The benzodiazepine trap

LINDSAY MAST, HOST: Today is Wednesday, May 14th.

Thank you for turning to WORLD Radio to help start your day.

Good morning. I’m Lindsay Mast.

MYRNA BROWN, HOST: And I’m Myrna Brown.

Coming next on The World and Everything in It: prescription drug addiction. The problems associated with opioid addiction are well documented. But it’s not the only prescription medication causing difficulty for patients.

MAST: Benzodiazepines —commonly called “benzos” —are sedatives prescribed for anxiety, epilepsy, and insomnia. Five years ago, the FDA cautioned that prescription guidelines for benzos do not “provide adequate warnings” about the risks of abuse, addiction, and withdrawal reactions. Even so, doctors wrote about 84 million prescriptions for the five most popular benzos in 2024.

BROWN: Many experts say these drugs are generally safe when used properly. And for no more than four weeks. But some people have been using them for much longer than that.

Here’s WORLD’s Les Sillars with the story.

LES SILLARS: Bob Martineau had his first bout with acute anxiety when he was in his early 30s.

BOB MARTINEAU: I had a panic attack out of nowhere while I was driving and it felt like I was gonna die right there.

His doctor prescribed Clonazepam, better known as Klonopin. Martineau, who lives near Calgary, Alberta, took the drug for the next 20 years. And he still had problems with anxiety. But in spring of 2024 he heard a podcast about the damage that long-term benzodiazepine use can cause. So, he decided to quit. The 53-year-old executive went from three pills to none in about nine months.

The withdrawal, he says, was brutal.

MARTINEAU: And I thought, what the heck is wrong with me? Like, what's wrong with me?

Benzos were first developed in the 1950s. At the time, doctors and patients saw them as an improvement over barbiturates…a class of sedatives that affect the brain much like alcohol but have dangerous side effects. One of the first and most popular benzos hit the market in 1963. Valium was so popular the Rolling Stones wrote a song titled “Mother’s Little Helper.” It’s about “a little yellow pill” for housewives. The lyrics go,

Kids are different today, I hear every mother say, Mother needs something today to calm her down; and though she’s not really ill, there’s a little yellow pill …

But soon scientists began to worry that long-term use could lead to addiction and serious withdrawal symptoms. Some even called the drug “Opium of the Masses.” Beginning in 1979, Valium came under heavy criticism. Bernard Silvernail is president and CEO of the Alliance for Benzodiazepine Best Practices.

BERNARD SILVERNAIL: So, Valium was like the sacrificial lamb at that point. It dropped out of being the world's most prescribed drug because they said, ‘Oh, the Valium is no good, but all these other benzos are great.’ ... the crisis just continued, but in a different form.

Doctors continued to prescribe benzos like Klonopin, Ativan, and other varieties. Through the 90’s and 2000’s the popularity of benzos fluctuated. But deaths involving benzos kept rising. One reason—some users were buying the drugs off the street. But most users, like Bob Martineau, had prescriptions.

Last year he tried to taper off benzos on his own.

MARTINEAU: I can't compare it to anything because it's not like an addiction where you crave something. It's just like you've gone crazy.

He began having convulsions. He developed light sensitivity and agoraphobia. He hated leaving his basement. His depression and anxiety shot through the roof.

MARTINEAU: I basically ended up in a catatonic state, like, so bad I couldn't even roll over to take a drink of water.

The medical community is gradually realizing the danger. In 2020, the FDA updated benzos with black box warnings to include risks of abuse, addiction, physical dependence, and withdrawal reactions. Today, more doctors are aware that benzos can be abused. But the dangers of overprescription are less widely known.

Doctors are using benzos as a long-term treatment instead of a temporary fix. So, the cycle of overmedication continues.

DON MIDDLETON: It almost always comes down to one underlying problem.

That’s Don Middleton, an osteopathic physician and chair of the Christian Medical and Dental Associations’ Addiction Medicine Section. He says there’s more to beating an addiction than just getting off benzos.

Middleton is a former alcoholic. He says people struggling with addiction are trapped and try to “white-knuckle” their way into solving the problem. But only Christ can provide the answer.

MIDDLETON: And so, getting people to understand, it's not just about stopping the drug. It's about teaching them you are worthy. Okay? And not because Don says so, but because your Creator says you are. ... That's what treatment should be like.

Martineau, for his part, is still struggling with benzos.

MARTINEAU: It’s like you’re stuck in a dark place and there’s no way of getting out.

He is trying to taper off the drugs even now and was hospitalized for a weekend in April. Martineau’s been told the withdrawal symptoms could last for years.

MARTINEAU: It's just trying to feel whatever my normal is. And I don't even remember what my norm was.

For WORLD, I’m Les Sillars.

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