Experts Warn Benzo Prescription Abuse on the Rise Among Youths

Staten Island Advance, N.Y.

Apr. 15—Just as the opioid epidemic has gained the full attention of the medical and law enforcement communities, experts say a new drug is trending upward on a national level among teens and young adults.

In New York City, statistics show the number of high school students abusing benzodiazepines remained steady in recent years, but experts caution the drug is something for parents and community leaders to keep an eye on, as it could prove deadly when mixed with other depressants, including alcohol.

Brand name pills that fall in to the category of benzodiazepines—a schedule IV controlled substance—include Xanax, Valium and Ativan. The pills are prescribed for anxiety, depression and in some cases suggested by doctors for use along with opioids to treat chronic pain.

About 13,000 high school students in New York City used the drug recreationally in 2017, which was about the same as 2015, according to the Center for Disease Control's Youth Risk Behavior Survey. However, the drug isn't included in the database prior to 2015, and experts say current data hasn't caught up with reality.

"There's so many resources that have been put toward educating young people about the dangers of opioid use, but I haven't seen any messaging toward 'benzos,'" said Jazmin Rivera, project director for Tackling Youth Substance Abuse, a coalition of stakeholders in the fight against addiction on Staten Island.

Overall use of "benzos" by high school students on Staten Island decreased slightly from 2015 to 2017, though it's increased among Latino students—which bucks a trend set during the current opioid epidemic of white students being statistically more at risk, said Rivera.

On a national level, addiction treatment centers are just seeing the tip of the iceberg when it comes to benzodiazepine addiction, according to a Stateline report.

"(Medical doctors) see things first, so I'm not surprised that the spike in Xanax use isn't reflected in national data yet," said Sharon Levy, director of adolescent addiction treatment at Boston Children's Hospital and lead author of an adolescent drug use study."

Medical experts say "benzo" use alone places users at risk of withdrawal and seizures, in addition to a higher risk of suicide. The biggest concern, however, is the mixture of "benzos" with opioids and other depressants.

More than half of the fatal overdoses reported on Staten Island in 2018 involved the presence of multiple depressants including "benzos," opioids and alcohol.

Co-prescribing "benzos" with opioids rose from 0.5 percent of doctor's visits to 2 percent, from 2003 to 2015, while co-prescribing with other sedating medications increased from 0.7 percent to 1.5 percent, according to recent findings by the American Medical Association.

"What is most striking is not just that the use of benzodiazepines has risen in the outpatient setting but also that it is increasingly being prescribed alongside opioids and other sedating medications, where the risks of adverse events are much more pronounced," wrote Dr. Sumit Agarwal, a co-author of the report.

From 2003 to 2015, the percentage of visits to general care physicians and ambulance rides in which "benzos" were prescribed doubled from about 3.7 percent of visits to about 7.5 percent, according to the American Medical Association.

The pills were prescribe for both mental and physical issues, including anxiety, depression, neurological conditions and back pain, according to the report.

Over that same time period, the rate of visits in which psychiatrists prescribed "benzos" remained steady at about 30 percent, according to the findings.

That being said, "...absolutely there are other ways to treat anxiety and depression," said Susan Abbott, a Manhattan-based child and adolescent psychiatrist.

Alternative treatments include counseling, meditation and non-addictive medications that work slowly over a long period of time to alter serotonin production in the brain, she said.

"People are willing to talk more about how they have anxiety now, and think, 'I can take a pill for that.'"
"But then a certain percentage of those people will go on to abuse it."

On Staten Island, the rate of "benzos" prescribed has dropped since 2015, along with the prescription of opioids amid a borough-wide effort to curb the trend.

While experts note a rise in the "benzo" use, prescription pain killers among high school seniors in New York City and across the country has dropped drastically over the past 15 years, according to the city's Youth Risk Behavior Survey and the National Institute on Drug Abuse.

Luke Nasta, founder of Camelot of Staten Island drug counseling, said he saw a similar trend about 40 years ago, as a decline in heroin use was making way for a boom in cocaine and prescription drug use.

"The younger brothers and sisters saw the damage done to their older brothers and sisters and to their family, and that was enough to say 'I'm not experimenting with that,'" said Nasta. "So they say to themselves, 'let's try something else... I don't hear of anyone overdosing on Xanax."

Nearly 70 percent of adolescents who try an illicit drug before age 13 will develop an addiction within seven years, compared with 27 percent for those who first try an illicit drug after age 17, according to the U.S. Surgeon General's 2016 report on drugs and alcohol.

Staten Island ranked second among the five boroughs in 2017 in regard to the number of fatal overdoses, while authorities reported an increase of fatal and non-fatal incidents in 2018.