Teen addiction to benzodiazepines, called "benzos" for short, is on the rise, and these drugs are easier for teens to access—and get addicted to—than most parents think. In fact, they can be as easy to order as direct-messaging a dealer on Instagram.
"Benzodiazepines are one of the most commonly prescribed classes of psychoactive drugs," says Lawrence Weinstein, M.D., chief medical officer at American Addiction Centers. "In the past 20 years, benzodiazepine prescriptions for adolescents have doubled. With the medication being so prevalent, it is not uncommon for a teen to either be prescribed the medication themselves, have a parent who keeps a prescription in the home, or know of someone with that prescription."
Even if teens do not have direct access to a prescription, finding a supplier can be as simple as logging into their social networks like Snapchat, TikTok, Facebook, and Instagram. "Where teens are getting these drugs from is simple: If they are social and tech-savvy, they can access them," says Dr. Weinstein.
Illustration by Yeji Kim
What Are Benzos?
According to the U.S. Drug Enforcement Administration, benzodiazepines are "depressants that produce sedation, induce sleep, relieve anxiety, and prevent seizures." The most common benzo drugs are Xanax, Valium, Ativan, Klonopin, and Restoril. Ambien is often mistaken for a benzo, but it's actually a sedative.
"Benzodiazepines, also referred to as tranquilizers, require a prescription to obtain," explains Kevin Wandler, M.D., medical director at The Recovery Village, a network of rehab centers for addiction treatment across the United States. "These medications cannot be purchased without a prescription for a pharmacy or retail store."
Benzos are generally taken orally but may be crushed and snorted when being misused. They're also available in syrups and injections. While there is a known prevalence for misuse, "the FDA does not monitor the sale of benzodiazepines per se," explains Dr. Wandler. Its job is more focused on record-keeping. "They track all benzodiazepine prescriptions, and medical providers should check if an adolescent (or any patient for that matter) has received a prescription for benzodiazepines, stimulants, or narcotics."
How Are Teens Accessing Benzos?
Most teens are accessing these drugs through friends or family members, according to a 2018 study on adolescent drug use, Monitoring the Future, conducted by the University of Michigan. The study found that teens who used tranquilizers, like benzos, in the last two years most commonly bought them from a friend or family member (45.5 percent) or got them for free from friends or family members (38.9 percent). Teens also access benzos for recreational use by buying from a dealer or stranger (24.8 percent), misusing existing prescriptions (9.3 percent), stealing them from friends or relatives (6.8 percent), or buying them on the internet (5.3 percent).
In short, this shows that the informal peer network is a major source of drug access for teens. "If teens are not getting benzodiazepines from friends, surprisingly, these drugs can also be legally purchased online," says Dr. Weinstein. When teens purchase benzos online, they are often buying a counterfeit medication often known as "designer benzos," which are not necessarily labeled or monitored as a controlled substance.
These counterfeit drugs are a combination of compounds created by pharmaceutical companies that "have a similar chemical structure and produce the same effects as their legal counterparts," says Dr. Weinstein. But they are considered extremely potent and have not been cleared for medical use. According to an overview of these designer benzos published in World Psychiatry, these drugs can cause strong sedation and amnesia at doses as low as 0.5 mg, which is difficult for dealers or users to measure. That means these designer drugs can lead to accidental overdoses.
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Since these "pharmaceutical compounds have not been declared as controlled substances, they are able to be bought and sold with little if any, trouble," says Dr. Weinstein. "There are even online communities and forums that instruct people on how to create chemical concoctions to produce the desired effects of benzos."
As for teens accessing drugs and connecting with drug dealers on social media networks, the platforms are working to curb this problem. In a statement sent to Parents.com, Facebook, which owns Instagram, says they are working to ensure illicit drug sales do not happen on the platform. "As our Regulated Goods policy explains, we prohibit attempts by individuals, manufacturers, and retailers to purchase, sell, or trade non-medical drugs and pharmaceutical drugs," says a Facebook spokesperson. "We also have a strict Advertising Policy and a Commerce Policy that prohibits the sale of opioids, prescription drugs, or the operation of online pharmacies without prior permission. We have proactive detection technology in place to find and remove such content before anyone sees it, we are constantly working to improve this technology to find more content, quickly."
Instagram also encourages parents to talk with their kids about reporting accounts they see that may be breaking these rules.
How Common Is Benzo Addiction in Teens?
Addictions to benzodiazepines is common because of their accessibility. "Between 1996 and 2013, the number of prescriptions for benzodiazepines filled increased by 67 percent to 13.5 million," says Dr. Weinstein. "They are commonly used in conjunction with other drugs, most often alcohol and opioids."
There is a risk for prescribed users to develop both a physical and psychological dependence. "Even if one is prescribed for a psychiatric condition such as anxiety or panic, be aware that in two to three months, adolescents and adults could become physically and psychologically dependent on them and have withdrawal symptoms if stopped," says Dr. Wandler.
But parents should note that it is rare for a true addiction to arise if someone is taking a legitimate and well-monitored prescription of benzodiazepines, says Ruben Baler, Ph.D., a health scientist at the National Institute on Drug Abuse. "It is more common, in fact, that intentional misusers of benzodiazepines suffer from other substance use disorders," he says. "Thus, benzodiazepines are usually a secondary drug of abuse—used mainly to augment the high received from another drug or to offset the adverse effects of other drugs."
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Signs of Teen Benzodiazepine Addiction
"Parents who are concerned their teen might be abusing or addicted to benzos should be on the lookout for symptoms, including slurred speech, impaired coordination, drowsiness, and sweating," says Freda Lewis-Hall, M.D., chief patient officer at Pfizer. "Other signs parents should be alert to include changes in diet and sleep patterns; poor job or school performance; impaired memory, focus, and attention; feelings of depression or hopelessness; changes in mood; risky behavior; avoiding people and activities they used to enjoy."
Dr. Wandler puts it simply: "Think of drug addiction looking like being drunk from alcohol, but with no smell of alcohol, as benzos work very similarly in the brain."
The Bottom Line
Though it can be hard for parents to monitor teen access to benzos, being informed about the signs of benzo addiction in teens as well as the many ways teens do have access to these drugs are the first steps to keeping your kids safe from this scary addiction.