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Is Xanax Dangerous? What's Hype and What Are the Real Threats?

A lethal combination of benzos and booze may have killed Whitney Houston. Is one of the most overprescribed (and profitable) drugs in America really that dangerous?

Photo Credit: Neno843 at Flickr.



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“Killed by Prescription Drugs” was the soundbite that headlined much of the instant media coverage of Whitney Houston's sudden death on Saturday. Some reports even named Xanax, a benzodiazepine, as the culprit; others repeated rumors of a Xanax/Ativan/Valium triple-benzo cocktail. If by Monday, after 24 hours of nonstop Whitney news—or non-news—the benzos were set to become the new Rx drug we love to hate, today it appears that medical reality has been, to some extent, restored, with the media reporting that a combination of benzos and booze took her life. But a  TMZ story sourced to a law-enforcement officer reported that Houston had what in the context of celebrity culture passes for a genuinely modest set of prescriptions: Xanax, Ibuprofin for pain, Midol for menstrual cramps, and the antibiotic amoxicillin for an upper respiratory infection. (A toxicology report will not be available for a month or more.)


The fact is that Xanax taken on its own is  rarely lethal. Benzos in general are simply not very toxic, except when taken in huge amounts—as in a suicide attempt. The problem with the Death-by-Xanax headlines, then, is that not only are they misleading, but that they also confuse the public, simultaneously obscuring the benefits of this class of sedatives and their more serious dangers: their addictiveness. When prescribed to a chronic addict like Whitney Houston, Xanax and the other benzos are likely to become habit forming—and downright harrowing to kick.

In certain morning-after eulogies, Houston, who blazed trails as the first African-American R&B singer to take pop music by storm, was likened, talentwise, to Judy Garland, widely regarded by her peers as the world’s greatest-ever entertainer. Oddly, it appears the two women’s deaths share several distressing details—both perished at 48, from heart and lung failure due to a combination of alcohol and sedatives, in a bathroom, alone. 

The toxicology report on Judy Garland, who died in 1969, revealed that her blood contained the equivalent of 10 capsules of the barbiturate Seconal.

Ironically, when the first benzodiazepines hit the market—Librium in 1960 and Valium ten years later—they were hailed as a great advance over barbiturates for the very reason that benzos appeared to be far less toxic and therefore harder to OD on. But just as Seconal, Nembutal and other “dolls” bagged some of Hollywood’s biggest hides, including Marilyn Monroe, Jimi Hendrix and Tennessee Williams, so Xanax can claim a star-studded (and growing) roster of RIPs, including, Michael Jackson and Heath Ledger. These and the vast majority of other fatal overdoses involve Xanax taken, not alone, but with a cocktail of other psychoactive drugs and/or alcohol. Anna Nicole Smith OD’d on nine such drugs, including four different benzos.

Xanax, approved in 1980 for the then-brand-new diagnosis of “panic attack,” is America’s most (over)prescribed psychiatric drug, outpacing even the antidepressants that made us “The Prozac Nation.” Every year, doctors write more than 50 million benzo scrips—more than one per second—and 11% to 15% of all adult Americans have a bottle in their medicine cabinet,  according to the American Psychiatric Association (APA). While only 1% are daily benzo users—denoting abuse or addiction—the prevalence of benzos is, somewhat paradoxically, exceptionally high in psychiatric and addiction treatment centers. These very addictive molecules are commonly given to alcoholics and opiate addicts to quell the existential fear and trembling that accompanies withdrawal during detox.

The popularity of benzos can be measured by their blockbuster sales: Xanax is ranked number nine on the list of the nation's top-earning drugs; Klonopin, no. 32, Ativan no. 33 and Valium (still, after 40 years!) no. 51. These rankings are even more remarkable when you consider that all four drugs are available as generics, costing pennies per pill. Are we really, as a nation, that panicked?

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