Why Prescribing Xanax May Make Your Doctor Uncomfortable

Benzodiazepines are to anxiety what opioids are to pain—and that's a prescription for addiction

Some doctors are reluctant to prescribe benzos because of the risk of addiction, overdose, and cognitive impairment. H_Ko/Shutterstock

As an academic psychiatrist who treats people with anxiety and trauma, I often hear questions about benzodiazepines and receive referrals for patients who are on these medications and reluctant to discontinue them.

There has been rising attention toward the long-term risks of benzodiazepines, including the potential for addiction, overdose, and cognitive impairment. The overdose death rate among patients receiving both benzodiazepines and opioids is 10 times higher than those only receiving opioids, and benzo misuse is a serious concern.

What Are Benzodiazepines?

Benzodiazepines are a class of anti-anxiety medications, or anxiolytics, that increases the activity of the gamma-aminobutyric acid receptors in the brain. GABA is a neurotransmitter, a molecule that helps brain cells, or neurons, communicate with each other. GABA receptors are widely available across the brain, and benzodiazepines work to reduce anxiety by enhancing GABA inhibitory function.