Patients taking benzodiazepines such as Xanax and Valium for anxiety, insomnia or panic attacks often face abrupt discontinuation, unsafe tapering and limited clinical guidance, which can lead to withdrawal and long-term harm, The New York Times reported May 14.
Here are five notes:
- Some physicians refuse to prescribe benzodiazepines due to reputational or liability concerns. “‘Benzos’ generate as much anxiety in the prescriber as they do in the patient,” Ronald Winchel, MD, an assistant clinical professor of psychiatry at Columbia University in New York City, told the Times. “Do I start it? Is it the right context? Is it safe? Is my patient going to abuse it? What will my colleagues think?”
- Benzodiazepines remain widely prescribed with nearly 92 million U.S. prescriptions dispensed in 2019. In 2018, half of patients used them for two months or more despite guidelines recommending less than four weeks.
- Tasha Hedges, a patient who took Xanax for 20 years, said her psychiatrist abruptly ended her prescription and for two years has been handling the fallout. “It was a nightmare,” she told the news outlet. “My brain has not been the same.”
- While dependence on benzodiazepines can form in just weeks, many physicians lack training in how to taper patients’ use safely. New guidelines from the American Society of Addiction Medicine recommend individualized plans with 5% to 10% dose reductions every two to four weeks and monitoring after discontinuation.
- In 2023, advocates labeled lingering withdrawal symptoms as “benzodiazepine-induced neurological dysfunction” and have said too many patients are harmed by overly aggressive tapering or being cut off abruptly.
“Most of us were never warned about the chances of dependency and long-term complications,” D.E. Foster, a researcher who contributed to the ASAM guidelines and is an advocate for individuals who have struggled with benzodiazepine complications, told the Times. Slow tapering can be difficult, he said, “but abrupt tapering can be dangerous.”
