Are benzos America's overlooked drug problem?

Are benzos America's overlooked drug problem?

VicesSeptember 12, 2018 By Reilly Capps

On a sunny Denver day, I was stepping out of my doctor's office at the largest hospital.

"Get any bars?" he asked.

He had a scuffed shirt; sandy, sun-splotched hair; the kind of dude who lived out of a van off disability; maybe with a girlfriend who dug his free spirit, which he clearly had, since he was going up to random strangers trying to do a drug deal. 

But, no, I don't do downers like xanax, klonopin or valium anymore — benzodiazepines, or benzos, anti-anxiety medications that swaddle like a velvet blanket whose fibers are made of baby cub hugs. (Xanax are called "bars" because of their long shape.)

"How much you give me?" I said, bluffing.

"Five," he said.

"Nah, not enough," I said.

"You could go over to Curtis Park and get seven," he shrugged. Curtis Park was 2.5 miles away and close to Denver's main homeless shelter. "I've heard it go as high as $10"  

I admired the dude's business plan. He knows patients get 30 or 60 xans from their shrinks for the cost of a prescription — $1 or $10. Then this guy stops them right outside the door and offers a quick payoff. Then he grabs a bus over to the homeless camp and makes enough money to get himself comfortably numb.

This is a snapshot of America in 2018, uncut.

Drug overdoses, as everyone knows, are deadlier to young Americans than cars or guns, filling up the morgues and the obit pages. You hear all the time about the "opioid crisis." And for good reason. Opioid-related overdoses — the most well-known kind — have increased four-fold this century.

Meanwhile, benzo-related overdoses have gone up eightfold, according to the New England Journal of Medicine.

"Despite this trend," the Fournal writes, "the adverse effects of benzodiazepine overuse, misuse, and addiction continue to go largely unnoticed."

That may be changing. This year, benzos have been called "The Danger Lurking in the Shadow of Opiates" by Psychology Today, "America's next drug crisis" by Health Day, America's "Other Prescription Drug Problem" by NPR, and "Terrifying" by Vice.

graph - death involving benzodiazepines

[Overdose Deaths in the United States Involving Benzodiazepines, 1999 through 2015. From the National Institute on Drug Abuse.]

Now, a lot of our benzo-related overdoses are also related to opioids; there are so many prescription meds mixed with street drugs it's hard to tease apart which is the killer.

Still, the numbers for benzo addiction pile up just like the corpses. Benzo prescriptions went up by at least 67 percent since 1996. Over that same time, the quantity of benzos has tripled. Meaning more people are taking way, way higher doses.

I've seen benzo addiction bad, known folks who got so barred out they mumbled and stumbled through their day like muppets. One barred-out dude I knew, his dad committed suicide not long before; who wouldn't love to check out at a time like that? A relative of mine spent decades in a valium haze: she was sweet as peach cobbler, her way of hiding from an alcoholic husband. 

I used to get an ativan script for my anxiety and existential boredom. I sometimes bought them in Mexican pharmacies. I sometimes smoked klonopin, another benzo, crushed up in marijuana bowls.

Given this huge demand, it's no surprise that this dude outside my doc's office was trying to do drug deals with strangers, since there's now a giant gray market for benzos. The need gets filled different ways: by "doctor shopping," hopping from office to office until you get a script; by the darknet, an unregulated and semi-invisible part of the Internet; by etizolam off the regular Internet, a drug feels like a benzo but, as a "research chemical," isn't quite illegal. There are also an increasing number of clandestine labs, since the precursur to valium is widely available.  "These drugs are indistinguishable from prescription benzodiazepines and are potentially as deadly as the synthetic opioid analogue fentanyl," the New England Journal writes. 

Where there's addiction, in other words, addicts will find a way.

There are attempts to curb this surging drug use. Following advice from the FDA, prescribers are cutting back on benzo scripts.

My doc eventually wouldn't give me more than five ativan month, and five is hardly worth your time. Plus about five years ago I realized I was a drug addict and alcoholic, and I've done what I can to drop all addictive drugs since then — and mostly succeeded.

So, outside my doc's office, that's what I told the dude: no bars.

He shrugged and looked past me. There would be another patient stepping out any minute.

When it comes to addiction and drug "epidemics," doctors can make a difference, but until there's a cure for suffering, boredom, entrepreneurship or desire — and there are none on the horizon — the world's various drug problems will roll on, too.

[Photos from Shutterstock.]