Balancing of the Benefits of Anxiety Relief Against the Risk of the Prescription Drug Abuse

Xanax is the most prescribed benzodiazepine in the United States. Now that is the kind of headline manufacturers love and health professionals hate. Taken under the right circumstances and with due precautions in place, Xanax is an effective medication for the relief of anxiety and panic disorders. But, as one of the benzodiazepines, it is habit-forming. Take Xanax for too long or at too high a dose, and you will become dependent fairly quickly. So, the decision to take Xanax should be a responsible balancing of the benefits of anxiety relief against the risk of withdrawal symptoms when you try to stop.

Unfortunately, US Government officials have now warned that the abuse of prescription medications is growing into a major public health problem. The latest statistics show that, in the period 2004 to 2005, the emergency departments of hospitals across America showed a 21% increase in the number of cases arising from the non-medical use of both prescription and over-the-counter medications — for those of you who like actual numbers, that was an increase of 100,000 to a total of nearly 600,000 people who had “abused” medications alone. To put that in context, there were a further 1•4 million emergencies solely caused by the use of illegal drugs and yet more who had mixed legal with illegal.

I have just taken a Xanax to stay calm in the face of such numbers. There is an implicit irony in the habit of Americans to prefer using the word “drug” for everything from magic mushrooms to aspirin rather than the rest-of-the-world English distinction between “medication” or “medicine” for therapeutic substances and “drugs” for the chemicals labelled illegal.

So which of the legitimate medications are being abused? Well, the numbers show that the misuse of benzodiazepines like Xanax was up by 19%. Why is this? It is an application of the old, “Familiarity breeds contempt”. Branded medications like Xanax are ruthlessly advertised in the mass media and their use has become socially acceptable. The fact that “safe” Xanax is an unsafe benzodiazepine often gets lost, and people simply accept that anything approved by the Food and Drug Administration must be safe for them to use. This particularly applies to the young who see nothing wrong in using medications without a prescription. Indeed, they are now preferring to use medications instead of the more dangerous illegal drugs.

When the Government convinces people that cannabis, LSD, etc. are unsafe, this drives those in search of recreation into the waiting arms of the pharmaceutical companies. Now add in the fact that buying legitimate medications like Xanax is often cheaper than the illegal drugs and the process of changing attitudes is complete.

Many argue that the rise of the internet and online pharmacies has hastened the trend. After all, with a credit card, anyone can buy Xanax online without a prescription. But all the research shows that most individuals simply get prescriptions from their doctors or buy from local dealers. It is more convenient. Although, of course, the dealers may be buying in bulk online. This seems to confirm that, in terms of regulation, a reasonable balance has been achieved between patient care and public safety. In any event, trying to produce regulations which restrict access to legitimate prescription medications with a proven track record like Xanax, would be difficult.

Should doctors do more to control their patients? The question is actually wrong because, unless the patients are certified incompetent, their actions cannot be controlled. They can walk out of the consultation room and do whatever they like with their Xanax. So that is the strength and weakness of every system of controls. People should be allowed relatively easy access to medications like Xanax that help them to continue functioning in today’s high-stress world. As we tolerate bars and pubs where sometimes dangerous alcohol is sold over-the-counter, so we have to accept that there will always be some who cannot control the way in which they use medications.