Most of us have heard of drugs like Xanax, Valium, Ambien, or Klonopin. These drugs are most commonly used to treat anxiety, which affects well over 40 million American adults. What you might not know is that these drugs can cause physical dependence and lead to addiction with long-term use.

The scope of the problem

These medications are all Benzodiazepines, one of the most commonly prescribed classes of psychoactive drugs used for their sedative properties. Xanax is the most prescribed psychotropic medication and is one of the top 25 most prescribed medications in the country. More prescriptions for Xanax are written than for aspirin or insulin.

Insomnia is another leading reason for benzo use, along with depression, panic attacks, alcohol withdrawal symptoms, muscle spasms, and more. A 2018 study found that 1 in 8 adults had used benzos in the past year.

Patients prescribed one of these medications as a short-term solution for less than several months can feel reassured that these cases typically don’t result in physical dependence. But when benzos are used for several months or more, the possibility of tolerance-building and addiction, and the likelihood of experiencing dangerous withdrawal symptoms grows stronger.

Tolerance, physical dependence, potential addiction and death are all possible with extended use. A study by the Centers for Disease Control showed that benzo-related deaths hit a record high of 11,537 in 2018, increasing more than tenfold over almost 20 years. Just in the past year, American Addiction Centers has seen a 35% increase in patients seeking treatment for benzodiazepine addiction.

When to be concerned

If your doctor decides prescribing benzos is the best course of action, patient education is the safety net that helps you through a short-term treatment plan. Those taking benzos should watch closely for signs of increased tolerance leading to dependence:

-Is your regular dose no longer effective?
-Does the frequency of doses need to be increased to continue giving you the same results?
-Are you regularly suffering from side effects like dizziness, confusion, or sedation?

Answering yes to any of these questions warrants a discussion with your doctor and a plan to change direction in the treatment of your symptoms.

Don’t just quit cold turkey

If your treatment with benzos becomes worrisome, it’s imperative that the medication isn’t abruptly stopped. The reason why short-term courses of this medication are preferred is because it takes as little as a few weeks to become physically dependent. The results of quitting benzos cold turkey can be dangerous and even life-threatening.

An individual taking benzos will develop a tolerance to certain aspects of the medication within weeks and, upon ceasing or reducing the medication without the guidance of a physician, will exhibit withdrawal symptoms. This can include a return of the insomnia or anxiety that the medication is treating, nausea, heart palpitations, and those with long-term use of benzos can experience hallucinations, seizures and psychosis.

Ending the use of benzos must be done in accordance with medical supervision. Based on the level of usage, the individual may be best, and most safely weaned off the drug in an inpatient setting. A slow medication taper will help the individual’s brain adjust to functioning without benzos, and this is not done quickly. For example, it can take a minimum of eight weeks to healthily taper off of Xanax depending on the dosage. The plan for abstinence from this medication must be dictated by a physician and never undertaken alone.

Consider the alternatives

While it’s difficult to find another solution to anxiety or insomnia quite as fast-acting as benzos tend to be, there are plenty of alternatives that shouldn’t be discounted. Lower-risk drugs, like selective serotonin reuptake inhibitors (SSRIs), such as Zoloft or Prozac, do not have the same addictive properties as some benzos and have a far lower likelihood of misuse. These medications are primarily used to treat depression but are also useful for patients with chronic anxiety.

Non-pharmacological interventions are, of course, the safest route, and can often be incredibly effective. The benefits of practices like yoga and meditation are proven time and time again. Even daily exercise has been shown to alleviate anxiety, elevate mood, and improve sleep. For a more intensive approach, cognitive behavioral therapy should be considered which works to change destructive habits and patterns of thinking, are highly recommended.

Anxiety and insomnia are widespread problems in the U.S., but benzo use doesn’t have to be. For most patients, benzos should be a second or third line of defense – one that has a clear end in sight. For others, they shouldn’t be used at all. Remember to know the risks, ask about potential drug interactions, and watch out for the warning signs of dependence or addictive habits. If you’re currently taking benzos and want to discuss other options, talk to your doctor about tapering off your prescription under their supervision. And most importantly, never be afraid to ask for help if you believe you’ve become dependent on the drug or suffering from an addiction.

If you or someone you know is struggling with addiction, visit americanaddictioncenters.org.

Author's Bio: 

Dr. Lawrence Weinstein was appointed chief medical officer of American Addiction Centers in August 2018. He is an accomplished physician executive with more than 20 years’ experience in managed behavioral healthcare. In addition to his extensive senior leadership background, he also delved into private practice, where he provided individual and group diagnostic psychotherapeutic services, family therapy and addiction psychiatry.