In a recent paper, researchers say that a class of drugs called benzodiazepines that can help treat anxiety and insomnia may lead to dangerous addiction.
The research was conducted by a team at Yale University.
Anxiety as a medical condition has plagued human beings for centuries.
Previous research has shown that benzodiazepines could help treat anxiety that previously didn’t respond to any other treatments and helped with insomnia.
They provided relief to many patients and were developed to replace another category of drugs called barbiturates.
The team found benzodiazepines also presented unforeseen risks. These drug work by binding to receptors in the brain called GABA, bringing calm and drowsiness.
But over time (about four weeks in 50% of patients), people may need higher doses to get the same sense of relief.
Although they take more time than barbiturates do to cause a reaction, benzodiazepines can still be addictive.
People who have been on them for a long time also find it hard to stop taking them because of withdrawal symptoms, such as increased tension and anxiety, panic attacks, and hand tremors.
And yet, because they are so helpful and anxiety is such a crippling problem (and on the rise), prescription rates soared.
Between 1996 and 2013, the number of benzodiazepines prescribed for adults increased by 67 percent to 135 million prescriptions per year, and the quantity prescribed per patient more than tripled during that period.
The team is worried that the trajectory of benzodiazepine prescription will lead to a medication epidemic in line with the opioid crisis.
The high prescription rates in both cases also have led to drug diversion—the phenomenon where drugs prescribed legally make their way into the illicit drug scene.
Among teenagers, rates of addiction to benzodiazepines have already overtaken rates of opioid addiction. They’ve even entered popular culture.
While benzodiazepines are safe when used as intended, the risk for overdose and death is much higher when combined with opioids (whether prescribed or not).
This is because they both affect the central nervous system and, when used together, can exacerbate dangerous side effects like difficulty breathing.
According to the National Institute on Drug Abuse, over 30% of opioid overdose deaths include a benzodiazepine.
While it’s unclear exactly what is causing benzodiazepines to become a problem, Yale Medicine experts believe that the primary care system is the linchpin to preventing the benzodiazepine crisis from becoming another opioid crisis.
They advocate for a different model of care, in which mental health professionals work in primary care settings to provide support and expertise to patients and doctors.
They say it’s not just benzodiazepines—SSRIs and anti-psychotics are emerging as some of the most commonly prescribed medications and a lot of doctors are being pushed out of their comfort zones in managing symptoms they don’t feel adequately prepared to manage.
Benzodiazepine overdose deaths have jumped exponentially in the last few years and could be headed in that direction soon.
The real illness is benzodiazepine over-prescription.
One researcher is David Fiellin, MD, an internal medicine and addiction medicine specialist at Yale Medicine.