What was at one time the most widely used prescription drug is also among the most commonly abused. Benzodiazepines are a sedative-hypnotic like alcohol and barbiturates that cause relaxation and euphoria. However, users who take them for more than a few months may become dependent on them, and addiction can lead to abuse, dangerous withdrawals, and a host of adverse side effects.

What is Benzodiazepine Addiction?

Benzodiazepines, or just benzos, are a category of psychoactive drugs that are widely used as a medicinal sedative. They work by enhancing the gamma-Aminobutyric acid (GABA) neurotransmitter at a particular receptor, which results in sedation and sleep-inducing effects. Benzos also help people with panic and anxiety disorders because of its anxiolytic effects. The neurotransmitter at play also controls muscle tone. When benzos are used, it can encourage the muscles to relax which makes the drug useful as an anticonvulsant. 

The relaxing and sedating effects work together to create euphoria, which plays on your reward center and contributes to possible benzo addiction. Benzodiazepines are recommended to be used as a short-term remedy, because long-term use can cause dependence. It’s also not recommended to be used by older people. Despite this, benzo use seems to increase with age since the largest age demographic that uses the drug are 65 and older.

After the drug was synthesized and tested in the 1950s, benzos quickly became widely used all over the world, primarily for insomnia and other problems with sleep. However, because of the adverse effects and the risk of benzodiazepine addiction, non-benzodiazepine hypnotics have recently been growing in popularity.

Benzodiazepines are a highly abused drug, but use outside the recommended dosages can lead to medical complications, addiction, and overdose. Here are some fast facts about benzo abuse:

Benzodiazepine Abuse Statistics

  • 5.2% of adults in the U.S. used benzodiazepines in 2008 
  • 30% of drug overdose deaths in 2013 were caused by benzodiazepines
  • 56% of benzodiazepine prescriptions are given because of anxiety.

Common Benzodiazepines

There are many benzodiazepines on the market today, and many of them share the same or similar effects. However, they do vary in some ways that makes them more likely to be abused. Some things to consider when you are being prescribed benzos is the strength, onset of action, and if it is a time release capsule. 

Strong, fast-acting time-release versions of the drug are more likely to be abused and create more intense highs. If you are prescribed one of these, it’s important to keep it in a safe place (especially if you have children, teens, or young adults in your household) and only use it as directed. Common benzos and their effects include:

  • Xanax is the trade name for alprazolam, a powerful short-acting drug primarily used to treat anxiety disorders. It can also be used as a sleep aid, muscle relaxant, and an antidepressant. Xanax is also sold in an extended-release form, which includes a larger dose but it releases slowly over time. However, people who abuse benzos can crush it to get all of the drug’s potency at once. Since it takes effect immediately, it can be very dangerous to take such a high dose.
  • Klonopin is the brand name for clonazepam and it’s used to treat panic disorders, seizures, and anxiety. Dependence occurs frequently in people who take it for longer than four weeks, up to a third of cases.
  • Valium is the most common trade name for diazepam and was one of the earliest benzos to be synthesized and marketed. It can treat anxiety disorders, muscle spasms, seizures, sleep disorders, and alcohol withdrawal symptoms. Like Xanax, Valium has an extended-release version on the market. However, it is slower acting, so it is less likely to be used recreationally.
  • Ativan is the most common brand name for lorazepam, which is primarily used for treating panic disorders. It can also be used to treat seizures, insomnia, and nausea induced by chemotherapy. It can begin to take effect quickly if injected intravenously and it can take around 15 minutes to take effect when taken orally. 

What are the Signs of Benzodiazepine Addiction?

Benzodiazepines are in a class of drugs called sedative-hypnotics that are known for their high addiction risk. One of the most common signs of benzodiazepine addiction is depending on it to sleep or feeling unable to cope without its effects. If you’ve tried to cut back or discontinue benzo use and had to restart because of withdrawal symptoms, you might have a benzodiazepine addiction. 

Another common symptom of benzo dependence is a change in the quality of your sleep. The drug is effective in helping people fall asleep, but it’s not proven to be useful in helping people stay asleep. You may wake up in the middle of the night or toss and turn without falling into a healthy sleep pattern. 

When you wake up, you may not feel rested, or it may take you a long time to fully wake up. People who successfully quit benzo use or abuse often report waking up feeling more refreshed than they did while on the drug. It may be ironic, but benzodiazepine use actually inhibits your sleep when it is intended to help.

