The Wall Street Journal‘s senior health and medicine reporter, Betsy McKay, has teamed up with WSJ investigative reporter, Shalini Ramachandran, and a team of visual communicators to produce a graphically intense deep dive into what they’re calling “Generation Xanax.” 

Benzodiazepines such as Xanax, Klonopin, Ativan and Valium have been used as psychiatric medications in the United States for more than 50 years. Benzodiazepine dependence impacts several generations, from boomers to zoomers. Addiction psychiatrist, Dr. Alexis Ritvo at the University of Colorado, shared some rough estimates with WSJ on the number of people impacted by benzodiazepine dependence:

• Between 15% and 44% of chronic benzodiazepine users experience moderate to severe withdrawal symptoms.

• Between 10% and 15% experience protracted symptoms that can last for months or years after withdrawal.

• Both the use of benzodiazepine and the discontinuation of use increase the risk for death by suicide.

• From 2017 to 2018, complaints about adverse effects from benzodiazepines shot up from 1.8 million to 2.2 million.

Dr. Ritvo is the medical director for The Alliance for Benzodiazepine Best Practices, whose mission is to “significantly reduce the number of benzodiazepine withdrawal sufferers,” in part by reducing the number of prescriptions and the duration of prescriptions. The organization includes “Z-drugs” — non-benzodiazepine sedatives such as zaleplon, zolpidem, and eszopiclone. Here are some of the main problems they’ve identified with overuse of these drugs:

• Benzodiazepines and non-benzodiazepines frequently lose efficacy over time.
• Both classes of drugs often lead to physiological dependence and its associated withdrawal syndrome.
• Benzodiazepines are ineffective for many common off-label applications.
• Both classes of drugs can induce new or increase current neural symptoms.
• Both classes of drugs can cause a wide range of side effects, including death.
• Both classes of drugs have adverse reactions related to interactions with other drugs.
• Both classes of drugs can make the use of life-saving antibiotics (fluoroquinolones) a very painful experience.

The WSJ interviews Dr. Peter Martin, professor of psychiatry and behavioral sciences at the Vanderbilt University School of Medicine, who cautioned that “in some people, long-term use of benzos can be neurotoxic and damage the brain. Even when withdrawal is gone, there are cognitive deficits left over.”

Prescriptions for Xanax and generic Xanax in the U.S. peaked in 2013 at over 130 million, and have declined steadily to roughly 80 million in 2024. Researchers have known since the 1970s that withdrawal from benzodiazepines can be exceptionally difficult, resulting in lasting problems. The recommended course of action is a gradual tapering off the medications. Some users seek recovery using substance use disorder treatments.

The Wall Street Journal isn’t done with this story yet. Their lengthy article, which includes many first-person accounts of people suffering from benzodiazepine dependence, ends with a promise to continue “reporting on the development and long-term impacts of benzodiazepines like Xanax, Ativan and Klonopin. We are seeking to talk to doctors, patients, veterans, drug company executives and public health officials.”

You can contact the authors using a form provided by WSJ at the following link: https://www.wsj.com/health/wellness/xanax-drug-benzodiazepines-research-harm-7a60f236

Written by Steve O’Keefe. First published March 18, 2025.

Sources:

“Generation Xanax: The Dark Side of America’s Wonder Drug,” The Wall Street Journal, March 13, 2025.

“Benzodiazepines: Uses, Dangers, and Clinical Considerations,” Neurology International, November 2021.

Image courtesy of Divine Harvester, used under Creative Commons license.