A recent UK investigation uncovered a healthcare company that was prescribing benzodiazepines (anti-anxiety drugs) to hundreds of patients for extended periods of time, countering the UK’s National Health Service’s warning that the drugs should not be taken for more than four weeks due to their ability to cause drug dependence.[1] In Australia, the Penington Institute’s Annual Overdose Report found that in 2021, benzodiazepines were the second most common drug leading to accidental overdoses, the first being opioids.[2] Citizens Commission on Human Rights International (CCHR) says the risk of addiction from benzodiazepines is reinforced by the FDA’s black box warning, which cites abuse, misuse, addiction, overdose, and potential death.
CCHR emphasizes the importance of the public being educated on the serious implications of benzodiazepine adverse reactions. According to American Addiction Centers, these drugs are “highly addictive.”[3] In 2020, the FDA issued its most severe warning, the black box, stating that the use of benzodiazepines “exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death.”[4]
In the U.S., benzodiazepines are among the most widely prescribed drug classes, according to a 2021 study in the journal, Neurology International.[5] Data obtained by CCHR from the largest vendor of U.S. physician prescribing data, IQVia (formerly IMS Health), reported that 24,725,785 Americans were taking benzodiazepines in 2013.[6] A study in the journal Psychiatric Services found that in 2015 and 2016, an estimated 30.6 million adults reported using benzodiazepines in the past year in the U.S., which is 12.6% of the U.S. adult population.[7]
Numerous studies have also shown the addictive nature of the class of antianxiety drugs, including a 2021 study in Neurology International, which states, “Regular use of BZDs [benzodiazepines] has been shown to cause severe, harmful psychological and physical dependence, leading to withdrawal symptoms…. Some of these withdrawal symptoms can be life threatening.”[8]
A 2013 study published in American Family Physician stated, “Withdrawal symptoms are possible after only one month of daily use.”[9]
According to a study in The British Journal of General Practice, in 2006, “Most guidelines recommend restricting their [benzodiazepines] use to no more than 3-4 weeks, but many patients take them for years, as addiction hinders their withdrawal, even when used at low doses.”[10]
Addiction and dependence aren’t the only serious side effects of benzodiazepines. A June 2023 study published in PLoS One conducted by researchers at the University of Colorado Anschutz Medical Campus revealed that the use and discontinuation of benzodiazepines can lead to nervous system damage and ongoing negative effects on one’s life (such as work life, recreation, social interactions, etc.), even after discontinuation.[11] Christy Huff, M.D., one of the study’s coauthors, who is also a former benzodiazepine patient, a cardiologist, and the director of Benzodiazepine Information Coalition, said, “Patients have been reporting long-term effects from benzodiazepines for over 60 years. I am one of those patients. Even though I took my medication as prescribed, I still experience symptoms on a daily basis at four years off benzodiazepines.”[12]
Another study published in The Primary Care Companion for CNS Disorders in 2017 found that benzodiazepines were associated with increased suicide risk, possibly due to the fact they can increase impulsivity, aggression, or withdrawal symptoms.[13]
Other side effects include increased anxiety, agitation, hostility, aggression, confusion, disorientation, disinhibition, hallucinations, and slurred speech, to name a few.[14]
While the FDA has issued a black box warning on the ability of benzodiazepines to cause addiction and overdose, and numerous studies and agencies have cited their potential to cause abuse and addiction, the U.S. Drug Enforcement Administration (DEA) still classifies benzodiazepines as Schedule IV drugs (having a low potential for abuse). CCHR says that given all the data available, the U.S. Department of Health and Human Services, the DEA, and the FDA should review this classification in order to better inform the public of the drug risks and align the DEA’s classification with the FDA’s own black box warning.
[1] Peter Walker, “Review of Valium prescriptions due to long-term cases,” BBC, 23 Aug. 2023, www.bbc.com/news/uk-england-cambridgeshire-66589042
[2] Amber Schultz, “The common medication involved in killing more Australians than alcohol,” The Age, 27 Aug. 2023, www.theage.com.au/national/the-common-medication-involved-in-killing-more-australians-than-alcohol-20230819-p5dxtq.html
[3] “Benzodiazepine Addiction: Symptoms & Signs of Dependence,” American Addiction Centers, 15 Sept. 2022, americanaddictioncenters.org/benzodiazepine/symptoms-and-signs
[4] “FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. Includes potential for abuse, addiction, and other serious risks,” Food and Drug Administration, 23 Sept. 2020, www.fda.gov/media/142368/download; www.accessdata.fda.gov/drugsatfda_docs/label/2023/017533s062lbl.pdf
[5] Amber N. Edinoff, Catherine A. Nix, et al., “Benzodiazepines: Uses, Dangers, and Clinical Considerations,” Neurology International, 2021, 13(4), 594-607; doi.org/10.3390/neurolint13040059, www.mdpi.com/2035-8377/13/4/59
[6] IQVia Total Patient Tracker (TPT) Database, Year 2013, Extracted April 2014.
[7] Donovan T. Maust, M.D., M.S., Lewei A. Lin, M.D., Frederic C. Blow, Ph.D., “Benzodiazepine Use and Misuse Among Adults in the United States,” Psychiatric Services, 17 Dec 2018, doi.org/10.1176/appi.ps.201800321, ps.psychiatryonline.org/doi/10.1176/appi.ps.201800321
[8] Amber N. Edinoff, Catherine A. Nix, et al., “Benzodiazepines: Uses, Dangers, and Clinical Considerations,” Neurology International, 2021, 13(4), 594-607; doi.org/10.3390/neurolint13040059, www.mdpi.com/2035-8377/13/4/59
[9] Brian Johnson, M.D. and Jon Streltzer, M.D., “Risks Associated with Long-Term Benzodiazepine Use,” American Family Physician, 2013;88(4):224-225, www.aafp.org/pubs/afp/issues/2013/0815/p224.html
[10] Catalina Vicens, MD, GP, et al., “Withdrawal from long-term benzodiazepine use: randomised trial in family practice,” Br J Gen Pract, 1 Dec 2006, 56(533), pp 958-963, www.ncbi.nlm.nih.gov/pmc/articles/PMC1934057/
[11] Alexis D. Ritvo, D. E. Foster, Christy Huff, et al., “Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey,” PLoS One, 29 June 2023, doi.org/10.1371/journal.pone.0285584, journals.plos.org/plosone/article?id=10.1371/journal.pone.0285584; “Benzodiazepine use associated with brain injury, job loss and suicide,” Newswise, 28 June 2023, www.newswise.com/articles/benzodiazepine-use-linked-to-brain-injury-job-loss-and-suicide
[12] Laura Kelley, “Benzodiazepine Use Associated With Brain Injury, Job Loss and Suicide,” University of Colorado Anschutz Medical Campus, 5 July 2023, news.cuanschutz.edu/news-stories/benzodiazepine-use-associated-with-brain-injury-job-loss-and-suicide
[13] Tyler J. Dodds, MD, “Prescribed Benzodiazepines and Suicide Risk: A Review of the Literature,” The Primary Care Companion for CNS Disorders, 2017, www.psychiatrist.com/PCC/article/Pages/2017/v19n02/16r02037.aspx
[14] www.accessdata.fda.gov/drugsatfda_docs/label/2016/017794s044lbl.pdf; www.medicalnewstoday.com/articles/262809#side-effects
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