High Risk of Overdose of Sleeping Pills in Young Adults

Higher risk of overdose in young adults being treated with benzodiazepines compared to other sleeping drugs.

Highlights:

Insomnia is a disorder where a person experiences lack of sleep or inadequate sleep
There is a rise in incidence of insomnia among teens and young adults
Medication prescribed for insomnia like Xanax (benzodiazepines) have the potential to be highly addictive

Teens and young adults being treated for sleep disorders with benzodiazepines like Xanax which helps with insomnia and anxiety face higher risk of overdose.

Between 1991 and 2019, inadequate sleep among adolescents in the United States increased from 44% to 66% (). Insomnia is associated with negative health consequences. Nonpharmacologic and pharmacologic treatments for insomnia are available, with cognitive behavioral therapy frequently recommended as first-line treatment ().

‘Insomnia is on the rise in teens and young adults. There is a higher risk of overdose with benzodiazepines which are used as sleeping pills.’

Benzodiazepines are 1 class of medications prescribed for the treatment of sleep disorders. Although effective, they are not recommended for children younger than 18 years of age and their use for more than 4 weeks due to its ill effects like non-medical use, benzodiazepine use disorders, and overdose ().

The risk of overdose increases when benzodiazepines are used in combination with opioids and other central nervous system depressants, benzodiazepine attributed morbidity and mortality have increased since the onset of the prescription opioid epidemic ().

The study examined how often young people with sleep disorders had a drug overdose in the months after starting a prescription sleep medication.

Deaths by Overdose of Benzodiazepines

Benzodiazepines were involved in 12,290 overdose deaths in 2020, up from 6,872 in 2011 and 1,135 in 1999 (). However, researchers said the risks of drug overdose in youth populations prescribed a benzodiazepine treatment for insomnia was unclear and inconclusive. It was found that young people using benzodiazepines for common sleep conditions had an increased risk of overdose during the six months after starting treatment compared with other prescription sleep medications, including trazodone, hydroxyzine and z-hypnotics ().

Benzodiazepine Use is Highest Among Older People, Despite Risks
Benzodiazepines, a widely used class of sedative and anti-anxiety medications, is increasingly prescribed with advancing age, despite the known risks for older people.

“The risk of drug overdose with benzodiazepine treatment is an important safety consideration when treating adolescents and young adults. We hope these results can inform prescribing decisions and encourage close monitoring in this young patient population.” said researchers.

Using a commercial claims database covering privately insured young people ages 10 to 29 years old, researchers identified nearly 90,000 people newly receiving benzodiazepine or an alternative prescription treatment for a sleep disorder. Researchers then examined drug overdoses in this group in the six months following the start of treatment.

Benzodiazepine Sedatives Linked to Higher Mortality Rates
Researchers analyzed data on 13,692 mechanically ventilated patients from 104 U.S. hospitals during the years 2003 – 2009.

Researchers also found the risk of overdose was highest among young people starting treatment with benzodiazepines who recently were prescribed an opioid.

Given the frequent co-use of benzodiazepines with other substances, it is important to discuss with young people the potential associated harms. Because other substance use may be unknown to the prescriber, adolescents and young adults should be screened for substance use and a history of overdoses before treatment.

Benzodiazepines Linked to Suicide Risk in Patients With COPD, PTSD
Long-term use of benzodiazepines in COPD patients who also had PTSD more than doubled their risk of suicide, stated study.

Researchers also added that continued research is needed to determine how specific benzodiazepine treatment details, such as dosage, alter the risks of overdose.

References:

Age, Period, and Cohort Effects of Internalizing Symptoms Among US Students and the Influence of Self-Reported Frequency of Attaining 7 or More Hours of Sleep: Results From the Monitoring the Future Survey 1991-2019 - (https://pubmed.ncbi.nlm.nih.gov/35048117/)
Comparative effectiveness and safety of pharmacological and non-pharmacological interventions for insomnia: an overview of reviews - (https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-019-1163-9)
FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class - (https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class)
Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996–2013 - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816010/)
Overdose Death Rates - (https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates)
Association of Benzodiazepine Treatment for Sleep Disorders With Drug Overdose Risk Among Young People - (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798875)

Source-Medindia