Between 1999 and 2016, as many Americans are now at least vaguely aware, the number of deaths from overdoses that included opioids quintupled. However, during roughly the same period, the number of OD deaths that involved benzodiazepines (a.k.a. “benzos”) increased by a mind-boggling factor of nearly eight. In terms of the absolute number of deaths, opioids are more deadly, but it’s important to note that more than 30 percent of opioid-overdose deaths are actually better described as fatal mixtures of the two classes of drugs.
Benzodiazepines include drugs like Xanax, Klonopin, and Valium, the drug immortalized in the Rolling Stones track “Mother’s Little Helper” for its sedative and calming (albeit, at least in the song, ultimately deadly) properties. As with opioids, a great deal of the harm associated with benzos comes when they are combined with other drugs. Opioids, alcohol, and benzodiazepines are exponentially riskier when taken together because their effects in slowing breathing are synergistic, not simply cumulative. Indeed, research has suggested that as many as 90 percent of benzodiazepine-associated deaths also involved an opioid and about 80 percent of benzo recreational use was carried out in concert with other substances.
But while attention has rightly focused on the role of pharmaceutical marketing in the opioid crisis, which included pushing hospitals to declare pain as “the fifth vital sign,” that doesn’t seem to explain the surge of benzo use and overdoses in recent years.