NBC News on 7/27/2018 by Avichai Scher
Doctors are prescribing benzodiazepines, like Xanax and Ativan, at skyrocketing rates. But most don’t know about their debilitating, even deadly, effects.
When Christy Huff developed a painful eye problem that led to insomnia, her doctor had a common solution— Xanax. She took the medication as directed.
One pill at night offered her some relief, but soon she began to experience anxiety, daytime terrors and tremors. Then, Huff had a startling realization. When she was off the Xanax she was going through withdrawal. And when she was on it “all of that just melted away,” she said.
In just three weeks, her body was dependent on Xanax.
“I don’t remember getting any warnings from doctors as far as addiction or dependence,” Huff, who is a cardiologist, told NBC News. “I was completely shocked at how sick I was.”
Xanax is part of a class of drugs called benzodiazepines, sometimes called “benzos” for short. Benzodiazepines are sedatives used primarily to treat anxiety and sleeplessness. The class of drugs also includes Valium, Ativan and Klonopin.
Dr. Anna Lembke, chief of addiction medicine at Stanford University Medical Center, said complications from benzos, such as dependency and addiction, are fueling a hidden epidemic akin to the opioid crisis.
“Medical students, residents and even doctors in practice don’t recognize the addictive potential of benzodiazepines,” she told NBC News. “There’s been all this awareness on opioids but very little focus on benzodiazepines and yet people are dying from them.”
According to data from the National Institute on Drug Abuse, there were 8,791 overdose deaths involving benzos in 2015, up from 1999 when there were 1,135 overdose deaths involving benzos. Between 1996 and 2013, the number of adults filling a benzodiazepine prescription increased by 67 percent, reaching 13.5 million in 2013, according to a study.
There is far less awareness of the dangers of benzos, perhaps because of attention over the opioid crisis. Opioids, including prescription opioids, heroin and fentanyl, killed more than 42,000 people in 2016, according to the Centers for Disease Control and Prevention.
The maker of Valium said it is commited to ensuring the drug is taken safely, and recommends it be prescribed carefully. The maker of Xanax said abuse of benzodiazepines has become a growing public health threat, and it will continue to educate consumers, patients and doctors about its proper use.
Lembke says more care should be taken when prescribing benzos.
“One of the silver linings of the opioid epidemic has been that the medical community has recognized that we have to educate doctors better about opioids and their risks,” Lembke said, “but we’re still not doing that for benzodiazepines.”
She explained that since benzos work so well for anxiety and sleeplessness and patients immediately respond to them, doctors are quick to prescribe them. But patients can quickly develop a tolerance, leading to higher and higher doses, and painful withdrawal symptoms between doses. Long-term use can even cause neurological damage, Lembke said.
Benzos are extremely difficult to kick, she said. For some of her patients, quitting opioids is easier. Benzos can be particularly dangerous when combined with opioids, which is not uncommon and can increase overdose risks nearly four-fold.
Huff has been working on kicking benzos for nearly three years.