Benzos for Anxiety: Insidious, Silently Addictive and Toxic as Alcohol

I’ve heard variations of the following tale numerous times among the recovery community: Someone relapses on alcohol after getting prescribed benzodiazepines (more commonly known as benzos) to manage their anxiety. Or, a person gets cleans and can’t sleep. A doc prescribes benozs as a fix. Game over. Others recant tales of going to a psychiatrist as an active alcoholic to get a handle on their anxiety. They walk away with a prescription for benzos, but instead of calm, they end up with another addiction to a drug that makes their alcoholism worse.

Benzodiazepines are a class of medications that slow down activity in your brain and nervous system, according to the Cleveland Clinic. They’re most often used for treating anxiety, and related mental health conditions, as well as brain-related conditions like seizures. Alcohol and benzos are depressants that act on similar receptors in the brain. There is a huge risk of cross tolerance and addiction when you take benzos and alcohol at the same time. Worse yet, problem drinkers are more likely to take benzodiazepines – as prescribed by physicians – than teetotalers and moderate drinkers, according to a study by UCSF-Kaiser Permanente.

Many people who are addicts, but especially alcoholics, struggle with anxiety (panic disorder, generalized and otherwise). Millions of them. It’s one of the reasons they drink. Alcohol temporarily calms the nerves and offers respite. The problem is the recurrent nature of the temporary fix. When alcohol subsides from the system of a habitual drinker, the individual is often overwhelmed with doom, panic, sweating, nervousness and sensitivity. As drinking becomes more problematic, anxiety that was once a hinderance becomes all consuming. The only chance for relief is drinking again.

This cycle isn’t shocking or revelatory, but it bears repeating due to the common pharmaceutical solution for anxiety management. Benzos are a magnificent temporary panacea for anxiety and are often legally prescribed by a doctor. They’re the most common form of anti-anxiety medication and among the most common form of all prescriptions. People in alcohol withdrawal are prescribed benzos to ease the symptoms. The problem is that they’re often used to treat chronic conditions over a long period of time. Many, like me, are on benzos for a long time and didn’t even know how big of a problem it was, especially when combined with alcohol.

I began having panic attacks in my early 20s, in my fourth and fifth year of college. I drank heavily socially, but I wouldn’t classify myself as an alcoholic at that point. When I began having anxiety symptoms, I thought I was having a heart attack, an asthma attack or suffering from a serious and potentially fatal malady. EKGs, stress tests and blood draws yielded no diagnosis the first couple of years after onset. Intense feelings of impending doom, a racing heart and panic persisted in my life. While driving home after playing tennis one afternoon, I had a paralyzing panic attack, forcing me to pull over to the side of the road and call an ambulance as I began to lose consciousness. Another time, while interviewing a cardiovascular researcher for an article I was writing at the University of Minnesota – the researcher told me about a young man in his 20s who had a sudden heart attack and died. I suddenly became sure I was going to suffer a similar fate. I clutched my heart as death crept into my core, but never delivered a fatal blow.

When I was finally diagnosed with anxiety and panic disorder by my internal medicine physician in my mid 20s around 2007, it was a relief. The worst part about being sick is when you can’t unearth a diagnosis for your ailment. You feel crazy. There is no treatment plan. When I discovered I didn’t have lethal health condition – it was assuring to learn that all I needed was a dose of something called lorazepam (a benzo) every morning and after lunch to calm my nerves. I was ecstatic to have a solution for my woes. There was no discussion about the side-effects or addictive nature of the medication or any type of probe into my alcohol use.

I didn’t stop taking benzos until I was in inpatient treatment for alcoholism in 2023. I found out that taking benzos every day for more than 15 years wasn’t good for my mental or physical health. And taking benzos as an alcoholic? That can be lethal. It also impairs and damages your memory, and I’m now at greater risk for dementia. Not one of the half-dozen psychiatrists I saw between 2007 and 2023 flagged my long-term alcohol use and simultaneous benzo prescriptions as problematic. One doctor switched me from lorazepam to clonazepam. That’s it. The refills came every month, no questions asked.

Unbeknownst to me in several of my initial failed sobriety attempts, was that due to my benzo dependence, I was torturing myself with cravings. Even sober, you’re still satisfying the urge to drink every time you take a benzo. That is detrimental to recovery because it takes 1-1.5 years to get over cravings from the last drink – or benzo – you took. You put that plane right back in takeoff mode every time you take a pill. I never had a chance of maintaining sobriety without cravings until I finally quit taking benzos in rehab. I had a narcotic problem I didn’t even know about.

It’s freeing to no longer be a slave to the perpetual cycle of prescription medication, especially benzos. Instead of reaping any perceived benefits from the drug, within a few years of taking them they only made me feel not terrible. I mostly noticed ill effects if I didn’t take them. If I missed a dose, I would suffer paralyzing withdrawals on par or worse than alcohol.

Unlike alcohol, there wasn’t an easy fix if my prescription ran out. I couldn’t simply drive to the drug store to fill an order of benzos. A doctor had to renew my prescription, a pharmacist had to fill it and my insurance had to comply to cover the bulk of the cost. If I ran out of a medication on the weekend or vacation, there were many times I simply had to writhe in agony for a few days. I was forced to call in sick to work more than once because I couldn’t get a medication filled. Going to work hungover was a frequent option, a mode of operation. Going to work after a day or two off benzos was not an option at all.

I don’t know why benzos are so freely prescribed. Perhaps it’s because alcoholics lie to their doctors about their alcohol use? More likely, providers who prescribe benzos are looking for an easy fix to a complex mental health diagnosis and management.

Benzos are a band-aid on a gushing wound. I’ve come to the belief that there is absolutely no benefit to prescribing benzos to patients who aren’t facing an acute healthcare crisis or someone who is closely monitored in an inpatient setting.

My suggestion? Don’t take them. No matter what your doctor says.