As the opioid crisis has continued to escalate, it has become clear that inappropriate marketing and overprescription of opioids played a substantial role in exacerbating addiction. Many patients who took opioids as prescribed after an injury or surgery, or to treat chronic pain, found themselves dependent on the drug.
However, opioids aren’t the only drug that is being dangerously overprescribed. Benzodiazapines (also known as “benzos”) are psychoactive drugs used to treat anxiety, insomnia, and stress. While they are generally seen as safe for short term use (two to four weeks), often doctors prescribe them for long-term use, not knowing the potential risks to patients.
Like opioids, long-term benzo use can create dependence. But the excruciating side effects and dehabilitating withdrawal symptoms from benzos are even worse than opioids, experts say. And advocates stress that most people dealing with withdrawal symptoms were not abusing benzos but were taking them as prescribed by a doctor.
For filmmaker Holly Hardman, tapering off Klonopin took nearly two years, and she still experiences physical reactions from the withdrawal. At its worst, she went through disturbing side effects such as akathasia, the feeling that you are about to jump out of your skin, and aphasia, the inability to form words and sentences. She’s now in the process of making a documentary about the dangers of benzodiazepines called “As Prescribed” (You can watch the trailer on her website).
“People are given these medications for normal life experiences and don’t realize what can happen,” said Hardman, “Their suffering is why we are fighting to get this film made.”
Overprescription of benzos is especially common among the elderly, who are more likely to be on multiple prescription drugs. One study found that among American patients age 65-80, 8.7% used benzos in 2008, compared to a rate of 5.2% among adults of all ages. Almost a third of older adults using benzos in 2008 were taking them long-term. However, elderly adults are also likely to suffer negative side effects from taking benzos such as falls and impaired memory; this danger prompted the American Geriatric Society to advise against prescribing them for insomnia or agitation.
Why are prescriptions of benzodiazepines so common, when they have such a high potential for dependence and patient harm? There is a widespread perception of benzos like Xanax and Klonopin as being harmless quick fixes for insomnia and anxiety. Television and movie characters are shown popping pills to deal with their anxiety when visiting family or getting on a plane.
Both patients and doctors can fall prey to this view of taking benzos as “no big deal.” One patient who was on clonazepam for years, said his doctor “encouraged me to take it as often as I want, every day of my life,” in an interview on Vice. Similarly, in the early 1990s, Hardman’s doctor assured her that Klonopin was safe to take long-term for chronic fatigue syndrome (CFS/ME). Hardman only began realizing that her side effects were due to the Klonopin after doing research herself in 2012.
Hardman and other advocates against benzo overprescription want to get the message out benzos, like opioids, can be dangerous even when taken exactly as prescribed. But just because you are prescribed a benzodiazepine doesn’t mean you have to take them without first seriously weighing the potential risks and benefits.
“Patients should not be afraid to question a drug,” says Hardman, “We shouldn’t assume these prescriptions are harmless.”