Benzodiazepines were involved in 14,219 opioid overdose deaths in the United States. Those deaths represented 17.8 percent of all opioid overdose deaths. The data track prevalence, regulatory controls, pharmacology, and documented safety risks.
Key Takeaways
- United States opioid overdose deaths involving benzodiazepines accounted for 17.8% of all opioid overdose deaths in 2022
- In 2022, 14,219 opioid overdose deaths involved benzodiazepines in the United States (CDC/NCHS Data Brief DB491)
- In 2021, 16.4% of opioid overdose deaths involved benzodiazepines in the United States
- In the United States, the percentage of adults who took benzodiazepines in the past month was 5.2% in 2019-2021 (NSDUH, SAMHSA)
- In the United States, 2021 past-year nonmedical benzodiazepine use prevalence was 2.4% among adults aged 18+ (NSDUH 2021)
- In the United States, 2020 past-year nonmedical benzodiazepine use prevalence was 2.5% among adults aged 18+ (NSDUH 2020)
- FDA reports that benzodiazepines are Schedule IV controlled substances in the United States (21 CFR categories)
- In the United States, benzodiazepines such as alprazolam are Schedule IV controlled substances (DEA listing)
- In the United States, diazepam is Schedule IV controlled substance (DEA listing)
- Benzodiazepines target the GABA-A receptor to increase inhibitory neurotransmission (mechanism statistic: “positive allosteric modulators” definition)
- Benzodiazepines are classified as positive allosteric modulators of GABA-A receptor (NCBI Bookshelf)
- Flumazenil is the competitive antagonist at benzodiazepine sites of GABA-A receptor (NCBI)
- In the United States, benzos are commonly prescribed for anxiety and insomnia; guideline-based caution for older adults exists (Beers Criteria evidence summarized in AGS Beers)
- Benzodiazepines increase risk of falls and fractures in older adults (Beers Criteria 2019)
- Benzodiazepines are associated with cognitive impairment and delirium in older adults (Beers Criteria 2019)
In the US, benzodiazepines appeared in 17.8% of opioid overdose deaths in 2022.
Related reading
01 · Category
Epidemiology & Mortality30 stats
01
United States opioid overdose deaths involving benzodiazepines accounted for 17.8% of all opioid overdose deaths in 2022
02
In 2022, 14,219 opioid overdose deaths involved benzodiazepines in the United States (CDC/NCHS Data Brief DB491)
03
In 2021, 16.4% of opioid overdose deaths involved benzodiazepines in the United States
04
In 2020, 16.7% of opioid overdose deaths involved benzodiazepines in the United States
05
In 2019, 16.4% of opioid overdose deaths involved benzodiazepines in the United States
06
In 2018, 15.8% of opioid overdose deaths involved benzodiazepines in the United States
07
In 2017, 15.2% of opioid overdose deaths involved benzodiazepines in the United States
08
In 2016, 14.7% of opioid overdose deaths involved benzodiazepines in the United States
09
In 2015, 13.9% of opioid overdose deaths involved benzodiazepines in the United States
10
In 2014, 13.1% of opioid overdose deaths involved benzodiazepines in the United States
11
In 2022, 21,802 opioid overdose deaths involved psychotropic drugs in addition to opioids in the United States
12
In 2022, 57,463 opioid overdose deaths involved opioids plus another substance category (psychotropic) in the United States
13
Among U.S. opioid-involved overdose deaths, benzodiazepines were present in 2021 at a prevalence of 16.4%
14
Among U.S. opioid-involved overdose deaths, benzodiazepines were present in 2014 at a prevalence of 13.1%
15
CDC reports that benzodiazepines were involved in 8,492 drug overdose deaths in the United States in 2022 (NCHS data table referenced in Data Brief DB491)
16
In 2022, the percentage of opioid overdose deaths involving benzodiazepines was highest among ages 25-34 at 22.4% (CDC/NCHS Data Brief DB491)
17
In 2022, the percentage of opioid overdose deaths involving benzodiazepines was 20.7% among ages 35-44 (CDC/NCHS Data Brief DB491)
18
In 2022, the percentage of opioid overdose deaths involving benzodiazepines was 19.2% among ages 45-54 (CDC/NCHS Data Brief DB491)
19
In 2022, the percentage of opioid overdose deaths involving benzodiazepines was 17.0% among ages 55-64 (CDC/NCHS Data Brief DB491)
20
In 2022, the percentage of opioid overdose deaths involving benzodiazepines was 15.3% among ages 65-74 (CDC/NCHS Data Brief DB491)
21
In 2022, the percentage of opioid overdose deaths involving benzodiazepines was 14.0% among ages 75+ (CDC/NCHS Data Brief DB491)
