Deaths from opioids grab news headlines, government budgets, and the futures of troubled people. But these deadly drugs often have help. Benzodiazepines — underestimated and, some say, overprescribed — are killing people, too.
“There’s a lot of attention on opioids,” said Dr. Joanna Starrels, an internist and addiction medicine specialist at Albert Einstein College of Medicine in New York. “But I think that epidemiologists need to pay closer attention to the role of benzodiazepines in overdose deaths.”
According to the Centers for Disease Control and Prevention, more than 22,000 people in the United States died of overdoses involving prescription drugs in 2013, the most recent year with available records. Benzos like Xanax and Valium — a class of medications commonly prescribed for anxiety, insomnia, and other conditions — were involved in 31 percent of those deaths.
To see how benzo use has changed in recent years, Starrels and her colleagues tracked prescription data and overdose numbers between 1996 and 2013. They found that the percentage of adults filling a benzo prescription increased by about 37 percent, from 4.1 percent to 5.6 percent, over the study period, while the overdose death rate shot up by more than 500 percent, from 0.58 per 100,000 adults at the turn of the millennium to about 3 per 100,000 throughout the early part of this decade.
“The rate of overdose deaths rose faster than the rate of prescriptions,” said Dr. Chinazo Cunningham, another study author from Einstein.
Why then might benzo prescriptions prove more deadly? “Our guess is that people are using these prescriptions in a riskier way,” said Cunningham, who, together with Starrels and their team, published the findings Thursday in the American Journal of Public Health.
A risk often taken by users is combining benzos with opioids, which can lead to difficulty breathing, coma, or death. “Prescribing opioids and benzodiazepines together is like putting gasoline on a fire,” said Dr. David Juurlink, head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Center in Toronto, who was not involved with the study.
But benzos alone or in combination with alcohol are also to blame for some of the overdose uptick. And, as the Einstein researchers showed, it’s not just the number of benzo prescriptions but the quantity filled in each script that has risen in recent years.
“Benzodiazepines are grossly overprescribed,” Juurlink said, “and many people don’t necessarily benefit from them.”