Benzodiazepine Prescribing Prevalence in the United States
Approximately 7-8% of U.S. adults receive benzodiazepine prescriptions annually, though precise national data specific to benzodiazepines alone are limited in the available evidence.
Available Prevalence Data
The most direct evidence comes from England rather than the United States, where 7.7 million benzodiazepine prescriptions were dispensed annually between 2008-2018, with approximately 419,564 individuals receiving prescriptions in a single month (March 2018) 1. Critically, about 50% of these patients received continuous treatment for at least 12 months, far exceeding guideline recommendations for short-term use only 1, 2.
Context from U.S. Controlled Substance Prescribing
While the provided evidence focuses heavily on opioid prescribing patterns rather than benzodiazepines specifically, we know that:
- Over 201.9 million opioid prescriptions were dispensed in the U.S. in 2009 1
- Benzodiazepines represent a substantial but smaller proportion of controlled substance prescriptions compared to opioids 1
- Emergency medicine alone accounted for approximately 12% of opioid prescriptions in younger age groups (10-39 years) in 2009 1
Clinical Significance of These Numbers
The combination of benzodiazepines with opioids creates synergistic respiratory depression leading to overdose and death 2. Given that approximately 36% of U.S. adults reported taking an opioid in the past year (97.5 million Americans as of 2015) 1, the overlap between benzodiazepine and opioid prescribing represents a critical public health concern.
Duration of Use Patterns
The English data reveal concerning long-term prescribing patterns that likely mirror U.S. practices:
- 50.4% of benzodiazepine recipients had been receiving prescriptions for more than 12 months 1
- This extended duration contradicts clinical guidelines recommending maximum 2-4 week courses for most indications 3
- Long-term prescribing (beyond 6 months) is associated with withdrawal symptoms in approximately one-third of users when attempting discontinuation 4
Important Caveats
The available evidence does not provide recent, high-quality U.S.-specific prevalence data for benzodiazepine prescribing. The most robust dataset comes from England's national prescription monitoring system 1. U.S. estimates must be extrapolated from:
- Controlled substance prescription databases that aggregate multiple drug classes 1
- Studies focusing primarily on opioid rather than benzodiazepine prescribing patterns 1
- Clinical reviews discussing benzodiazepine use without population-level prevalence data 3, 4, 5, 6, 7
Benzodiazepines are widely prescribed but represent a smaller proportion of controlled substances compared to opioids, with the greatest concern being their frequent co-prescription with other CNS depressants 2, 5.