The opioid epidemic has gained widespread attention, but another class of drugs is quietly causing an epidemic of invisible illness: benzodiazepines. More than 30 million Americans report using medications like lorazepam (Ativan), alprazolam (Xanax), clonazepam (Klonopin), and diazepam (Valium) for concerns such as anxiety and insomnia.
When used for less than three months, they are safe and effective. But more than 30 percent of people ages 65 to 80 are given long-term prescriptions, according to the National Institutes of Health, and that’s where problems arise.
Complications with long-term use
When taken long term, these medications pose a risk of tolerance, which means that they don’t work as well as they used it, so users need a higher dosage to get the same effects. They also have a high potential for abuse and misuse.
These medications increase cognitive impairment, driving accidents, and falls, which can lead to hip fractures, especially in older people. There is also an elevated risk of overdose and overdose deaths among people who are also prescribed opioids.
About half of 1,200 surveyed long-term users report experiencing several symptoms for months to more than a year, according to University of Colorado researchers—even those who had stopping taking the medication. Those symptoms include low energy, difficulty focusing, memory loss, anxiety, insomnia, sensitivity to light and sounds, digestive problems, symptoms triggered by food and drink, muscle weakness and body pain. More than half of the surveyed respondents reported suicidal thoughts or attempted suicide.
One of the authors of the paper, Christy Huff, MD, shared her personal experience: “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.” Dr. Huff is a cardiologist and director of the Benzodiazepine Information Coalition.
How to stop taking these drugs
When you’re ready to stop taking a benzodiazepine, it’s imperative to work with a knowledgeable physician to reduce the risk of withdrawal. Withdrawal symptoms may begin after as little as three to six weeks, even when used as prescribed. Long-term use increases the risk.
In early withdrawal, the user may experience rebound of the symptoms that led them to use the medication initially. That can be followed by acute withdrawal, which can last from five days to several months. Symptoms may include insomnia, pain, abnormal sensations, muscle spasms, seizures, hyperventilation, sweating, nausea and vomiting, anxiety attacks, trouble concentrating, hypersensitivity, detachment from reality, and hallucinations or delusions. Up to 25 percent of long-term users experience withdrawal symptoms for a year or more.
To safely and more comfortably stop using these drugs, you must work with a physician on a gradual tapering program in which you take increasingly smaller doses over a long period of time. Do not stop abruptly. It can cause severe withdrawal symptoms and even increase the risk of death.
Not all physicians are aware of best practices and may cut patients off abruptly or too quickly. If your physician refuses to refill a prescription, it’s important to get a second opinion so you can work with someone who can help you safely and successfully wean off the medication.
