The number of benzodiazepine prescriptions like Xanax and Valium dispensed in the United States decreased over the past 10 years, potentially suggesting that doctors have become more cautious when prescribing these sedatives, according to Rutgers Health researchers.
The medications, which also include Ativan and Klonopin, slow down the activity of the central nervous system and are commonly used to treat anxiety, panic attacks, insomnia and some seizure disorders.
In the study , published in the American Journal of Psychiatry, Rutgers Health researchers analyzed more than 1.1 billion benzodiazepine prescription fills between 2013 and 2024 and found a 26.7% decline during this period.
"Benzodiazepines are among the most commonly prescribed medications in the United States, and they provide meaningful benefits for many patients," said Naomi Cruz , a recent doctoral graduate at the Rutgers School of Public Health and Rutgers Center for Pharmacoepidemiology and Treatment Science and the lead author of the study. "But these medications also carry risks, particularly when used with other drugs or over long periods of time. Our findings suggest that prescribing practices may have become more cautious or selective over the past decade, but continued monitoring is important to ensure that patients receive the safest care."
Benzodiazepine medications are increasingly involved in overdose deaths , many of which are in combination with other drugs such as opioids. The Food and Drug Administration issued warnings about prescribing these medications along with opioids and risks of medication misuse in 2016 and 2020. The prevalence of prescriptions decreased across all patient populations, with the largest decline observed among young adults between ages 18 and 29.
Amidst a changing health care workforce, researchers also found shifts in who was prescribing the medications. Primary care physicians and psychiatrists wrote fewer prescriptions while prescriptions by advanced practice providers – such as nurse practitioners and physician assistants – increased.
Researchers also found declines in the amount of medication dispensed per prescription. The average dose per prescription decreased by 18.3%, which may reflect the adoption of more selective prescribing practices, the researchers said.
"While the trends we observed may indicate shifts toward safer prescribing, ongoing research can help us better understand how practices are evolving and where opportunities exist to improve care," said Cruz.
Coauthors of the study include Hillary Samples, Greta Bushnell, Stephen Crystal and Fangzhou Xie of Rutgers Institute for Health, Health Care Policy and Aging Research and Mark Olfson of Columbia University.
This research was supported in part by the National Institute on Drug Abuse, K01DA050769. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
