The Benzos Factor in America’s Addiction Crisis

An estimated 100,000 Americans died of drug overdoses in just one year, a never-before-seen milestone that US health officials say is tied to the COVID-19 pandemic and a more dangerous drug supply. Overdose deaths have been rising for more than two decades now, but sharply accelerated in the past two years, according to new data released in November.

The current estimate is for the period of May 2020 to April 2021. In July, the US government reported that drug overdose deaths had soared to a record 93,000 in 2020 eclipsing the high of about 72,000 drug overdose deaths reached the year before and amounting to a devastating 29 percent increase in only 12 months. The 2021 death toll is now expected to exceed that 2020 mark significantly. 

As the Associated Press reported, “experts believe the top drivers are the growing prevalence of deadly fentanyl in the illicit drug supply and the COVID-19 pandemic, which left many drug users socially isolated and unable to get treatment or other support.”

While opioids like fentanyl, heroin, and oxycodone get most of the attention, other components of America’s addiction crisis are frequently overlooked. “It has been estimated that concurrent use of benzodiazepine and opioids may occur in as many as 50 percent of opioid overdose deaths,” wrote addiction psychiatrist Steve Adelman recently on Psychiatric Times.

Concurrent use of alcohol and benzodiazepines such as the much-prescribed and widely misused alprazolam (Xanax) is equally dangerous as both alcohol and Xanax act as depressants on the central nervous system. If the dosage is high enough, the combined effect can cause respiratory depression, respiratory failure, coma, and death.

Polydrug use poses significantly higher risks than the use of a single illicit drug alone, due to such drug synergies. A 2020 study published in the Journal of Substance Abuse Treatment found that “polysubstance use is common in hospitalized patients with substance use disorders and identifying patterns of polysubstance use can guide clinical management. Hospital providers should prepare to manage polysubstance use during hospitalization and hospitals should broaden care beyond interventions for opioid use disorder.”

In his story on the current overdose escalation, AP reporter Mike Stobbe mentioned a 21-year-old man from Minnesota, who died in February. His blood was found to show “signs of fentanyl, heroin, marijuana, and the sedative Xanax.”

While many states adopted restrictions for opioid prescriptions, people with addiction have been switching to other substances—often using them concurrently. Dr. Adelman cautioned against overprescribing yet another medication. “More and more patients leave their doctors’ offices with prescriptions for benzodiazepine medications,” he wrote. “Across the medical profession, the percentage of outpatient visits resulting in a benzodiazepine prescription has increased from 3.8 percent in 2003 to 7.4 percent in 2015. This startling statistic suggests that more cautious and conservative use and prescription of benzodiazepines has the potential to save thousands of lives per year.”

Fighting America’s addiction crisis needs to go beyond restricting access to dangerous substances, however. Addiction is a complex bio-psycho-social disease and measures to curtail access to specific substances have repeatedly failed in the past because they don’t address the actual drivers of substance use disorders and addictive behaviors.

In the case of a severe substance use disorder, necessary detoxification should be supervised by medical professionals—especially in the case of polydrug use. Each drug has different effects on the brain and body—a medical detox can help ensure that the process is safe and as comfortable as possible. 

Detoxing on your own at home by going “cold turkey” can be particularly dangerous if you’re withdrawing from multiple addictive substances. Sudden unsupervised withdrawal from alcohol or benzodiazepine can result in life-threatening seizures. The treatment team at Valiant Living Detox and Assessment utilizes a multidisciplinary approach that includes a medical director, psychiatric nurse practitioner, LPNs, counselors, and addiction technicians.

If you or someone you care about is struggling with addiction, contact or call us today at 720-796-6885 to learn more a

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