Benzodiazepines And Alcohol: Major Factors In the Drug Overdose Crisis That Are Largely Ignored
Drug overdose deaths have been climbing significantly in the last few years, and opioids, such as prescription painkillers and heroin, have received the most blame. Other substances, however, such as benzodiazepines and alcohol, are often being used in conjunction with opioids, thus creating a toxic cocktail that is far more dangerous than any one drug alone.
The use of sedatives – namely anti-anxiety benzodiazepines such as Xanax and sleep aids such zolpidem – has increased in the last decade along with opioid use. According to the Centers for Disease Control and Prevention (CDC), nearly one-third (31%) of opioid-related overdose deaths also involved a benzodiazepine, and some believe that number may be much higher.
Alcohol use has also climbed among most groups, especially women and older adults. Alcohol by itself is responsible for the overdose deaths of an average of 16-17 people per day. Most are aged 34-65.
Indeed, about one-quarter of overdose death certificates do not list all of the substances involved, and the CDC estimate does not include sleep aids such as zolpidem (Ambien) which has an action similar to benzodiazepines. In fact, many overdose fatalities occur due to the combined use of sedatives and alcohol, no opioid needed.
But unlike opioids, state governments aren’t doing much to limit the use of prescription sedatives, which are associated with a wealth of problems far beyond overdoses, including falls, injuries, and car accidents.
Most recently, a study found that the use of benzodiazepines is associated with a 40% increase in mortality among people with Alzheimer’s disease. Interestingly, yet another study found that high cumulative doses of zolpidem increase the risk of developing Alzheimer’s for elderly patients.
The CDC also estimates that in 2013, around 30% of all prescription overdoses involved benzodiazepines, second only to opioids at 70%. Deaths related to benzodiazepines quadrupled between 1999-2010.
In 2016, researchers published findings partially based on CDC data that revealed the following:
- From 1996-2013, the percentage of adults filling a prescription for benzodiazepines increased from 4.1% to 5.6% with an annual percent change of 2.5%.
- The quantity of benzodiazepines filled increased from 1.1 to 3.6-kilogram lorazepam equivalents per 100,000 adults.
- The overdose death rate increased from 0.58 to 3.07 per 100,000 adults and leveled off for whites only (deaths continued to rise for blacks and Hispanics) after 2010.
- Anxiety was the most common reason given for these prescriptions (56%).
Finally, other recent research found that roughly three-quarters of benzodiazepine overdose death fatalities also involved opioid use.
The takeaway is this: it’s not just an opioid epidemic. Polydrug intoxication is likely responsible for far more deaths than are addressed in research and the media. This, despite the fact that using substances such as opioids, benzodiazepines and alcohol in combination increases the risk of complications and overdose deaths significantly.
~ G. Nathalee Serrels, M.A., Psychology