Anxiety and Benzodiazepine Dependence: The Very Real Concern

Anxiety and Benzodiazepine Dependence: The Very Real Concern

According to the Anxiety and Depression Association of America, 40 million American adults struggle with some type of anxiety disorder. The most-common treatment option is a combination of therapy and medication, usually drugs in the benzodiazepine class, referred to as tranquillizers.

This includes such medications as Valium, Klonopin, Ativan, and of course, Xanax. In fact, Xanax—the brand name for generic alprazolam—is the most-prescribed psychotherapeutic medication in America.  Every year, over 17 million people take Xanax or its generic.

What You Need to Know about Benzodiazepine Abuse

Unfortunately,  benzodiazepines are also the most-abused.  Of those 17 million, approximately 5 million misuse the drug.  All told, there are 30 million benzodiazepine users trying to treat their anxiety and almost 6 million benzodiazepine abusers in the United States.

People in the 50-65-year-old age demographic have the highest rates of benzodiazepine use or dependence. 

18-25-year-olds who smoke marijuana are very likely to develop benzodiazepine dependence. Why? Because people in this age range smoke or eat cannabis/marijuana, and the chemicals stay in the person’s body close to 30 days. As cannabis leaves the body slowly, a feeling of anxiety is created during this period of time, causing young people to seek help from their doctors or friends for benzodiazepine medication to treat their ‘anxiety’.  They don’t realize the anxiety is a withdrawal symptom and leads to continued use of benzodiazepines.

In some ways, that’s not entirely surprising, because “benzos” are among the most habit-forming prescription drugs available.  For example, even a person taking the medication exactly as prescribed can rapidly develop a benzodiazepine dependence.  Up to half of all users become dependent, and every year, there are 200,000 new tranquilizer abusers.

According to Dr. Carla Marienfeld, MD, the Director of Addiction Services in the Department of Psychiatry at the University of California, San Diego, “Patients who are prescribed benzodiazepines only to be taken when needed had higher markers of misuse. Clinicians may falsely assume that someone prescribed the medication on a scheduled basis would be at higher risk of misuse.”

Over-prescribing is a real concern.  For example, a benzodiazepine dependence can develop in as little as two weeks, and although they start to lose effectiveness as early as the fourth month, most patients receive the drug for far longer.  1 out of 7 patients are given benzodiazepines for a year or longer.

Over the past 20 years, the number of US adults with a benzo prescription mushroomed from 1 million to 13.5 million.

  • Even more significant, the amount of medication contained in tranquilizer prescriptions increased by 40%.

The Dangers of Benzodiazepine Abuse

Besides the risk of tolerance, dependence, abuse, and addiction, there are other dangers associated with a benzodiazepine use.

  • Overdose – Approximately one-third of all overdose deaths involve a benzodiazepine-class drug.
  • 75% of those deaths also involve an opioid such as prescription painkillers, often prescribed together, illicit synthetics, or heroin.
  • Falls—Use by senior patients is associated with a 40% increase in the risk of falling.
  • Depression—May result in treatment-resistant depression.
  • Cognitive Impairment— Persistent problems have been seen among long-term users (5+ years)
  • Cancer – Especially of the brain, bladder, breast, bowel, and lung

One of the greatest dangers of benzodiazepine dependence or addiction is from complications during withdrawal. This class of drugs is so habit-forming that quitting “cold turkey” causes seizures which can be deadly.  For this reason, benzodiazepine detox should ALWAYS be done slowly and only under the close supervision of trained medical personnel.

Treating a Dual Diagnosis

Treating anxiety can be tricky.  While benzodiazepines already a safe and effective option, they only remain so when they are used over the extreme short term in conjunction with therapy to resolve the sources of the anxiety.  And even when a patient is told that they may take the drug “as needed”, in their mind, that means “as often as necessary”.

What ends up happening is patients self-medicate, they feel uplifted and have more energy in the beginning, and take much more of the drug than they should, and their descent into dependence and addiction speeds up.

As a result, the person now struggles with two co-occurring disorders: anxiety and benzodiazepine dependence. In this case, the best treatment option is to regard both conditions as the primary illness and treat both simultaneously.

To do this successfully, it takes a rehab program that is both comprehensive and integrative, with all service providers working within a shared and treatment philosophy.

Comorbid benzodiazepine addiction and anxiety can be treated successfully on an outpatient basis, most effectively in a full day treatment program, referred to as Partial Hospitalization Program.  Because of the seriousness of such a dual diagnosis, multiple treatment strategies are employed, and adjusted to the individual:

  • Medically-supervised drug detox
  • Individual counseling
  • Behavioral modification
  • Mindfulness training
  • CBT or DBT therapy
  • Peer group therapy
  • Education
  • Relapse prevention/response
  • Medication Assistance
  • Stress reduction techniques
  • Trigger avoidance

If you think that sounds intense, you are right.  Benzodiazepine dependence is a serious illness that requires an immediate response.

What Does This Mean for San Diego Residents?

Benzodiazepine prescription drug abuse is a major problem in the San Diego area, affecting almost every community.

According to the San Diego Prescription Drug Task Force, in 2017, 12.5 anti-anxiety pills prescribed per resident. 2011’s rate was 14.4.  While that might sound encouraging, keep in mind that the number of total prescriptions and the medication contained therein has risen significantly.

Obviously, not every San Diego County resident was prescribed a tranquilizer, so that means that among those who actually received a benzodiazepine medication, the number of pills in their possession was much, much higher. And according to the 2015-2016 National Survey on Drug Use and Health, only 10% of patients take their benzodiazepine as directed.

This is backed up by data from local law enforcement agencies.  In 2016, for example, San Diego County prosecuted over 1500 people for prescription drug-related crimes. Significantly, half of all adult arrestees report some kind of medication abuse.

What all this means to you is that if you or someone you care about is struggling with anxiety and they have been prescribed a benzodiazepine-class medication, it is very possible that now, you/they are also dealing with the additional problem of addiction.

In that case, your best local resource is Lasting Recovery, the premier dual diagnosis rehab program in San Diego.  By utilizing a comprehensive evidence-based treatment strategy, Lasting Recovery can help you safely regain your sobriety and your good mental health.

For more information and to get the help you need right away, contact Lasting Recovery TODAY.

Lasting Recovery – “Where Wellness Begins…”