Over 30 million Americans a year use benzodiazepines, or “benzos,” including Xanax, Valium, Ativan and Klonopin.
Benzodiazepines are prescribed to treat anxiety disorders, insomnia, muscle spasms, schizophrenia, bipolar disorder, seizures and epilepsy.
But this widely used class of drugs is linked to severe side effects and life impacts that can last for years — even after people have stopped taking the drugs — a new study finds.
“Patients have been reporting long-term effects from benzodiazepines for over 60 years. I am one of those patients,” Dr. Christy Huff, a cardiologist and co-author of the study, said in a news release.
Huff, who is co-director of a patient advocacy group, Benzodiazepine Information Coalition, noted that she took the medication as prescribed and has not taken any benzodiazepines in four years, yet still experiences symptoms daily.
“My life is quite frankly a living hell,” Huff wrote in a 2016 statement on the group’s website.
“The only thing that has kept me going is the fact that I have a husband and 5-year-old daughter,” she added. “Honestly this is probably the only reason I have not ended my life.”
Benzodiazepines side effects
The new research, published in PLOS One, includes a lengthy list of side effects that a majority of benzo users experienced more than a year after they stopped taking the drugs.
Those long-lasting 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.
Alarmingly, users also struggled with severe life impacts: 54.7% reported suicide attempts or suicidal thoughts, for example.
Other negative life impacts included being fired or loss of employment, marriage and relationship problems, lower income or loss of income, increased medical costs and violent thoughts or actions.
“This should change how we think about benzodiazepines and how they are prescribed,” Dr. Alexis Ritvo, assistant professor of psychiatry at University of Colorado Medicine, said in the news release.
The researchers surveyed 1,207 people who were still using benzodiazepines, were reducing their dosage of benzos (“tapering off”) or had completely stopped taking the drugs.
Several members of the research team — which included experts from the University of Colorado and Vanderbilt University Medical Center — have personal experience with benzodiazepines, which helped guide the survey questions.
Stuck in a BIND
The researchers have coined the term BIND, or benzodiazepine-induced neurological dysfunction, to describe the long-lasting effects of benzo use.
Though BIND is a new term and the condition is not yet well-defined or universally accepted by doctors, the study authors believe it could be a result of brain changes resulting from benzodiazepine use.
BIND could occur in roughly one in five long-term users of benzodiazepines. The risk factors for BIND are not yet understood, and more research is needed to define the condition and treatment options, according to the news release.
What are benzodiazepines?
Benzodiazepines are a class of drugs that act as central nervous system depressants by slowing brain activity. They produce sedation and hypnosis, reduce seizures and relieve anxiety and muscle spasms, according to the Drug Enforcement Agency.
Benzodiazepines have been available since the 1960s, when Librium and Valium were introduced. Within a few years, benzos were the most prescribed medications worldwide, according to a 2020 report in the Brazilian Journal of Psychiatry.
A 2019 study in the journal Psychiatric Services found that 30.6 million US adults used benzos annually. Of those, 17.2% misused the drugs in some way. This could mean taking benzodiazepines without a prescription and/or with opioids — a potentially deadly combination.
Health experts noted numerous other problems with benzos, including an increased risk of suicide and dependence on the drug, among other adverse side effects.
Benzodiazepine black box warning
The Food and Drug Administration requires that all benzodiazepines have a “black box warning,” the most serious warning about a drug’s effects on users. In 2020, the FDA updated the black box warning for benzos to include risks of physical dependence, withdrawal reactions, misuse, abuse and addiction.
People who use benzos for more than 3 or 4 weeks can be at risk for developing an addiction, according to the National Center for Health Research.
And when patients stop taking benzodiazepines, they should gradually taper down their usage by reducing the dose before discontinuing completely, the FDA advises.
Withdrawal from benzos can produce troubling symptoms as soon as within 24 hours, and these adverse effects can last for months.
Symptoms of benzo withdrawal include anxiety, panic, insomnia, muscle spasms, nausea, vomiting, diarrhea, blurred vision, seizures, hallucinations, memory loss, trouble concentrating, clouded thinking, mood swings, agitation, drug cravings, twitching and loss of appetite.
And suicidal thoughts and actions often occur during withdrawal from a benzodiazepine. About 10% of people who abuse benzos continue to have withdrawal symptoms years after stopping, according to American Addiction Centers
Patient advocates like Ritvo and Huff hope that their survey report will help health care providers and the general public understand the long-term risks of benzo use.
“Despite the fact that benzodiazepines have been widely prescribed for decades, this survey presents significant new evidence that a subset of patients experience long-term neurological complications,” said Ritvo.
Huff added, “Our survey and the new term BIND give a voice to the patient experience and point to the need for further investigations.”