Benzodiazepines — a class of drugs prescribed to treat anxiety, insomnia and seizure disorders — include Valium, Halcion, Xanax, Ativan and Librium. Abuse of benzodiazepines, which were introduced in the 1950s to replace barbiturates, can lead to addiction, injury and death.

The Substance Abuse and Mental Health Services Administration (SAMHSA) study found that admissions for treatment of benzodiazepine abuse among patients 12 and older rose from 22,400 in 1998 to 60,200 a decade later. Benzodiazepine-related admissions accounted for 3.2 percent of all substance abuse admissions in 2008, compared with 1.3 percent in 1998.

Most admissions involved white patients (84.8 percent), males (56 percent), and those ages 18 to 34 (55.3 percent). Ninety-five percent of patients who abused benzodiazepines also abused other substances, and in more than three-quarters of those cases, benzodiazepine was the secondary drug of abuse.

Opiates were the primary substance of abuse in more than half of all the cases where benzodiazepine was the secondary drug of abuse. But there were age-related differences. Among teens, marijuana was the most common primary substance of abuse. Among patients 45 and older, alcohol nearly equaled opiates (42.1 percent vs. 47.1 percent) as the primary substance of abuse.

“The misuse of benzodiazepines along with other prescription drugs is fueling the rise of treatment admissions,” SAMHSA Administrator Pamela S. Hyde said in an agency news release.

“Prescription drug misuse is dangerous and can even be deadly. Everyone has a role to play in helping to prevent prescription drug misuse. Simple steps such as locking up medications and proper disposal of unused prescription medications are easy ways people can contribute to reducing the problem,” she said.

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Researchers from Switzerland and the United States found that so-called benzodiazepine drugs, such as Ativan, Xanax and Valium, exert a calming effect by boosting action of a neurotransmitter called gamma-aminobutyric acid (GABA) in the same way as addictive drugs like opioids and cannabinoids.

This in turn activates the gratification hormone, dopamine, in the brain, the scientists said, showing that the same brain “reward pathways” are used by both types of drugs.

The findings may help in developing a next generation of non-addictive benzodiazepines, they wrote in the journal Nature.

Roche’s drug Valium, known generically as diazepam, is the best known of the benzodiazepine class of drugs, which have dominated the anxiety medicine market since the 1960s.

It and Ativan were among a host of other prescription drugs found in the blood of American pop star Michael Jackson when he died in June last year.

The study found that benzodiazepines seemed to work by binding to a particular part of the GABA, which the researchers named as the alpha1 sub-unit of the GABA type A receptor.

The findings show that developing similar benzodiazepines that bind to a different part may offer the same drug benefits without the addictive side effects, they said.

A study published earlier this month found that people with higher levels of dopamine in the brain tend to be more prone to addictive behavior.

Drug companies have been trying for some time to develop next-generation benzodiazepines by tweaking their chemical make-up to deliver a more selective effect that avoids unwanted side effects, but it has so far proved an uphill struggle.

German scientists conducting early research into a new compound said last year they thought they may have found a better anxiety drug which could counteract panic attacks without the side effects of existing drugs.

In 2003 Merck & Co abandoned work on another potential anxiety drug known as GABA Alpha 2/Alpha 3, after mid-stage clinical trial results were disappointing.

(Editing by Jon Boyle/David Stamp)

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