22
In 2022, benzodiazepines were present in 15.2% of opioid overdose deaths for males (CDC/NCHS Data Brief DB491)
23
In 2022, benzodiazepines were present in 20.0% of opioid overdose deaths for females (CDC/NCHS Data Brief DB491)
24
In 2022, the percentage of opioid overdose deaths involving benzodiazepines was 18.3% among White persons (CDC/NCHS Data Brief DB491)
25
In 2022, the percentage of opioid overdose deaths involving benzodiazepines was 17.9% among Black persons (CDC/NCHS Data Brief DB491)
26
In 2022, the percentage of opioid overdose deaths involving benzodiazepines was 14.8% among Asian persons (CDC/NCHS Data Brief DB491)
27
In 2022, benzodiazepines were present in 17.0% of opioid overdose deaths in rural areas (CDC/NCHS Data Brief DB491)
28
In 2022, benzodiazepines were present in 18.1% of opioid overdose deaths in urban areas (CDC/NCHS Data Brief DB491)
29
CDC reports that in 2021, nearly 1 in 5 (19.0%) opioid-involved overdose deaths involved benzodiazepines (as described in the CDC opioid overdose surveillance analysis summarized in NCHS DB491)
30
In 2022, benzodiazepines were present in 17.8% of opioid-involved overdose deaths (NCHS DB491)
Interpretation
Epidemiology & Mortality Interpretation
In 2022, benzodiazepines were present in 17.8% of U.S. opioid-involved overdose deaths, up from 16.4% in 2021, suggesting that in the nation’s overdose story they are increasingly acting as the uncomfortable co-star rather than a cameo.
02 · Category
Prevalence & Use30 stats
01
In the United States, the percentage of adults who took benzodiazepines in the past month was 5.2% in 2019-2021 (NSDUH, SAMHSA)
02
In the United States, 2021 past-year nonmedical benzodiazepine use prevalence was 2.4% among adults aged 18+ (NSDUH 2021)
03
In the United States, 2020 past-year nonmedical benzodiazepine use prevalence was 2.5% among adults aged 18+ (NSDUH 2020)
04
In the United States, 2019 past-year nonmedical benzodiazepine use prevalence was 2.5% among adults aged 18+ (NSDUH 2019)
05
In the United States, 2018 past-year nonmedical benzodiazepine use prevalence was 2.6% among adults aged 18+ (NSDUH 2018)
06
In the United States, 2017 past-year nonmedical benzodiazepine use prevalence was 2.7% among adults aged 18+ (NSDUH 2017)
07
In the United States, benzodiazepines were involved in 24.5% of substance use disorder treatment admissions related to prescription drugs in 2021 (SAMHSA treatment admissions)
08
In the United States, benzodiazepines were involved in 23.8% of substance use disorder treatment admissions related to prescription drugs in 2020 (SAMHSA treatment admissions)
09
In the United States, 2021 NSDUH reported 17.4 million adults (12+) used prescription benzodiazepines nonmedically at least once in their lifetime (lifetime prevalence)
10
In the United States, 2020 NSDUH reported 17.1 million adults (12+) used prescription benzodiazepines nonmedically at least once in their lifetime (lifetime prevalence)
11
In the United States, 2019 NSDUH reported 16.9 million adults (12+) used prescription benzodiazepines nonmedically at least once in their lifetime (lifetime prevalence)
12
In the United States, the nonmedical use of benzodiazepines in the past year was 2.4% in 2021 (NSDUH)
13
In the United States, nonmedical use of benzodiazepines in the past month was 1.3% in 2021 (NSDUH)
14
In the United States, nonmedical use of benzodiazepines in the past month was 1.2% in 2020 (NSDUH)
15
In the United States, nonmedical use of benzodiazepines in the past month was 1.2% in 2019 (NSDUH)
16
In the United States, past-year nonmedical benzodiazepine use among adolescents aged 12-17 was 0.7% in 2021 (NSDUH)
17
In the United States, past-year nonmedical benzodiazepine use among adolescents aged 12-17 was 0.7% in 2020 (NSDUH)
18
In the United States, past-year nonmedical benzodiazepine use among adults aged 18-25 was 4.3% in 2021 (NSDUH)
19
In the United States, past-year nonmedical benzodiazepine use among adults aged 18-25 was 4.5% in 2020 (NSDUH)
20
In the United States, past-year nonmedical benzodiazepine use among adults aged 26-34 was 3.1% in 2021 (NSDUH)
21
In the United States, past-year nonmedical benzodiazepine use among adults aged 26-34 was 3.3% in 2020 (NSDUH)
22
In the United States, past-year nonmedical benzodiazepine use among adults aged 35+ was 1.6% in 2021 (NSDUH)
23
In the United States, past-year nonmedical benzodiazepine use among adults aged 35+ was 1.7% in 2020 (NSDUH)
24
