Overdose Deaths from Benzos Spiked During Pandemic: CDC

Fatal overdoses from benzodiazepines have increased significantly over the past few years, largely driven by use of illicit formulations during the COVID-19 pandemic, according to the findings of a new federal report.

Benzodiazepines, often referred to as benzos, are sedatives and tranquilizers used to lower brain activity. They are used to treat anxiety and insomnia.

The latest issue of the U.S. Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report highlights a growing problem throughout the U.S. with overdose deaths from benzos, which appears to be associated with the rise in synthetically manufactured versions of prescription drugs like Valium and Xanax.

Information from the CDC’s Overdose Data to Action program on benzo overdose deaths indicates that the number of fatal overdoses associated with benzodiazepines increased sixfold during 2019 and 2020. This followed several years of decreasing benzo abuse rates.

From April to June 2019 to April to June 2020, benzodiazepine overdose deaths increased 43%, according to the CDC. Overdose deaths involving prescription benzo tranquilizers like Ativan and Xanax increased 22%, but overdoses involving illicit manufactured versions increased 520%.

In 2016, the FDA required a black box warning for combining use of benzodiazepines and opioid painkillers, warning that taking the two together increases the risk of extreme sleepiness, respiratory depression, coma, or death.

Illicit benzodiazepines are structurally similar to FDA-approved prescription medications, but illegally manufactured benzos may have unknown side effects and toxicities which have not been studied in clinical trials. These are not approved by the FDA and are not deemed safe or effective. Illicit benzodiazepines include etizolam, flualprazolam, and flubromazolam, which have been increasingly detected in postmortem and clinical samples over the past year, most often together with opioids.

The CDC’s findings indicate that from January to June 2020, more than 90% of benzodiazepine overdose deaths also involved opioids, and 67% involved illicitly manufactured fentanyl. Fentanyl is powerful opioid painkiller, originally developed to treat cancer pain that wasn’t alleviated by traditional painkillers. It is 50 to 100 times more powerful than morphine.

Overall emergency room visits for benzodiazepine overdoses increased 24% from 2019 to 2020. Visits for benzodiazepine overdoses involving opioids increased 34% and without opioid involvement increased 21%.

Doctor overprescribing has been largely to blame for the ever-worsening opioid epidemic. More and more people are combing opioids with other drugs. Opioids now account for nearly 70% of all overdose deaths in the United States.

CDC researchers emphasized the need for improving naloxone availability, the overdose reversal drug, and enhancing treatment access for those using benzodiazepines and opioids. However, the main prevention method should be preventing drug use and misuse early, they concluded.