“I’ve taken this for years. It works. Why would I stop now?”

If you’ve heard that—or said it—you’re not alone.

Many older adults have been on medications like Xanax, Ativan, or Valium for years. No major issues. No big side effects. So the thinking becomes:

If it ain’t broke, don’t fix it.

But here’s the problem:

What looks like it’s working can quietly be creating risks—especially when it comes to benzodiazepines in older adults and long-term use.

What Are Benzodiazepines and Why Are They Used?

Many older adults have been on medications like Xanax, Ativan, or Valium for years. No major issues. No big side effects. So the thinking becomes:

If it ain’t broke, don’t fix it.

Benzodiazepines are commonly prescribed for anxiety and sleep issues in older adults, including anxiety, insomnia, panic, and agitation. They work by slowing down the central nervous system—turning down the volume on an overactive brain.

And they work fast.

You take it…
You feel calmer…
You finally sleep…

That kind of quick relief is powerful—especially for someone dealing with ongoing anxiety or sleep problems.

Which is why long-term benzodiazepine use happens so easily.

Over time, the body adapts. The medication feels necessary. And what started as short-term use becomes routine.

Add in the fact that stopping can feel uncomfortable—or even scary—and it’s easy to see how someone ends up on the same medication for years.

Not because they’re doing anything wrong.

Because it worked… and no one revisited the plan.

Why Long-Term Benzodiazepine Use Is Risky for Seniors

This shift away from long-term benzodiazepine use in older adults is not a trend—it’s driven by updated safety data and national guidelines.

Benzodiazepines are listed in the Beers Criteria as higher-risk medications for seniors.

Agencies like the Centers for Disease Control and Prevention and the Food and Drug Administration have reinforced concerns due to:

Increased risk of falls and fractures in older adults

• Memory problems and confusion (often mistaken for dementia)

• Slowed reaction time and driving risk

• Physical dependence—even when taken as prescribed

• Difficult and sometimes dangerous benzodiazepine withdrawal

• Higher overdose risk, especially when combined with other medications

In short: the risks of benzodiazepines in seniors are clearer—and harder to ignore.

Safer Alternatives for Anxiety and Sleep in Older Adults

When it comes to safer alternatives to benzodiazepines, the answer is often yes—but they look different.

• Non-drug approaches for anxiety and insomnia (like sleep routines or therapy)

• Alternative medications with safer profiles for older adults

• Addressing the root cause instead of masking symptoms

Not quick fixes. But better long-term strategies for medication safety in older adults.

Questions to Start the Conversation with Your Provider

If this hits close to home, start here:

• Is this still the best medication for me at my age?

• What are the risks of continuing benzodiazepines long-term?

• If I wanted to taper off safely, what would that plan look like?

• Are there safer alternatives for anxiety or sleep?

• Could any of my symptoms be medication side effects? Learn more in Is It Just Aging or Is It My Medication?

You don’t have to commit to stopping. You just have to start the conversation.

If you or a loved one is questioning long-term medication use, polypharmacy, or benzodiazepine safety, you don’t have to sort it out alone.

That’s exactly what we do together. 👉Ask the Advocate

Cheers!

Dr. T