Benzodiazepines - Mental Health

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  1. Category includes Xanax and Valium
    1. Benzodiazepines (benzos) are a class of drugs including prescription sedatives, like Xanax and Valium.
  2. Concerns over how benzos are prescribed
    1. Experts are growing increasingly concerned about how these drugs are prescribed for mental health challenges like anxiety and insomnia, the length of time for which benzos are used, and potential fatalities caused by mixing benzos with alcohol or opioids.
  3. Accurate portrayal is key
    1. Storytelling can help reduce the harmful impact of benzodiazepine misuse by accurately portraying the intended use and risks of these drugs, educating medical professionals and patients on the dangers of these controlled substances, and dispelling the myth — especially among youth — that benzos are a safe way to self-medicate or relax.

This section was developed using scientific resources available from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

Storytelling Tips

Diversify Representation
  • Tell a broader range of stories that show how misuse of benzodiazepines can affect people of all backgrounds. For example, benzodiazepines are most often prescribed to older individuals who are also at higher risk for accidents/falls or even suicide-related to using these drugs. Telling these less visible stories can help make viewers more aware of the importance of supporting loved ones who might be at risk.  
Show Conversations About Mental Health and Help-Seeking
  • Depict effective family dialogues around misuse of benzodiazepines.
  • Studies show that teens who have learned about the dangers of misusing prescription drugs from their parents or grandparents are over 40% less likely to misuse prescription drugs than teens who did not talk about this issue. Storytelling can help start these conversations. 
Spotlight Support from Friends and Family
  • Highlight loved ones who spot the warning signs of misuse of benzodiazepines to better equip friends and family to notice someone struggling in their own lives. Visit the substance use disorder page for common warning signs. 
Depict Effective, Realistic Help-Seeking and Treatment
  • Highlight the importance of seeing a trained mental health professional when using prescription benzodiazepines. A high percentage of people who receive benzodiazepine prescriptions get them from a primary care physician rather than from a mental health professional, which some experts believe can contribute to misuse. While primary care physicians can play an important role in recognizing and providing support for mental health challenges, it can be helpful for people to work with a specialized mental health professional, particularly when using medication to treat their symptoms.
  • Show people getting treatment before reaching the point of crisis. Stories about treatment for substance use disorder involving benzodiazepines sometimes center on the moment a character or cast member hits rock bottom or overdoses. Seeking help earlier can reduce the chances of long-term health consequences. 
  • Depict the importance of getting professional support when trying to end benzodiazepine misuse. Stopping benzodiazepines abruptly or reducing the dosage too quickly can result in acute withdrawal reactions, including seizures, which can be life-threatening.
Highlight the Power of Coping Skills and Self-Care
  • Highlight self-care and coping strategies that are more effective than misusing prescription drugs. The reason most people give for misusing benzodiazepines is to “relax or relieve tension.” However, the misuse of these drugs can lead to serious mental health issues and long-term negative health outcomes. Stories can spotlight more effective coping strategies. 
Represent the Causes of Mental Health Challenges Accurately
  • Highlight the connection between substance misuse and mental health challenges, and the reality that people can become dependent on these drugs after they are prescribed by doctors for legitimate physical or mental health issues. 
  • Stigma around substance use disorder is sometimes rooted in the belief that people are choosing to misuse drugs to have fun or because they lack discipline. This stigma can prevent people from getting help. 
Consider the Impact of Language
  • Avoid using terminology that may reinforce the false narrative that substance misuse is a moral failing on part of the person (like “drug abuse” or “addict”). Instead use language like “he’s misusing prescription drugs” or “she has a substance use disorder.” Check out the language section for more guidelines on using the right terminology. 
Move Past Stereotypes
  • While research gives us a snapshot of who is most frequently using and being harmed by prescription drug misuse, the reality is that substance use disorder and mental health challenges can impact anyone. It’s important to move past the stereotypes about who may misuse benzodiazepines to counteract the belief that these problems happen to “other people.”
Avoid Sharing Potentially Harmful Details
  • Avoid providing any details in your story that might help viewers hide misuse of prescription drugs, or obtain or use them for the wrong reasons. Storylines that give specifics about how benzodiazepines are inappropriately obtained can unintentionally provide a blueprint for people struggling with misuse to obtain these drugs through similar channels. Avoid showing characters or cast members sharing prescription medications without consulting a trained medical professional. 
  • Don’t overemphasize the “benefits” of misusing benzodiazepines. Audience members who are facing mental health challenges and looking for a way to “escape” may retain only the positive messaging around these drugs and not the risks and associated negative outcomes. 

Snapshot

Benzodiazepines (sometimes called benzos) increase the effect of the inhibitory neurotransmitter GABA in the brain as a way to calm or sedate an individual. Common benzos include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin). These drugs are generally prescribed for short-term use of weeks or months.

Experts are growing concerned about the length of time benzodiazepines are being used by patients. Usage of benzos is associated with cognitive problems, increased risk of dementia, and can lead to an increased risk of suicide. Nevertheless, half of all patients receiving benzodiazepines in 2018 received them for two months or longer. When discontinued suddenly, benzodiazepines also present the risk of strong withdrawal symptoms and can cause seizures and death. 

While benzodiazepines themselves carry a lower overdose rate than some other substances, overdoses related to these drugs increased 100% over eightfold from 1999 to 2019 — and there’s particular concern around fatalities caused by mixing benzodiazepines with alcohol or opioids. A study found that up to 17% of patients who are prescribed opioids also receive benzodiazepines.

The mental health community is particularly concerned about the way that benzodiazepine use has entered popular culture through lyrics about Xanax in popular songs and casual references to drugs on social media. Rates for benzos increased 50% for youth from 2005 to 2019.

Given the risks associated with benzodiazepines, some mental health professionals recommend other therapies that are equally as effective as benzodiazepines, if not more so, but without the dangers. Benzodiazepines should only be used — if at all — as short-term therapeutic support as part of a larger treatment plan that involves psychotherapy and safer medications, like antidepressants when needed.

Facts & Stats

Most people who misuse benzodiazepines obtain them from friends or relatives, with only about 20% receiving them from their doctor.
Among people who misuse benzodiazepine, 46% report that the motivation for their most recent misuse is to relax or relieve tension, followed by helping with sleep (22.4%), getting high or being “hooked” (12%), and experimentation (6%).
Racial/ethnic minority groups are more likely to receive just one benzodiazepine prescription for short-term usage, while white patients are most likely to receive more than 18 or more prescriptions or refills.

Need more guidance on depicting substance misuse? Browse the expert directory >

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