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A study of more than 1.1 billion U.S. benzodiazepine prescription fills found that the number dispensed fell 26.7% between 2013 and 2024. Researchers also found an 18.3% decline in the average dose per prescription, trends they said may reflect more selective prescribing but do not by themselves establish why use fell or whether patient outcomes improved.
U.S. benzodiazepine prescription fills fell 26.7% between 2013 and 2024, according to a Rutgers Health-led study of more than 1.1 billion fills. Researchers also found an 18.3% decline in average dose per prescription, trends they said may indicate more cautious or selective prescribing, though the study does not establish what caused the changes or whether they improved health outcomes.
Published in the American Journal of Psychiatry, the study examined national trends in dispensing for benzodiazepines, a class of medicines that includes Xanax, Valium, Ativan and Klonopin. These drugs slow activity in the central nervous system and are prescribed for conditions including anxiety, panic attacks, insomnia and some seizure disorders. The researchers described the medicines as beneficial for many patients while also carrying risks, particularly with prolonged use or when combined with other drugs.
The decline appeared across the patient populations studied, with the largest decrease among adults aged 18 to 29. Researchers also reported 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 supplied report does not give the size of those changes by provider group.
The study’s lead author, Naomi Cruz, a recent doctoral graduate affiliated with the Rutgers School of Public Health and Rutgers Center for Pharmacoepidemiology and Treatment Science, said the pattern may reflect more cautious prescribing. That is an interpretation of the dispensing trends, not proof that prescribing decisions alone caused them. The study was supported in part by the National Institute on Drug Abuse; its authors said the findings do not necessarily represent the institute’s views.
Changing Patterns in Sedative Prescribing
Benzodiazepines can provide meaningful treatment benefits, but their use also requires attention to dose, duration and combinations with other medicines. The researchers highlighted concern about overdose deaths involving benzodiazepines, many of which involve other drugs such as opioids. A fall in dispensing may be relevant to efforts to reduce avoidable risks, but it cannot on its own show that fewer people experienced harm or that patients’ treatment needs were met.
The reported 18.3% decrease in average dose per prescription adds another measure beyond the number of fills. Together, the findings point to changes in both dispensing volume and the amount supplied on an average prescription. They do not show how individual patients’ care changed, whether people switched to other treatments, or how the trends affected symptoms and access to care. Those distinctions matter: a lower overall count is not automatically evidence of better care for every patient.
The shift in prescriber mix also raises practical questions about how prescribing patterns are changing across the health care workforce. The data show that prescriptions by advanced practice providers increased while those from primary care physicians and psychiatrists declined; they do not explain why. Understanding those differences may help researchers and health systems track care and safety, without assuming that a particular clinician group is responsible for the overall decline.
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A Decade of Safety Warnings
The study covers 2013 to 2024, a period during which the U.S. Food and Drug Administration issued warnings in 2016 and 2020 concerning risks associated with benzodiazepines. The source report says the warnings addressed prescribing these medicines with opioids and risks of medication misuse. The researchers place the prescribing trends alongside these safety concerns, but the study summary does not establish that the warnings caused the decline.
Benzodiazepines are used for several medical indications, so a national decrease does not mean the medicines are inappropriate for all patients. The study, titled National Trends in Benzodiazepine Dispensing, was published in 2026 and reports dispensing patterns rather than a direct assessment of individual prescribing decisions, clinical need or patient outcomes. Its authors include researchers from Rutgers and Columbia University.
What the Dispensing Data Cannot Show
The reported figures do not establish why prescriptions declined. The study summary does not separate the effects of FDA warnings from other possible influences, such as changes in clinical practice, patient needs or access to care. Nor does it report whether patients who received fewer or smaller prescriptions had comparable treatment, stopped medication under clinical supervision, or experienced changes in health outcomes.
The source material also does not provide detailed year-by-year figures, the absolute number of fills at the beginning and end of the period, or the size of prescribing changes by clinician type. The findings describe dispensing trends across populations; they do not determine whether an individual should start, stop or change a medication. The authors call for continued monitoring and further research.
Further Tracking of Prescribing and Care
The researchers say continued monitoring and additional research can clarify how prescribing practices are evolving and where care could improve. Follow-up work would need to examine the drivers of the decline, differences among patient and prescriber groups, and whether dispensing changes correspond with safety outcomes and access to appropriate treatment.
No specific next study or timetable is identified in the supplied report. For patients taking benzodiazepines, the national trend is not a substitute for individual medical guidance; decisions about medication should be discussed with a qualified health professional.
Key Questions
How much did benzodiazepine dispensing decline?
The Rutgers-led study found that the number of U.S. benzodiazepine prescription fills fell 26.7% from 2013 to 2024. It analyzed more than 1.1 billion fills.
Did the study prove that doctors became more cautious?
No. The authors said the patterns may suggest more cautious or selective prescribing. Dispensing data show what changed but do not establish why it changed or prove that prescribing decisions alone caused the decline.
What happened to the average dose per prescription?
The researchers reported an 18.3% decrease in average dose per prescription over the study period. The report says this may reflect more selective prescribing, but does not establish that explanation as the cause.
Which group saw the largest decline?
The largest decline was reported among young adults aged 18 to 29. The supplied study summary does not give the size of the decrease for that group.
Should patients change their medication because of these findings?
No individual treatment advice follows from a national dispensing trend. Anyone considering a change to benzodiazepine use should discuss it with a qualified health professional.
Source: rss