If you use benzos recreationally, you are more likely to become addicted and may start experiencing some adverse effects. Several mental and physical symptoms accompany a benzodiazepine use disorder. These signs include:

  • Depression
  • Tremors
  • Dysphoria or feeling separated from reality
  • Appetite loss
  • Muscle twitching
  • Memory impairment
  • Motor impairment
  • Nausea
  • Muscle pains
  • Dizziness
  • Apparent movement of still objects
  • Lightheadedness 
  • Sensitivity to touch, sound, and light
  • Numbness or pins and needles sensation
  • Hallucinations
  • Smell sensitivity

If you are experiencing any of these signs and symptoms or if you are seeing them in someone else, it could be indicative of a benzodiazepine addiction.

Benzodiazepine Addiction Treatment

Benzodiazepine addiction treatment typically will start with medical detox. Benzos are one of a few addictive drugs that have the potential to cause life-threatening withdrawal symptoms. If you have developed a dependence on the drug, medical detox is the safest way to avoid or prepare for possible delirium tremens and seizures.

After detox, you may still have cravings that threaten your sobriety. The best relapse prevention strategy is a continuum of care. Continually pursuing recovery can help you ensure lifelong sobriety. Addiction treatment like residential and outpatient treatment can offer behavioral therapies, group therapy, and family therapy to not only show you how to deal with cravings but also to address the deeper issues that may have contributed to your addiction.

Once you’ve completed a treatment program, alumni and aftercare programs can help you safeguard your sobriety. Through 12-step programs, you can connect to a broader community of people in recovery that share your commitment to a drug-free lifestyle and can help encourage you along the way.

Who is at Risk For Benzodiazepine Abuse?

While benzodiazepines are among some of the most common prescription drugs on the market, some are more susceptible to ill-effects that others. Identifying risk factors is important if you are considering benzos or if they have been prescribed to you already. Here are two groups that should be careful about benzo use:

Older People

Benzodiazepines aren’t recommended for use among people over the age of 65. Older people are more susceptible to dangerous side effects, including dependency. Plus, benzos frequently cause drowsiness and dizziness, which can lead to dangerous falls and injures for older patients. One study showed that the benefits of sleep improvement may not be significant enough to justify the risks. Despite this, older demographics are the number one most frequent users of benzodiazepines. As of 2012, the American Geriatrics Society advised doctors to avoid prescribing benzos to older patients.

People With Depression

Benzos are primarily used to treat anxiety; however, they are sometimes used in other cases of mental illness and mood disorders like bipolar disorder. The mania symptoms associated with bipolar disorder can be calmed by certain benzos. However, benzos (and other central nervous system depressants) can make depression symptoms worse. Researchers who studied treatment-resistant depression found a link to benzos. Use of the drug was very high among people who had treatment-resistant depression. Depression is a major factor in substance use disorders in general. Your options should be weighed carefully when you have a history of depression and you are considering benzos.

Benzodiazepine Withdrawal: How Dangerous are They?

Benzodiazepines are a serious prescription drug that have a high risk for abuse. People who abuse the drug are more likely to experience dangerous side effects. Like alcohol, overuse of benzos can cause blackouts and memory loss along with several other psychological effects like paranoia and anxiety. Benzos have also shown to cause paradoxical reactions in some users. A paradoxical reaction refers to a drug effect that seems to contradict its intended use. Benzos are intended to decrease anxiety, remedy panic attacks, and relax the user. However, some users may experience behavioral disturbances, including increased irritability, hostility, and aggression.

Even benzodiazepine withdrawal can be dangerous. If you regularly abuse benzos or if you have used them for a long time (they are not recommended for use longer than a few weeks), quitting cold turkey can have some life threatening consequences. Seizures have been known to occur in instances of abrupt cessation of benzo use. Seizures may not typically be deadly but if they occur when you are alone or driving, they can be. Quitting benzos abruptly might also cause delirium tremens, a condition characterized by confusion, hallucinations, and shaking. 

In a small percentage of cases, delirium tremens can be fatal.

Benzos also carry the risk of fatal overdose. In 2015, nearly 9,000 people were killed by benzodiazepine overdose. By themselves, overdose rarely leads to deadly complications. However, benzos are much more likely to lead to a deadly overdose when combined with alcohol.

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