Victoria Ratliff awakens in her lavish suite, the Thai sun piercing through the curtains. She blinks slowly, her head heavy. Was it too much wine again last night? Or was it the lorazepam? From the adjacent bathroom, her husband showers, oblivious to the small internal struggle playing out in her mind. The children? They lost interest in their mother long ago.
She closes her eyes for a moment, takes a deep breath, and imagines herself as someone else—someone who doesn’t need a pill to get through the day. But reality waits. As anxiety creeps in, she reaches for the bottle, pops a pill, washes it down with a sip of water, and lets the familiar calm settle in.
Though fictional, Ratliff’s story mirrors a harsh reality. In recent years, addiction to anti-anxiety medications such as Valium, Klonopin, and lorazepam (sold in Israel as Lorivan) has become a global concern, transcending age, class, and geography. What often starts as a "harmless pill for relaxation" can quickly spiral into dependence, making withdrawal a daunting challenge.
Dr. Chen Avni, a psychiatrist and deputy director of the psychiatric day treatment department at Ramat Hen Mental Health Center in Tel Aviv, explains that these medications belong to a class of drugs called benzodiazepines. "They enhance the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that slows down brain activity. In low doses, they induce relaxation, but in higher doses, they can cause drowsiness, memory impairment, confusion, and loss of balance."
While the effects are similar to alcohol, benzodiazepines lack the intoxicating high. However, prolonged use can lead to cognitive impairment, decreased alertness, and, in elderly patients, an increased risk of dangerous falls.
According to Avni, addiction often develops when usage extends beyond the prescribed timeframe. "Initially, these medications are intended for short-term relief—typically no more than six weeks," he says. "The problem arises when patients feel they can’t function without them. That’s when we see cases of dependency, sometimes at alarmingly high doses."
Shahar Cohen, a clinical social worker specializing in addiction treatment, has seen this trend intensify. "Anxiety levels across the population have been rising, especially in the past year and a half," she says. "This isn’t just an individual issue—it affects families, workplaces, and entire communities."
For many, obtaining benzodiazepines legally isn’t enough. "One former patient of mine was using 16 times the recommended dose," Avni recalls. "He bought part of his supply through his healthcare provider and the rest on the black market."
This underground trade of prescription medication underscores a major challenge: when patients become addicted, they will go to great lengths to maintain their supply. "People often don’t realize they’re dependent until it’s too late," Cohen warns. "When the thought of being without the drug becomes unbearable, that’s a red flag."
For those struggling with benzodiazepine dependency, gradual withdrawal under medical supervision is crucial. "Abrupt discontinuation can be dangerous, leading to severe withdrawal symptoms like seizures and psychosis," Avni cautions. "I’m currently treating a patient who experienced vivid hallucinations after trying to quit cold turkey. We had to introduce a slow, controlled tapering process."
Beyond physical detoxification, long-term recovery requires psychological support. "Cognitive behavioral therapy (CBT) is an effective tool, especially for sleep disorders," Avni says. "For chronic anxiety or post-traumatic stress disorder, alternative psychiatric treatments that are non-addictive should be considered."
Awareness around prescription drug dependency is growing, but change is slow. "There are still doctors who hesitate to confront addicted patients and continue writing prescriptions out of convenience or pressure," Avni notes. "But every physician prescribing these drugs should recognize the long-term risks. This isn't just a temporary fix—it can become a lifelong struggle."
Ultimately, the best way to combat prescription drug addiction is prevention. "It’s crucial to start with the lowest effective dose and treat the root cause of the anxiety, insomnia, or distress," Avni advises. "No one is immune to addiction. The key is to monitor usage, avoid increasing dosages without medical guidance, and seek alternative therapies when possible."
Cohen echoes this sentiment. "Science still can’t predict who will become addicted and who won’t, so awareness is critical," she says. "If you suspect dependence—whether in yourself or someone close to you—don’t ignore it. Seeking help early can make all the difference."
Victoria Ratliff’s story may be fictional, but the crisis it highlights is very real. For countless individuals, the journey from prescription to addiction is deceptively short. The challenge now is ensuring that those in need receive the right treatment—before their escape becomes their prison.