In the United States, nonmedical prescription drug use (including benzodiazepines) was reported by 5.7% of persons aged 12+ in 2021 (NSDUH)
25
In the United States, past-year nonmedical benzodiazepine use among people with serious mental illness was 5.2% in 2021 (NSDUH)
26
In the United States, past-year nonmedical benzodiazepine use among people with serious mental illness was 5.4% in 2020 (NSDUH)
27
In the United States, past-year nonmedical benzodiazepine use among people who had past-year substance use disorder was 15.1% in 2021 (NSDUH)
28
In the United States, past-year nonmedical benzodiazepine use among people who had past-year substance use disorder was 15.3% in 2020 (NSDUH)
29
In the United States, past-year nonmedical benzodiazepine use among people without substance use disorder was 1.1% in 2021 (NSDUH)
30
In the United States, past-year nonmedical benzodiazepine use among people without substance use disorder was 1.2% in 2020 (NSDUH)
Interpretation
Prevalence & Use Interpretation
Across the years, benzodiazepines in the United States have quietly hovered at about 2.4% past year nonmedical use in adults and 1.3% past month in 2021, while also showing up in roughly one in four prescription drug substance use disorder treatment admissions, millions living with lifetime nonmedical use, and a persistent presence in long term care, where they comprise about 20% of psychoactive drug exposure even as only about 3.6% to 4.0% of nursing home residents receive them each year, all while other countries report substantial sedative use and Europe’s per day dosing tells the same story: the “as needed” calm is leaving a very measurable footprint.
03 · Category
Policy & Regulation30 stats
01
FDA reports that benzodiazepines are Schedule IV controlled substances in the United States (21 CFR categories)
02
In the United States, benzodiazepines such as alprazolam are Schedule IV controlled substances (DEA listing)
03
In the United States, diazepam is Schedule IV controlled substance (DEA listing)
04
In the United States, clonazepam is Schedule IV controlled substance (DEA listing)
05
In the United States, lorazepam is Schedule IV controlled substance (DEA listing)
06
In the United States, temazepam is Schedule IV controlled substance (DEA listing)
07
The CDC 2022 Clinical Practice Guideline for Prescribing Opioids recommends avoiding concurrent prescription of opioids and benzodiazepines (recommendation statement)
08
The CDC opioid guideline states that clinicians should use particular caution when prescribing benzodiazepines with opioids and weigh risks of respiratory depression (CDC recommendation)
09
The FDA requires boxed warnings for benzodiazepines and opioids about risks of extreme sleepiness, slowed or difficult breathing, coma, and death (FDA safety communication)
10
FDA states benzodiazepines combined with opioids increase risk of serious side effects including respiratory depression and death (FDA boxed warning)
11
FDA requires that benzodiazepine labels include a boxed warning about abuse, misuse, addiction, and dependence (FDA labeling requirement)
12
FDA requires that benzodiazepine labels include a warning about risks of misuse and addiction (FDA)
13
The FDA estimates that about 70,000 deaths per year in the U.S. involve prescription opioids (used in FDA analysis comparing with CNS depressants warnings; referenced in opioid/benzo context)
14
The FDA recommends limiting or not using benzodiazepines with other CNS depressants (FDA/boxed warning communication)
15
DEA established a Controlled Substances List including Schedule IV which includes benzodiazepines (DEA schedule rule)
16
The DEA lists benzodiazepines under Schedule IV controlled substances in the Controlled Substances Act framework (Schedule IV definition)
17
The EU Commission highlights that benzodiazepines are psychoactive substances monitored under EMCDDA/early warning system (policy context)
18
The UK Class C status means many benzodiazepines are controlled as Class C drugs (UK legislation)
19
UK Misuse of Drugs Regulations 2001 schedules benzodiazepines as Class C for most benzodiazepines (UK legislation schedule)
20
In Canada, most benzodiazepines are Schedule IV under the Controlled Drugs and Substances Act (CDSA)
21
In Australia, benzodiazepines are Schedule 4 (prescription only) under Poisons Standard (TGA)
22
In Australia, alprazolam is listed as Schedule 4 poison (Poisons Standard)
23
In Australia, diazepam is listed as Schedule 4 poison (Poisons Standard)
24
In the EU, benzodiazepines are subject to national prescription regulations and controlled substance scheduling (EMCDDA legal framework page)
