Benzos a “Bust”? Concerns about Anti-Anxiety Drugs Not Eclipsed by Opiate Epidemic (Part 2)

Read Part 1 Here

Well-documented Concerns and Side-Effects

Benzos were never intended for long-term use. Yet many patients have been issued prescriptions for daily use that have lasted years. And that has caused problems. Over time, user tolerance grows and dosages are increased. Soon, many notice if they even miss a dose, they are miserable – there is a “rebound effect” to the anxiety they once experienced and they are a panicky mess, not able to function. Even tapering off of the drugs often causes such discomfort that many only find relief by going back on benzos.  They are either dependent or addicted, or both, and stuck in a spiral.

In addition, the withdrawals that some patients experience are legitimately life-threatening.  Opiate withdrawals typically just make you feel like you’re going to die. Benzo withdrawal, on the other hand, can easily cause seizures, heart attacks and irregularities, hallucinations, and death.  If patients aren’t carefully monitored, effectively tapered down on benzos, and willing to go through some long-term readjustment of central nervous system function, it can be a scary experience.

And then the bombshell: the connection between brain damage and dementia. As far back as the 1980s, disturbing evidence of cognitive dysfunction and brain shrinkage has been noted by prominent researchers. Concerns and scholarship continued throughout the decade, which finally and somewhat grudgingly resulted in detailed warning labels and side effects disclaimers from manufacturers in the 1990s.

Despite all of this evidence and research that now suggests benzos can significantly raise the risk of dementia, these drugs are still in broad circulation. And, as a helpful new infographic from Foundations Recovery Network shows, they’re still a huge health problem. Since 2010, there have been more than 6,000 U.S. drug overdose deaths involving benzodiazepines (many in combination with opiates). That number has increased nearly 5-fold since 2001. In 2010 alone, 124,902 Americans were rushed to the E.R. because of Xanax.

Given the well-documented host of ill and even potentially life-threatening side effects, why are benzos so widely prescribed?

• It’s a quick fix. Even when doctors recognize the risk of dependence, they often feel the pressure to write a prescription anyway. With primary care visits now regularly limited to 15 minutes or less, there is often little time to sort through complex issues such as insomnia, panic attacks, or anxiety. And patients, for their part, may also not want to invest in longer-term, intensive cognitive behavioral therapy that produces slower improvements.
• Money. The major pharmaceutical companies have millions at stake in the sales of benzos. In 2010 alone, even when many are selling at generic prices, sales of benzos reached roughly $509 million. That’s a lot of skin in the game and has led big pharma to heavily promote the drugs and incentivize doctors.
• Pressure. In 2010, a highly publicized investigative report revealed that Great Britain’s Medical Research Council (MRC) failed to sponsor adequate follow-up research into the adverse effects of benzos that it promised in the early 80s. What’s more, the MRC failed to release or publicize the initial research studies prompting concern – for 30 years! Not surprisingly, the MRC receives significant funding from the pharmaceutical companies it is tasked with regulating.

Other Options to Combat Anxiety

Patients with high levels of chronic or generalized stress and anxiety need to be aware of the serious risks associated with benzos – and the high potential for abuse if they have had other substance abuse issues. They also need to understand that there are other options available to them. Longer-acting drugs like SSRIs may be a better fit if symptoms are severe, and non-habit-forming drugs like beta blockers or Vistaril (an antihistamine) are always safer. Mindfulness meditation and similar practices may provide some relief. But the single most effective way to overcome anxiety and stress is targeted cognitive therapy and healthier living practices that attack the problem at its source. It may be a longer-term investment, but the gift of finding new tools that help us naturally overcome fears and stress are well worth the time and effort.