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A Rutgers-led study of more than 1.1 billion U.S. benzodiazepine prescription fills found dispensing fell 26.7% between 2013 and 2024, while the average dose per prescription declined 18.3%. The researchers said the pattern may reflect more cautious or selective prescribing, but the data alone do not establish why prescribing changed or what it means for individual patients.
U.S. benzodiazepine prescription fills declined 26.7% between 2013 and 2024, according to a Rutgers Health-led study analyzing more than 1.1 billion fills. The researchers also found an 18.3% decrease in average dose per prescription, trends they said may indicate more cautious prescribing of medicines such as Xanax, Valium, Ativan and Klonopin.
Published in the American Journal of Psychiatry, the study examined national trends in dispensing of benzodiazepines, a class of medicines that slows activity in the central nervous system. They are commonly used for conditions including anxiety, panic attacks and insomnia, and for some seizure disorders. The study measured prescription fills and medication amounts; its findings do not show why every prescription was written or whether each patient’s treatment was appropriate.
The decline was reported across all patient populations, with the largest decrease among adults ages 18 to 29. Researchers also found a shift in the types of clinicians writing prescriptions: primary care physicians and psychiatrists wrote fewer, while prescriptions from advanced practice providers, including nurse practitioners and physician assistants, increased. The report does not provide percentages for these workforce changes in the supplied findings.
The researchers said the average dose per prescription fell 18.3% over the study period. This measure is separate from the 26.7% decline in fills and should not be read as a change in the dose taken by every patient. The study’s lead author, Naomi Cruz, a recent doctoral graduate of the Rutgers School of Public Health and Rutgers Center for Pharmacoepidemiology and Treatment Science, said the patterns may suggest more selective prescribing, while stressing the need for continued monitoring.
Prescribing Trends and Medication Risks
The findings matter because benzodiazepines can offer meaningful benefits, but their use also carries risks, particularly when they are taken with other drugs or over extended periods. The researchers note that benzodiazepines are increasingly involved in overdose deaths, many involving combinations with other substances, including opioids. The study documents a broad reduction in dispensing; it does not establish that the decline caused changes in overdose rates or improved patient safety.
For patients and clinicians, the results describe a changing national prescribing pattern rather than a recommendation to start, stop or alter treatment. A reduction in prescriptions could reflect more selective decisions, changes in clinical practice or other factors not established by the reported data. Cruz said monitoring remains important so patients who benefit from these medicines can receive care that accounts for potential risks.
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Warnings and a Decade of Change
The U.S. Food and Drug Administration issued warnings in 2016 and 2020 about prescribing benzodiazepines alongside opioids and about medication misuse risks. Those warnings form part of the relevant policy backdrop, but the study does not attribute the decade-long decline directly to either warning. It tracks dispensing from 2013 through 2024 and reports changes in fills, average dose and prescriber categories.
The research was conducted by investigators affiliated with Rutgers institutions and Columbia University. It was supported in part by the National Institute on Drug Abuse through grant K01DA050769. The authors stated that the study’s content is their responsibility and does not necessarily represent the official views of the National Institutes of Health.
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What the Dispensing Data Cannot Show
The reported results do not identify the reasons for the decline, establish whether FDA warnings or other developments drove it, or measure whether patients experienced better health outcomes. Dispensing records also cannot, by themselves, show how a patient used a medicine or whether a prescription was clinically appropriate. The supplied report does not specify the absolute number of fills, the underlying data source, or detailed year-by-year changes, so those figures cannot be assessed here.
It also remains unclear how the shifts among prescriber types affected access to treatment or the distribution of prescriptions across different clinical settings. The researchers describe the overall trends as potentially consistent with more cautious prescribing, not as definitive evidence that prescribing became safer in every case.
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Further Study of Prescribing Patterns
The Rutgers-led researchers called for continued monitoring and further research to clarify how prescribing practices are changing and where care could improve. Follow-up work would need to examine factors behind the observed trends and connect dispensing patterns with patient outcomes, including potential harms and access to treatment. No specific next study or publication date was provided in the supplied report.
For people currently prescribed a benzodiazepine, the study is not individual medical guidance. Decisions about treatment should be discussed with a qualified health professional, who can consider a patient’s circumstances and other medicines.
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Key Questions
How much did benzodiazepine dispensing decline?
The study found that U.S. benzodiazepine prescription fills fell 26.7% from 2013 to 2024. It also reported an 18.3% decline in average dose per prescription; these are distinct measures.
Which age group had the largest decline?
The researchers reported the largest decrease among adults ages 18 to 29. The supplied findings do not give a percentage for that group.
Does the study prove doctors are prescribing more safely?
No. The authors said the trends may indicate more cautious or selective prescribing. The study reports dispensing patterns and does not establish the reasons for the decline or prove improved safety outcomes.
What kinds of medicines are benzodiazepines?
Benzodiazepines include medicines such as Xanax, Valium, Ativan and Klonopin. They are used for several conditions, including anxiety, panic attacks, insomnia and some seizure disorders.
Should patients change their medication because of these findings?
The study is not a treatment recommendation. Patients should discuss medication decisions with a qualified health professional, particularly because risks can depend on a person’s circumstances and other medicines.
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