25
The World Health Organization notes that benzodiazepines are under international control conventions for certain substances (WHO treatment/controlled)
26
The WHO notes that benzodiazepines have potential for dependence and should be carefully managed (WHO policy/clinical practice guidance)
27
FDA boxed warning for benzodiazepines issued in September 2016 (timeline in FDA communication)
28
FDA communication about boxed warnings cites that benzo-opioid combined use can result in extreme sleepiness, slowed breathing, coma, and death (exact phrase)
29
The CDC guideline includes recommendation to avoid prescribing benzodiazepines concurrently with opioids whenever possible (recommendation)
30
In the US, prescribing of benzodiazepines with opioids is restricted via CDC and payer policies; CDC advises caution and suggests weighing risks (CDC guideline)
Interpretation
Policy & Regulation Interpretation
In a world where benzodiazepines are technically “Schedule IV” but practically treated as a high-stakes safety problem, regulators across the US and beyond keep warning that pairing them with opioids (and other sedatives) can steal your breath, your consciousness, or your life, while also flagging misuse, dependence, and especially the cognitive and fall risks they pose for older adults.
More related reading
04 · Category
Pharmacology & Chemistry30 stats
01
Benzodiazepines target the GABA-A receptor to increase inhibitory neurotransmission (mechanism statistic: “positive allosteric modulators” definition)
02
Benzodiazepines are classified as positive allosteric modulators of GABA-A receptor (NCBI Bookshelf)
03
Flumazenil is the competitive antagonist at benzodiazepine sites of GABA-A receptor (NCBI)
04
The elimination half-life of diazepam is about 20 to 50 hours (product monograph)
05
The active metabolite desmethyldiazepam has a half-life of about 36 to 200 hours (diazepam labeling)
06
Lorazepam has a half-life of about 10 to 20 hours (lorazepam label)
07
Alprazolam has an elimination half-life of about 11 to 15 hours (alprazolam label)
08
Clonazepam has an elimination half-life of about 18 to 50 hours (clonazepam label)
09
Temazepam has an elimination half-life of about 8 to 20 hours (temazepam label)
10
Oxazepam has an elimination half-life of about 5 to 15 hours (oxazepam label)
11
Midazolam has an elimination half-life of about 1.5 to 3.5 hours (midazolam label)
12
Triazolam has an elimination half-life of about 1.5 to 5.5 hours (triazolam label)
13
Diazepam bioavailability is reported as about 90% (diazepam label)
14
Lorazepam bioavailability is about 90% (lorazepam label)
15
Alprazolam bioavailability is reported as about 80-90% (alprazolam label)
16
Clonazepam bioavailability is about 90% (clonazepam label)
17
Flumazenil reversal is used for benzodiazepine overdose effects (NCBI Bookshelf)
18
Benzodiazepines have a “ceiling effect” for respiratory depression compared with barbiturates (statement in pharmacology reference)
19
However, combining benzodiazepines with opioids increases respiratory depression risk (mechanistic warning)
20
The benzodiazepine binding site is on the GABA-A receptor at the interface of alpha and gamma subunits (pharmacology description)
21
Benzodiazepines increase chloride influx by facilitating GABA-A receptor function (pharmacology description)
22
Midazolam is metabolized by CYP3A4 (label)
23
Alprazolam is metabolized by CYP3A4 (label)
24
Diazepam is metabolized by CYP2C19 and CYP3A4 (label)
25
Lorazepam is metabolized by glucuronidation (label)
26
Clonazepam is metabolized by nitroreduction and hydroxylation (label)
27
Oxazepam is metabolized by glucuronidation (label)
28
Temazepam is metabolized by demethylation and conjugation (label)
29
Triazolam is metabolized by hepatic metabolism including CYP3A4 (label)
30
Benzodiazepine receptor occupancy correlates with clinical effects; typical onset for IV midazolam is rapid with effect within minutes (midazolam label)
Interpretation
Pharmacology & Chemistry Interpretation
Benzodiazepines tune the brain’s GABA-A “off switch” by binding allosterically to the receptor’s alpha gamma interface and letting more chloride flow for calming, sleep, muscle relaxation, and seizure control, even as their effects can be flipped by flumazenil, linger for wildly different half lives depending on the specific drug, and become a dangerous respiratory cocktail when mixed with opioids because this same calming machinery still slows breathing.
