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A Rutgers Health study of more than 1.1 billion U.S. benzodiazepine prescription fills found that fills declined 26.7% between 2013 and 2024. The average dose dispensed per prescription also fell, while prescribing patterns shifted among types of health professionals. The study suggests prescribing may have become more selective, but does not establish why the trends occurred or how they affected patient outcomes.
Benzodiazepine prescription fills in the United States fell 26.7% between 2013 and 2024, according to a Rutgers Health study covering more than 1.1 billion fills. The researchers said the decline, along with a reduction in the average dose dispensed per prescription, may reflect more cautious or selective prescribing of medicines such as Xanax and Valium. The findings describe dispensing trends; they do not establish what caused the change or whether it improved patient outcomes.
Published in the American Journal of Psychiatry, the study analyzed benzodiazepine prescription fills over the 12-year period. The medications, which also include Ativan and Klonopin, slow activity in the central nervous system and are used for conditions including anxiety, panic attacks, insomnia and some seizure disorders. The researchers found that the average dose per prescription declined by 18.3% over the same period.
The decline appeared across patient populations, with the largest reduction among adults ages 18 to 29. The study also found changes in the mix of prescribers: primary care physicians and psychiatrists wrote fewer prescriptions, while prescriptions from advanced practice providers, including nurse practitioners and physician assistants, increased. The reported results do not give a reason for those changes.
Benzodiazepines can provide meaningful benefits, the researchers noted, but carry risks, particularly with long-term use or when combined with other drugs. The study describes trends in dispensing and prescribing; it does not report that every patient received a lower dose, stopped treatment or experienced a change in health as a result.
A Shift in Sedative Prescribing
The decline matters because benzodiazepines are widely used medicines with risks that can depend on how they are taken and what other drugs a patient uses. The researchers point to overdose deaths involving benzodiazepines, often in combination with other substances such as opioids. A reduction in fills and average quantity could be consistent with more selective prescribing, but the study does not show that the observed changes caused fewer overdoses or other harms.
The findings also describe a change in who writes prescriptions. As prescriptions by primary care physicians and psychiatrists declined and those by advanced practice providers rose, monitoring prescribing across the health care workforce may help clarify how care is changing. The study does not assess whether these shifts affected access, treatment quality or safety for particular groups.
Warnings and the Study Period
The study period followed federal safety communications about benzodiazepines. The Food and Drug Administration issued warnings in 2016 and 2020 concerning use with opioids and risks of medication misuse. Those warnings are relevant context for the decade-long trend, but the study does not establish that they caused the decline in dispensing.
The findings were published in 2026 in the American Journal of Psychiatry under the title “National Trends in Benzodiazepine Dispensing.” Lead author Naomi Cruz was affiliated with Rutgers School of Public Health and Rutgers Center for Pharmacoepidemiology and Treatment Science. The research was supported in part by the National Institute on Drug Abuse; the authors said the study’s content is their responsibility and does not necessarily represent the official views of the National Institutes of Health.
Causes and Patient Outcomes
The analysis found changes in dispensing, but it does not determine why prescriptions declined. The timing of FDA warnings provides context, not proof that the warnings drove the trend. The reported findings also do not establish whether changes reflect altered clinical judgment, patient demand, access to care or other factors.
It is also unclear from the reported results how the decline affected individual patients, including whether people who needed treatment faced barriers or whether risks changed. The study reports aggregate dispensing patterns, not the appropriateness of a prescription for a particular patient. It does not measure whether overdose deaths or other health outcomes changed alongside prescribing.
Further Research on Prescribing
The researchers say continued monitoring and further research are needed to understand how prescribing practices are evolving and where care might be improved. Follow-up work could examine reasons for the decline, differences among patient groups and prescriber types, and links between dispensing patterns and health outcomes. The report does not specify a timeline for additional findings.
For now, the study offers a national account of prescription fills through 2024. It does not set treatment guidance or advise patients to change medication use. People with questions about a prescription or treatment should discuss them with a qualified health professional.
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 found an 18.3% decrease in average dose per prescription over that period.
Which patients saw the largest decline?
The researchers reported that dispensing declined across patient populations, with the largest decline among adults ages 18 to 29. The reported findings do not provide a reason for that difference.
Does the study prove prescribing became safer?
No. The researchers said the trends may indicate more cautious or selective prescribing. The study did not establish the causes of the decline or measure whether patient outcomes or overdose rates improved.
What medicines are benzodiazepines?
Benzodiazepines include medicines such as Xanax, Valium, Ativan and Klonopin. They slow activity in the central nervous system and are used for several conditions, including anxiety, insomnia and some seizure disorders.
What should patients do about their medication?
The study does not provide individual treatment advice. Patients with questions about a benzodiazepine prescription should speak with a qualified health professional before making decisions about their care.
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