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The FDA’s Messaging About the Risk of Benzo Use

— February 4, 2022

In September of 2020, all benzos became black box drugs. This means that the FDA required their most prominent boxed label warning designed to call attention to life-threatening risks. 

Benzodiazepines have not yet risen to the category of ‘drug epidemic’ in the United States, such as the likes of opioids and methamphetamines. However, the growing trend of illicit use and abuse is causing many, including addiction experts at Yale Medicine, to sound the alarm. Worried that benzo use may be an epidemic in the making, medical experts are calling for better healthcare services to treat the symptoms that benzos are commonly prescribed for. In other words, even the medical community is seeking alternatives to benzo use because of the potential dangers associated with them. Here’s what we can learn about the danger of benzo use, especially from the updated warnings issued by the FDA in 2020.

A Black Box Drug

For over half a century, benzos have been an FDA-approved drug used to treat conditions like anxiety and insomnia. Probably the most well-known brand name for benzodiazepines is the brand Xanax, which is a long-acting drug prescribed to treat anxiety. Benzos also include short-acting varieties, which are commonly used as sedatives. However, FDA approval is not the same as “harmless,” and this is certainly the case with benzos. In September of 2020, all benzos became black box drugs. This means that the FDA required their most prominent boxed label warning designed to call attention to life-threatening risks. 

The warning served to communicate the danger of using benzos inappropriately, such as mixing them with other substances. Perhaps the most important part of the warning was the point that dependence can often occur even when strict adherence was given to prescription instructions and dosage amounts with a high risk of adverse withdrawal symptoms once a dependency is developed. In other words, users can easily become addicted to benzos even when taking the drug “by the book.”

Benzos’ Popularity

This FDA warning is troubling enough for those who have not yet begun their treatment with benzos, but what does it say about the countless people who were already prescribed, not to mention others who are using benzos illicitly? If we interpret the messaging from the FDA and the medical community, it seems that some backpeddling is occurring from what is the single most prescribed psychiatric medication in the United States. 

For some people, this will help them rethink using a drug that is now labeled and documented as highly addictive. However, will it be enough to dissuade others who are currently using benzos, either illegally or by prescription? Regrettably, the answer is probably not. The draw of benzo use is the escape from anxiety, the sedative effects for those with a racing mind, and an overall euphoric “high” feeling when the drug floods the brain with GABA (gamma-aminobutyric acid), producing intense relaxation for several hours. For those who have come to depend on this euphoria, it is difficult to convince them by merely mentioning the risks involved.

Deadly Relaxation

Certificate Project Lists Doctors Cited for Narcotic Overdoses
Photo by DAVIDCOHEN on Unsplash

The intensity of a drug used to combat anxiety is part of the rebound effect that makes it so addictive. Escape from anxiety is a powerful incentive in the decision to get high on benzos, but once the drug wears off, users will often experience more severe forms of anxiety. This is a sign that drug dependency has developed. While some may decide that the reward is not worth the risk, others will go to drastic measures such as mixing benzos with each other, like Xanax and Klonopin. While the goal is to make the positive effects of the drugs last longer, it greatly increases the possibility of experiencing adverse effects. 

Additionally, mixing benzos or increasing the dosage amount can cause overdose and death. Not all overdoses end in death. However, it is important to know some of the warning signs that an overdose has occurred, such as bluish skin, weak pulse, or problems breathing and swallowing. If you or someone you know has become dependent on any variety of benzos, it is very important to take the FDA’s black box warning seriously. This drug is virtually guaranteed to negatively affect individuals who choose to use benzos long-term, and there remains a strong possibility for addiction even when using it properly. Because of this, avoid trying to detox from this powerful drug without professional help. It is important to interpret the messaging from the government and the medical community and free yourself from a drug that continues to raise both doubts and concerns. 


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