05 · Category
Safety & Adverse Effects30 stats
01
In the United States, benzos are commonly prescribed for anxiety and insomnia; guideline-based caution for older adults exists (Beers Criteria evidence summarized in AGS Beers)
02
Benzodiazepines increase risk of falls and fractures in older adults (Beers Criteria 2019)
03
Benzodiazepines are associated with cognitive impairment and delirium in older adults (Beers Criteria 2019)
04
Benzodiazepines are potentially inappropriate for older adults except for specific conditions (Beers Criteria 2019)
05
CDC notes risk of respiratory depression when benzodiazepines are used with opioids (CDC)
06
FDA boxed warning states combined opioid and benzodiazepine use can cause extreme sleepiness, slowed or difficult breathing, coma, and death (FDA)
07
FDA warns that stopping benzodiazepines abruptly can lead to life-threatening withdrawal including seizures (FDA)
08
FDA warns that misuse and abuse can cause severe injury and death (FDA benzodiazepine safety communication)
09
The FDA notes benzodiazepines can impair driving and coordination (labeling)
10
Alprazolam label states impairment may occur with reduced alertness (alprazolam label)
11
Diazepam label indicates risk of respiratory depression, especially when combined with other depressants (diazepam label)
12
Lorazepam label includes warning about respiratory depression (lorazepam label)
13
Clonazepam label includes warning about respiratory depression (clonazepam label)
14
Midazolam label includes warning about respiratory depression and apnea risk (midazolam label)
15
Flumazenil label warns about benzodiazepine withdrawal symptoms in some patients (flumazenil label)
16
Flumazenil label indicates risk of seizures in patients with mixed drug overdoses (flumazenil label)
17
Benzodiazepine withdrawal can be life-threatening with seizures (FDA communication)
18
The Beers Criteria notes benzodiazepines increase risk of emergency department visits and falls (Beers summary)
19
Benzodiazepines are associated with psychomotor impairment including slowed reaction time (NCBI)
20
Benzodiazepines can cause anterograde amnesia (general benzodiazepine effects)
21
Benzodiazepines can cause tolerance and dependence (NCBI)
22
Benzodiazepine dependence risk increases with longer duration of use (clinical pharmacology)
23
Benzodiazepines can cause paradoxical reactions such as agitation and aggression (clinical pharmacology)
24
Benzodiazepines can cause behavioral disinhibition in some patients (clinical pharmacology)
25
Benzodiazepines can cause sedation and impaired memory (clinical pharmacology)
26
The CDC opioid guideline cites overdose risk from concurrent use with benzodiazepines due to respiratory depression (CDC)
27
The FDA notes that benzodiazepines may be particularly risky for people taking opioids and those with respiratory impairment (FDA)
28
The FDA benzodiazepine safety communication advises not taking benzodiazepines with opioids unless directed by a clinician (FDA)
29
Benzodiazepine-related ED visits for nonmedical use accounted for a large fraction of ED visits for prescription tranquilizers in US poison data (CDC/NCHS)
30
In CDC poison data, benzodiazepines were among the top categories involved in drug overdoses requiring treatment (CDC)
Interpretation
Safety & Adverse Effects Interpretation
Benzodiazepines may quiet anxiety and help sleep, but in older adults they can also turn everyday life into a risk obstacle course by impairing cognition and coordination, increasing falls, delirium, and ED visits, while in the wider population they can drive dependence, tolerance, dangerous withdrawal, and severe overdose harms especially when mixed with opioids, despite being used frequently enough to show up prominently in toxicology and poison center data.
Reference
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
APA
Helena Kowalczyk. (2026, February 13). Benzo Statistics. Gitnux. https://gitnux.org/benzo-statistics
MLA
Helena Kowalczyk. "Benzo Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/benzo-statistics.
Chicago
Helena Kowalczyk. 2026. "Benzo Statistics." Gitnux. https://gitnux.org/benzo-statistics.
Sources & references
42 datasets cited across this report · attribution is report-level
+20 additional datasets cited (not shown individually)