Benzodiazepine prescriptions dropped sharply in the US over the past decade, research finds
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The number of prescriptions dispensed for benzodiazepines like Xanax and Valium declined in the United States over the past 10 years, potentially suggesting that doctors have become more cautious about prescribing these sedatives, according to Rutgers Health researchers.
The medications, which also include Ativan and Klonopin, slow activity in the central nervous system and are commonly used to treat anxiety, panic attacks, insomnia and some seizure disorders.
In the study, published in the American Journal of Psychiatry, Rutgers Health researchers analyzed more than 1.1 billion benzodiazepine prescriptions filled between 2013 and 2024 and found a 26.7% decline over that period.
"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 study's lead author. "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."
Benzodiazepines are increasingly involved in overdose deaths, many of which also involve other drugs such as opioids. The Food and Drug Administration issued warnings about prescribing these medications along with opioids and risks of medication misuse in 2016 and 2020. Prescriptions declined across all patient populations, with the largest decline among young adults ages 18 to 29.
Amid changes in the health care workforce, researchers also found shifts in who prescribed the medications. Primary care physicians and psychiatrists wrote fewer prescriptions, while prescriptions by advanced practice providers—such as nurse practitioners and physician assistants—increased.
Researchers also found declines in the amount of medication dispensed per prescription. The average dose per prescription decreased by 18.3%, which may reflect the adoption of more selective prescribing practices, the researchers said.
"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.
Co-authors of the study include Hillary Samples, Greta Bushnell, Stephen Crystal and Fangzhou Xie of Rutgers Institute for Health, Health Care Policy and Aging Research and Mark Olfson of Columbia University.
Publication details
National Trends in Benzodiazepine Dispensing, American Journal of Psychiatry (2026). doi.org/10.1176/appi.ajp.20251346
Journal information: American Journal of Psychiatry
Key medical concepts
BenzodiazepinesAnalgesics, Opioid
Clinical categories
PsychiatryPsychology & Mental healthClinical pharmacology Provided by Rutgers University Who's behind this story?
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