Anti-Anxiety Meds Kill Thousands Every Year

Combining benzodiazepines like Valium, Ativan or Xanax with other drugs can have dangerous or deadly consequences.

bottle of pill spilling onto blue background

Medically reviewed in March 2018

Updated on February 1, 2021

More than 15 percent of Americans will have an anxiety disorder at some point in their lives. Anxiety affects people for many reasons, but an anxiety disorder can be crippling. Benzodiazepines like Xanax, Valium or Ativan are being used more and more to control symptoms. In fact, the percentage of adults getting a prescription for benzodiazepines increased from 4.1 percent in 1996 to 5.6 percent in 2013. 

As the number of people taking benzodiazepines has increased, so has the number of people dying from overdoses. The benzodiazepine overdose death rate jumped from 0.58 per 100,000 adults to 3.07 per 100,000 during those same years—a fivefold increase. Here’s what you need to know about anxiety, benzodiazepines and how to prevent an overdose. 

Anxiety or anxiety disorder? 
Anxiety is a catchall term for a variety of disorders, says Yevgeniy Gelfand, MD, a psychiatrist and internist with Trident Medical Center in Charleston, South Carolina. “It’s a spectrum disorder, everything from panic attacks, to excessive worrying, to post-traumatic stress disorder, to phobias,” he says. “It’s a separate cluster of diagnoses and can coexist with anything else. It’s basically a doctor word for ‘worrying.’” 

The difference between normal worrying and an anxiety disorder is, with an anxiety disorder, “People have it all the time, no matter what,” says Dr. Gelfand. “The difference is duration.” 

How benzodiazepines can help—or harm 
Benzodiazepines are sedatives and hypnotic agents that work quickly to relieve symptoms of anxiety, says Gelfand. Typically, benzodiazepines are to be used for a short time with other drugs (often antidepressants) and in conjunction with therapy. Benzodiazepines are addictive, says Gelfand. It’s easy to become hooked on their effects, and the body develops a tolerance to the drugs over time, he says. 

“These medications are very effective, but only when used appropriately, for a short time and as needed instead of, ‘Oh, I don’t want to deal with this, let me take some meds,’” says Gelfand. “The underlying problems won’t go away by putting on a Band-Aid, which is what benzodiazepines are. They’re for symptomatic improvements.” 

Deadly combinations 
A benzodiazepine overdose results in slower breathing and using fewer muscles to breathe, says Gelfand. On their own, benzodiazepines are rarely fatal. A benzodiazepine overdose becomes deadly when you combine them with other drugs, or alcohol. The Centers for Disease Control and Prevention (CDC) reported in 2014 that alcohol was involved in more than a quarter of benzodiazepine-related ER visits, and more than one in five benzodiazepine deaths. 

That’s not all. A March 2017 study in the journal BMJ found that people who used opioids and benzodiazepines together had double the risk of emergency room visits or hospitalization than people who only used opioids. The study also found that the percentage of people who were prescribed both opioids and benzodiazepines nearly doubled in the US between 2001 and 2013. 

Symptoms of a benzodiazepine overdose can include: 

  • Dizziness 
  • Confusion 
  • Drowsiness 
  • Blurred vision 
  • Agitation 
  • Slurred speech 
  • Weakness 
  • Low blood pressure 
  • Slowed breathing 

Beat back anxiety without the meds 
Gelfand says that since anxiety is experienced subjectively—it’s different for everyone—you can trick yourself into instantly feeling better after taking your medication. “Some people report that their meds kick in instantly, which is impossible,” he says. “That’s the placebo effect. Help is coming, it’s on its way, I don’t have to feel like this forever. And then people get relaxed, breathe differently, their heart rate comes down and muscle cramps stop.” 

You can go straight to this effect without medication, says Gelfand. It takes mindfulness. “The mind can’t focus on many things at once. One thing we can do is bring your awareness to the body,” he says. “Feel the skin, feel the air brush it, feel the clothes on your skin. Feel yourself inhabit your body.” 

Then, switch to focusing on your breath. “Use your belly to push your diaphragm down and cause air to rush into your lungs,” says Gelfand. “The reason we do that is we stimulate the vagus nerve. That’s what produces relaxation. It brings out more calmness. We’re not thinking of whatever stressful thing, we’re changing our breathing, making it slower and more efficient. There’s some relief.”

Diaphragmatic breathing is vital in the practice of yoga, which has been shown in small studies to reduce anxiety in people with generalized anxiety disorder, working women, people with atrial fibrillation, pregnant women and people being treated for infertility. 

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