NEW JERSEY — The number of benzodiazepine prescriptions dispensed in the United States declined sharply over the past decade, potentially signaling more cautious prescribing practices, according to a Rutgers Health-led study.
Researchers analyzed more than 1.1 billion benzodiazepine prescription fills between 2013 and 2024 and found the number of prescriptions decreased 26.7% during that period.
The findings were published in the American Journal of Psychiatry.
Benzodiazepines, which include medications such as Xanax, Valium, Ativan and Klonopin, slow activity in the central nervous system and are commonly used to treat anxiety, panic attacks, insomnia and some seizure disorders.
“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.”
Researchers found prescriptions declined across all patient populations, with the largest decrease among young adults ages 18 to 29.
The study also found changes in who was prescribing benzodiazepines. Primary care physicians and psychiatrists wrote fewer prescriptions, while prescriptions from advanced practice providers, including nurse practitioners and physician assistants, increased.
Researchers also found the amount of medication dispensed per prescription declined. The average dose per prescription decreased 18.3%, which researchers said could reflect the adoption of more selective prescribing practices.
Benzodiazepines have increasingly been involved in overdose deaths, often in combination with other drugs such as opioids. The U.S. Food and Drug Administration issued warnings in 2016 and 2020 about prescribing benzodiazepines with opioids and the risks of medication misuse.
“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.
Other study authors include Hillary Samples, Greta Bushnell, Stephen Crystal and Fangzhou Xie of the Rutgers Institute for Health, Health Care Policy and Aging Research and Mark Olfson of Columbia University.
The research was supported in part by the National Institute on Drug Abuse. The researchers said the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
