The dangerous side of popular sleep and anxiety drugs like Xanax and Lorazepam

If you've been HBO’s new season of White Lotus, then you've seen Parker Posey’s character Victoria Ratliff popping a steady stream of Lorazepam while on a family vacation at a Thailand wellness resort, at one point comically declaring, “Someone stole my Lorazepam. I’m going to have to drink myself to sleep.” 

The drug, also known under the brand name Ativan, is part of a class called benzodiazepines, which also includes Xanax and Klonopin. Only available through prescription, they are used to help relieve anxiety and muscle spasms, and reduce seizures, according to the DEA. However, as seen in the show, they can lead to dependence and overuse. 

“We definitely see that a lot in real life as well,” Dr. Ian Neel, a geriatrician at UC San Diego Health, tells the New York Times about the class of drugs.

Of the over 30 million adults who reported using benzodiazepines in the last year, over 5 million misused them (described as “any way a doctor did not direct”), per 2019 data from the National Survey on Drug Use and Health. 

While some people may have taken a one-time Xanax to calm flight anxiety, for example, long-term use is what poses the most danger as it can lead to dependence. People can become dependent even when taking the prescribed amount, Dr. Ludmila De Faria, chair of the American Psychiatric Association’s council on women’s mental health, told the New York Times. 

Particularly important is the appeal of "benzos" to older adults: Those ages 50 to 64 are the biggest consumers of this class of drugs, according to the 2019 study, and need to use extra caution due to the drugs' potential effects on slowing cognition.

The class of drugs slows down the nervous system and often takes an immediate effect. And while they are generally safe when taken as prescribed for a limited time, side effects include drowsiness, memory problems, and slurred speech. Overuse can cause worsened effects, including dependence, cognitive impairment, coma, and potential death, although rare. 

Neel cautioned that older adults may metabolize drugs differently, and should be aware of the potential for negative interactions with other medications and drugs they might be taking. Combining benzodiazepines with other depressants like alcohol, for example, can exacerbate feelings of sedation, as seen on White Lotus, as Posey's character usually pops Lorazepam with a glass of wine. 

When regular users of benzodiazepines—often called benzos—try to wean off the drugs, it’s common to experience withdrawal symptoms, like sweating, headaches, and heart palpitations according to the American Addiction Centers. 

“Each benzodiazepine medication has a specific half-life that influences the length of time it takes for the drug to leave the bloodstream,” according to the Center. “If an individual is dependent on a benzo, once the drug is purged from the body, withdrawal may begin.” 

It’s important to talk to a medical doctor and a mental health professional if you think you’re experiencing any withdrawal symptoms or negative side effects from benzodiazepines because there are other ways to treat anxiety and sleep orders. “The first-line treatment [for anxiety] is typically antidepressants like SSRIs [antidepressants], plus psychotherapy,” Dr. David Merrill, a geriatric psychiatrist at Providence Saint John’s Health Center in Santa Monica, Calif. told Healthline.

This story was originally featured on Fortune.com