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Our Uneasy Tranquility 

Heather Zeiger

American use of anti-anxiety pills has skyrocketed. Should we be worried?

As the opioid crisis has consumed national attention, a quieter discussion has emerged about what some are calling another, perhaps intertwined, prescription drug epidemic. In 2017, according to statistics from the National Institute on Drug Abuse, more than eleven thousand Americans died from overdose deaths involving benzodiazepines, a class of anti-anxiety drugs that includes Xanax and Valium. Those deaths — most of which also involved opioids — constituted a sixth of all U.S. overdose deaths that year, and a ten-fold increase since 1999.

While the scope of the crisis is unprecedented, Americans’ fraught relationship with anti-anxiety medications, also known as tranquilizers, is anything but new. Tranquilizers have been a staple of American life for at least a century, with the first barbiturate entering the U.S. market in 1904 and the first benzodiazepine in 1960. Although benzodiazepines have been used to treat a variety of mental illnesses and other conditions, including schizophrenia, epilepsy, insomnia, and alcohol withdrawal, the majority of patients have taken them for anxiety. According to recent statistics, roughly one in five adults in the United States experiences an anxiety disorder at some point in a given year, and one in twenty uses a benzodiazepine, the prevailing anti-anxiety medication today.

If another illness affected such a large share of the population over such a long period of time, we might raise the alarm of a public health crisis. The lack of an acute response to a century of anxiety disorders in growing numbers of people suggests that we have come to regard the widespread presence of this condition, and its treatment with psychoactive drugs, as a more or less normal part of modern life. Perhaps our culture has difficulty fully confronting the implications of this situation. Our acceptance of it suggests that anxiety might be not only a common but a reasonable response to cultural circumstances that were made by us but not entirely for us, causing many of us to feel profound unease. We seek autonomy from historical and moral authority, but are overwhelmed by the difficulty of creating our own identity; we try to fit in, while seeking to stand out; we pursue happiness, but fear we might be missing out.

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Heather Zeiger is a science writer living in Dallas, Texas and a research analyst for The Center for Bioethics & Human Dignity, a research center at Trinity International University.

Heather Zeiger, "Our Uneasy Tranquility," The New Atlantis, Number 58, Spring 2019, pp. 15-27.