drugs more frequently misused recreationally? Different benzodiazepines may have a faster onset of effects or a longer duration of action – meaning substance users may find them to be more powerful and desirable for recreational use. This may also be due to the wider availability of certain medications: Xanax (alprazolam) was the most frequently prescribed and dispensed benzodiazepine in the U.S. from 2008 to 2012.
Benzodiazepine use and misuse can lead to more than just an ER trip – these medications can result in fatal overdoses. The CDC reported an alarming number of benzodiazepine-related deaths in 2014.
These deaths were most frequently seen among users age 45 to 54 years old (5.2 deaths per 100,000 people) and those age 35 to 44 years old (4.6 deaths per 100,000).
Clearly, benzodiazepine misuse and overdose is a problem that spans across all age groups. During a benzodiazepine overdose, the depressant’s effects on the central nervous system produce dangerous symptoms. These effects can lead to unconsciousness, difficulty breathing, coma, or death.
The potential for benzodiazepine dependence and abuse is alarming; however, many individuals are seeking treatment. Data from the national Survey of Substance Abuse Treatment Services indicates that benzodiazepines are the third most common substance in detox facilities.These facilities, which typically provide medical management of withdrawal from substances, most commonly treated opioid addiction in 2012 (2,195 instances). However, alcohol and benzodiazepine dependence were also commonly treated (1,740 and 1,546 instances, respectively).
Medical detox treatment for benzodiazepines and alcohol can be especially important. Unmonitored and unmanaged withdrawal from heavy benzodiazepine or alcohol use can lead to delirium, seizures, and even death in severe cases. Inpatient medical treatment can manage the symptoms experienced during withdrawal, allowing for patients to wean off benzodiazepines safely.
Older Patients’ Risk of Benzodiazepine Misuse
Overprescription and over medication for older adults is a well-reported issue. It’s common for elderly adults to receive prescriptions for drugs indefinitely, without ongoing review of their conditions to determine whether these medications are still necessary. As a result, older people can often end up taking a higher number of prescription medications, including benzodiazepines.
According to a study conducted in Japan, those aged 65 and older are much more likely than 18- to 35-year-olds to continue taking prescription benzodiazepines after a year. These drugs can be especially risky for older adults, as they can slow reaction time and lead to greater chances of slips, falls, and resulting injury.
Treatment for Benzodiazepine Dependence
The prescription and misuse of benzodiazepines, like Xanax, Klonopin, and Valium, have become remarkably widespread in the U.S. in recent years. Millions of people – including those who use these drugs for medical purposes – have formed a chemical dependence, or could be at risk of developing an addiction. Benzodiazepine addiction is a serious condition: The effects of overuse or misuse can be life threatening, and withdrawal may require inpatient medical monitoring and detox.
If you or someone you know is struggling with benzodiazepine use or dependence, help and treatment are available. Visit DrugAbuse.com or call to find information about the withdrawal process and treatment options for specific substances like benzodiazepines so you can find the specialized help you need.
Data on benzodiazepine-related emergency room visits in the U.S. were sourced from SAMHSA DAWN reports from 2005 to 2011. Benzodiazepine-related deaths were located via CDC’s WONDER Multiple Causes of Death dataset, with a search for ICD codes indicating benzodiazepine use. Detox treatment episodes for substance addictions were sourced from the SAMHSA N-SSATS 2012 report. Statistics on the use of benzodiazepines in the emergency treatment of poisoning was taken from the American Association of Poison Control Centers’ 2014 annual report.
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