Frequently Asked Questions

Benzodiazepine prescribing went down overall between 2018 and 2022. In the Medical Expenditure Panel Survey, the percentage of US adults with at least 1 benzodiazepine prescription fell from 4.7% in 2018 to 3.4% in 2022. The decline was largest in adults aged 56 years and older, whose use dropped from 7.2% to 4.7%, compared with 4.4% to 3.4% in adults aged 36355 years and 2.1% to 1.8% in adults aged 18335 years.

Adults aged 56 years and older had the highest benzodiazepine use. Across 20182022, annual use was 5.9% in adults aged 56 years and older, 3.8% in adults aged 36355 years, and 1.8% in adults aged 18335 years. The authors found that this age gradient was generally consistent across sex, race and ethnicity, marital status, education, income, insurance, employment, and residence groups.

Benzodiazepines were most commonly prescribed for anxiety or stress across all adult age groups, but insomnia-related use became more common with older age. Anxiety or stress accounted for 78.6% of benzodiazepine use in adults aged 18335 years, 70.2% in those aged 36355 years, and 56.8% in those aged 56 years and older. By contrast, insomnia or sleep disorders accounted for 4.4%, 7.7%, and 18.5% of benzodiazepine use in those same age groups, respectively.

Same-year prescribing with other CNS depressants was common: 41.6% of adults treated with benzodiazepines also received at least 1 other CNS-depressant medication in the same year. In this study, other CNS depressants included prescribed opioids, nonbenzodiazepine hypnotics, gabapentinoids, muscle relaxants, and antipsychotic medications. The authors also note that 93% of participants with both benzodiazepines and other CNS depressants in the same year received both prescriptions in the same survey round.

Yes. Among adults who received benzodiazepines, other CNS depressants were prescribed in the same year to 44.6% of adults aged 36355 years and 42.9% of adults aged 56 years and older, compared with 30.0% of adults aged 18335 years. The study found this age pattern for same-year use of opioids, nonbenzodiazepine hypnotics, gabapentinoids, and muscle relaxants.

Among adults treated with benzodiazepines, same-year exposure to other CNS depressants was higher in women, in adults aged 36355 years and 56 years and older than in those aged 18335 years, in Hispanic than White non-Hispanic individuals, in adults with serious or moderate psychological distress, and in adults with worse general health. Two especially high-risk groups were adults with serious psychological distress, 62.9%, and those in fair or poor general health, 72.0%, who also received other CNS depressants.

Yes. Among adults aged 56 years and older who received at least 1 benzodiazepine prescription in a year, the mean annual number of prescriptions declined from 5.4 in 2018 to 4.3 in 2022. The reported difference was 1.0 prescriptions (95% CI, 1.6 to 0.5).

Yes. Among benzodiazepine-treated adults, 38.0% of those aged 18335 years received only 1 benzodiazepine prescription, compared with 28.5% of adults aged 36355 years and 23.8% of adults aged 56 years and older. Younger adults were also less likely to receive 5 or more annual prescriptions: 35.8% versus 43.6% in adults aged 36355 years and 42.0% in adults aged 56 years and older.

Across 20182022, benzodiazepine use was highest among separated, divorced, or widowed individuals (6.9%), publicly insured adults (6.1%), and nonemployed persons (6.0%). It was lowest among uninsured persons (1.0%), Black non-Hispanic adults (1.8%), and adults in the "Other," non-Hispanic racial and ethnic group (1.8%).

The main limitation is that the Medical Expenditure Panel Survey is a household-reported survey, so benzodiazepine use may be underestimated and reasons for use may be misattributed if respondents do not report medications accurately. The authors also note that nonresponse bias may persist despite statistical adjustment, some subgroup estimates had limited power and wide confidence intervals, and same-year prescribing of benzodiazepines and other CNS depressants does not necessarily mean the drugs were used concurrently.

Additional limitations were the lack of data throughout the study period on whether prescriptions came from office-based or telemedicine visits, and the absence of information on prescriber specialty, benzodiazepine dose, and nonmedical benzodiazepine use.