What Are Benzodiazepines?
Benzodiazepines are a certain class of drugs that are among the most commonly prescribed psychiatric medications. More than 15 specific benzodiazepines are approved for use by the FDA, and they are used to relieve anxiety and panic disorders, and as a short-term sleep-aid. Sometimes benzodiazepines are also used to treat certain seizure disorders.
When someone uses benzodiazepines, they affect something in the brain called GABA. GABA is a neurotransmitter with an inhibitory effect. When benzos increase the effects of GABA, it calms how neurotransmitters and nerve signals are sent in the brain. The result is feelings of calm and relaxation in users.
Some of the benzos that may be prescribed include:
- Triazolam (Halcion)
- Midazolam (Versed)
- Clorazepate (Tranxene)
- Alprazolam (Xanax)
- Lorazepam (Ativan)
- Temazepam (Restoril)
- Oxazepam (Serax)
- Estazolam (Prosom)
- Diazepam (Valium)
- Chlordiazepoxide (Librium)
- Flurazepam (Dalmane)
- Quazepam (Doral)
- Clonazepam (Klonopin)
Benzodiazepines are further categorized into groups based on whether they’re short-, long- or immediate-acting.
Benzodiazepines are classified by the Drug Enforcement Administration as Schedule IV controlled substances. Schedule IV substances have the potential for abuse and addiction, along with their approved medical uses.
Side effects of benzodiazepines can occur even when someone uses these drugs as prescribed. However, the risk of pronounced side effects is greater when large doses are used.
Potential side effects of benzodiazepines can include:
- Impaired coordination
Other side effects that are considered more severe and may require medical attention if they occur include:
- Feelings of depression
- Sleep disturbances
- Memory impairment
Long-term potential effects associated with benzodiazepine abuse include:
- Impaired thinking
- Memory and cognition problems
- Paranoia or aggression
- Changes in personality
- Loss of motivation
- Weight gain
This article is part of our series on substance abuse.
Are Benzodiazepines Addictive?
Benzodiazepines, since they affect the central nervous system, have an effect on the brain that can lead to them being addictive. When someone uses any benzo, it not only slows the functionality of their central nervous system. It can also create feelings of euphoria or a pleasant feeling. This can trigger a reward response in the brain, which then leads to addiction.
Along with becoming addicted to benzodiazepines, dependence and tolerance are possible as possible as well. Tolerance to benzos can form relatively quickly. For some people, tolerance can form in just a few weeks, meaning the person would need higher and higher doses to get the same effects.
Due to the potential for addiction and dependence, benzos aren’t supposed to be prescribed for long-term use. Instead, they’re usually only prescribed for periods of two to four weeks in many cases. The longer someone uses a benzodiazepine, the more likely addiction and dependence are.
Anytime a person uses benzodiazepine outside of how it’s prescribed or intended to be used medically, it can be considered abuse.
According to the Drug Enforcement Administration, the benzodiazepines that have the greatest addiction potential are ones that have a rapid onset. That means they take effect quickly and are most frequently used to achieve a high.
The DEA also points out that benzodiazepines are commonly combined with substances that have similar effects to increase the effects, but also with stimulant drugs as a way to alleviate the symptoms of coming down from them.
Symptoms of benzodiazepine abuse can include:
- Taking high doses of benzodiazepines—higher than what’s prescribed
- Using benzodiazepines without a prescription—for example, using someone else’s prescription or buying benzos illegally
- Taking benzos for longer than prescribed
- Using benzos in any way other than what’s prescribed, such as crushing them and snorting them
What’s common with benzodiazepine recreational abuse is often that people will combine these drugs with other central nervous system depressants to increase the effects. For example, someone might combine benzos with opioids or alcohol. This is not only risky in terms of addiction and dependence, but it can also increase the likelihood of an overdose occurring. When multiple central nervous system depressants are used simultaneously, it can cause breathing and heart rate to slow to a dangerous level. Signs of a possible benzodiazepine overdose can include:
- Impaired balance
- Impaired or slurred speech
- Slow, irregular or stopped breathing
- Paradoxical reactions such as anxiety or delirium
When someone recreationally abuses benzodiazepines, they are at risk for becoming addicted. Benzodiazepine is a chronic disorder that’s complex but treatable. Certain criteria are used to make a diagnosis. Some of the symptoms of benzodiazepine addiction can include:
- Compulsive, out-of-control use of benzodiazepines
- Continuing to use the substance even when it causes negative physical or psychological effects
- Problems with relationships or in areas of one’s life due to the use of the substance
- Wanting to stop using benzos but feeling unable to
- Intense cravings to use benzodiazepines
- Foregoing responsibilities to instead use benzodiazepines or because of the effects of benzos
A dependence on benzodiazepines is different from addiction, although the two do tend to occur together. When someone’s dependent on benzodiazepines, if they stop using them suddenly without gradually tapering their dosage, they will very likely go through withdrawal symptoms.
Benzodiazepine withdrawal symptoms can be severe and often require medical treatment.
Due to how commonly benzodiazepines are prescribed, there are a lot of statistics surround their use as well as their abuse.
The following are key benzodiazepine statistics:
- The number of overdose deaths related to the use of benzodiazepines has gone up significantly since 1996
- Between 1996 and 2013, the number of adults who filled a benzodiazepine prescription increased 67 percent—it went from 8.1 million to 13.5 million
- The median cumulative quantity of prescriptions increased by 140 percent from 1996 and 2013
- Most overdoses involving opioids also included benzodiazepines and one study indicated almost 95 percent of hospital admissions related to a benzo overdose also included the abuse of at least one other substance
- Every year there are more than 50 million prescriptions written for benzodiazepines in the United States
- 11 to 15 percent of Americans have a benzo drug at home according to the American Psychiatric Association
Struggling with benzodiazepines can be difficult, and overwhelming, but there is treatment available for benzodiazepine addiction and dependence. What begins as mild recreational use of benzodiazepines can turn into abuse and addiction. Amethyst Recovery Center offers detox and addiction treatment for benzodiazepine addiction. Please contact us for more information.