About Benzodiazepines

Why We Are Different

Finding accurate information on benzodiazepines is extremely difficult. Many prescribers are not informed about the issues arising from as-prescribed use, while many websites are selling inappropriate and dangerous solutions for financial gain. Our coalition is different. With both professional and patient experience, we exist solely to raise awareness of the complex issues surrounding prescribed benzodiazepine use, and to prevent further patient injury.

Our advocacy and awareness efforts consider the potentially deadly consequences to patients and society arising from inadequate understanding of these problems by the medical profession and general public, such as inappropriate prescribing of these medications, mislabeling prescribed physical dependence as addiction, and subjecting patients to forced cessations.

Commonly Prescribed Benzodiazepines 

 

  • alprazolam (Xanax, Xanax XR)

  • clobazam (Onfi)

  • clonazepam (Klonopin)

  • clorazepate dipotassium (Tranxene)

  • chlordiazepoxide (Librium)

  • diazepam (Valium)

  • lorazepam (Ativan)

  • temazepam (Restoril)

  • triazolam (Halcion)

Fast Facts About Benzodiazepines

A brief overview of the problems with prescribed benzodiazepines.

Shaded areas indicate confidence intervals.
Source: Sumit Agarwal, Brigham and Women’s Hospital
Credit: Koko Nakajima/NPR

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Scope of Prescribed Use

Alprazolam, clonazepam, and lorazepam are among the 10 most commonly prescribed psychotropic medications in the United States.  Prescriptions are on the rise with at least 25.3 million (10.4%) adults in the United States reporting prescribed benzodiazepine use from 2015-2016, nearly doubling the 4-6% estimated in 2013-2014, with the highest consumers being those adults aged 50-64. From 2003 to 2015, the percentage of outpatient medical visits that led to a benzodiazepine prescription doubled, as well as the prescribing rate among primary care doctors.  Additionally, the rate of co-prescribing benzodiazepines with opiates quadrupled from 0.5% in 2003 to 2% in 2015.

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Indications and Safety

Long-term prescribed use (>2-4 weeks) can result in heightened anxiety, increased incidence of falls and accidents, persistent insomnia, impaired learning, higher rates of suicide, a greater risk of dementia, the development of new or worsening symptoms, and a reduction in efficacy of nonpharmacologic interventions for PTSD and Panic Disorder, impairing recovery from these conditions. Existing estimates are disparate indicating 20-80% of patients stopping a benzodiazepine will experience withdrawal effects, of which a percentage will be severe.

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Detrimental Prescribing

Current medical training does not provide adequate education about the risks of benzodiazepines or safe tapering practices. Therefore, many are prescribed to patients without full informed consent. An informal poll of patients prescribed benzodiazepines 4 weeks revealed that, of the 606 respondents, 570 (94%) reported receiving no warnings about physical dependence or withdrawal. Of those warned, many reported it insufficient in regards to the severity and/or difficulty of withdrawal.

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Inappropriate Cessation

Patients are often unable to obtain useful cessation advice from the prescribers, and frequently have their prescriptions abruptly stopped to their detriment. Inpatient “detox,” rapid taper, cold turkey and forced cessation are dangerous and inappropriate for prescribed patients. The result can be reinstatement, disabling protracted symptoms or death. Slow (5-10% every 2-4 weeks), patient-controlled tapers are the best way to discontinue use in patients agreeable to cessation.

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Long Term Disability

Many patients while taking benzodiazepines, as well as during and after cessation, will experience long-term disability which may persist years.  More research is needed to predict who will suffer detrimental effects from prescribed benzodiazepines and to determine how to help those already harmed.

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Patient Groups

For over 50 years, advocacy and support for harmed patients has been mostly handled by laypeople due to the lack of medical help for benzodiazepine-related injury. Although several patient-led movements and support groups have existed since the 1970s, there continues to be insufficient mainstream resources and medical recognition, resulting in sustained patient harm.

 

Recommended Reading 

While our site contains numerous blogs, we recommend reading these to gain an understanding the prescribed benzodiazepine problem and our perspective on it.

 

Benzo-Induced Harm: The Nameless Problem

Benzo-Induced Harm: The Nameless Problem

I can’t believe I have to say this, but brain and neurological injuries are not addictions. One way that benzodiazepine-damaged ...
Read More
10 tips to help patients through benzodiazepine withdrawal

10 tips to help patients through benzodiazepine withdrawal

A printable version is available here As physicians, we are experts at prescribing medications. However, we often fail miserably when ...
Read More
10 Things Uninformed Benzodiazepine Prescribers Do

10 Things Uninformed Benzodiazepine Prescribers Do

1. They prescribe benzodiazepines long-term without informed consent. A long-term (2-4 weeks or more) benzodiazepine prescription should be accompanied with ...
Read More
How Benzodiazepines Mimic Chronic Illness and What To Do About It

How Benzodiazepines Mimic Chronic Illness and What To Do About It

There is an ongoing failure in the field of medicine of patients and prescribers to recognize or properly diagnose problems ...
Read More

It’s Rarely About Addiction

Addiction language is inaccurate and harms compliant patients who were injured by their prescribed dose.

Benzo-Induced Harm: The Nameless Problem

Benzo-Induced Harm: The Nameless Problem

I can’t believe I have to say this, but brain and neurological injuries are not addictions. One way that benzodiazepine-damaged ...
Read More
Benzodiazepine Related Problems: It’s Almost Never Addiction

Benzodiazepine Related Problems: It’s Almost Never Addiction

It’s complicated. Actually, it’s quite confusing. But most of all and importantly, it’s mischaracterized.  Benzodiazepine-related problems are often categorized as ...
Read More
Why Prescribed Benzo Patients Shouldn’t Go To Detox or Rehab

Why Prescribed Benzo Patients Shouldn’t Go To Detox or Rehab

This article explores five reasons why drug and alcohol detox or rehab facilities are inappropriate for withdrawing compliant, prescribed benzodiazepine ...
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Dependence is Separate from Addiction

Dependence is Separate from Addiction

Addiction is not the right word for the majority of benzodiazepine consumers. While many symptoms of addiction and dependence overlap, ...
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Don't Harm Them Twice: When the Language Surrounding Benzodiazepines Adds Insult to Injury (Part 1)

Don’t Harm Them Twice: When the Language Surrounding Benzodiazepines Adds Insult to Injury (Part 1)

Language is important. And when language dictates specific treatment protocols, it should be used with extreme scrutiny. Using the wrong ...
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