Benzodiazepine (benzos) medications are used to treat anxiety, insomnia, panic disorder, seizure disorder and, in certain cases, as muscle relaxants. They may also be used to treat symptoms of alcohol withdrawal.
As sedative-hypnotics, these drugs create a calming or tranquilizing effect, making benzodiazepines attractive as drugs of abuse and increasing their potential for addiction.
Benzodiazepines are particularly dangerous due to their potential for dependence and addiction. When abused, these drugs also carry an increased risk of overdose and adverse health effects.
Benzodiazepines are frequently abused with other drugs. In fact, 30 to 75 percent of alcohol abusers and up to 80 percent of opiate abusers also abuse benzodiazepines. This polydrug abuse increases the risk of addiction and overdose exponentially.
Comprehensive and customized inpatient drug rehabilitation gives a person a space to heal and recover from a benzodiazepine addiction.
Benzodiazepines Of Abuse
Benzodiazepines come in a variety of potencies and forms. These range from high-potency, short-acting forms to those which are low-potency and long-acting. Medications are offered as extended-release (long-acting) capsules, tablets, orally-disintegrating tablets or liquids.
Examples of abused benzodiazepine medications include:
- alprazolam (Xanax)
- chlordiazepoxide (Librium)
- clonazepam (Klonopin)
- clorazepate (Tranxene)
- diazepam (Valium)
- lorazepam (Ativan)
- midazolam (Versed)
- temazepam (Restoril)
- triazolam (Halcion)
Though not legal in the United States, flunitrazepam (Rohypnol) is smuggled in for recreational use.
When abused, these medications are most commonly taken orally. However, drug abusers also attempt to smoke, snort or inject these substances.
Signs And Symptoms Of Benzodiazepine Abuse
Most individuals who abuse benzodiazepines takes dosages greater than would be prescribed. These amounts can cause a person to act as if they are moderate to severely intoxicated, similar to the effects of alcohol intoxication.
Physical symptoms of benzodiazepine abuse include:
- altered breathing
- dry mouth
- impaired motor coordination
- low blood pressure
- slow reflexes
- trouble talking
- vision changes
Mental symptoms of benzodiazepine abuse include:
- clouded thinking
- emotional numbness
- impaired memory
- poor judgment
As dosages increase, the frequency and severity of these symptoms may increase. High doses of benzodiazepines may cause shifting moods and hostile, erratic behavior.
Drug abuse changes the landscape of a person’s life. As abuse becomes compulsive, a person’s day-to-day routines gradually shift to accommodate frequent acts of drug-seeking and using.
To ensure constant access to the drug, an individual may:
- say that they’ve lost their medication.
- steal pills from friends and family.
- steal money or items to fund their drug abuse.
- “doctor shop,” or go to multiple doctors to obtain multiple prescriptions for the drug.
- buy pills off the street.
- pretend to have anxiety or another condition treated by benzodiazepines in order to get a prescription.
Drug abuse changes a person’s behavior, causing them to act in uncharacteristic ways.
Behavioral signs of abuse include when a person:
- uses benzos more often or in greater quantities than they intended.
- cannot reduce or stop their use even if they want to.
- spends large amounts of time using the drug or being sick from its effects.
- engages in risky behaviors while under the influence.
- continues to use the drug even while knowing that it’s causing them physical or mental harm.
- continues to use the drug despite the fact it’s creating problems at home or in important relationships.
- begins struggling in school, work and/or on the job due to drug abuse.
An addicted individual may also experience a tolerance or a need to use more of the drug to achieve the sought-after effect. Further, an addicted person’s body will begin to require constant doses of the drug to function in a normal manner. This is called a dependency. A dependent person will likely exhibit withdrawal symptoms upon discontinuation of the drug.
Dangers Of Benzodiazepine Abuse
The greatest dangers of benzodiazepine abuse are addiction and overdose. The higher doses which accompany tolerance and dependence increase the danger of these risks.
Strong physical dependencies cause severe withdrawal. Withdrawal from benzodiazepines, like withdrawal from alcohol, can be deadly. The seizures and delirium tremens which result can require hospitalization, and without this care, symptoms may advance to the point of death.
Even if withdrawal doesn’t progress to this extreme, certain individuals experience post-acute-withdrawal syndrome (PAWS), which can last for months. These symptoms can make day-to-day life difficult and impair a person’s health and well-being.
A declining quality of life is a hallmark sign of addiction and a significant danger of benzodiazepine abuse. As drug abuse becomes chronic, a person’s health, relationships, livelihood and social interactions all begin to decline.
Prolonged use of benzodiazepines can cause serious mental health problems. Chronic use can have the opposite action of the medication’s prescribed effect, creating rebound anxiety.
Depression has also been linked to chronic, heavy use of benzodiazepines, especially when an addicted person stops using the drug. Certain individuals using these amounts have also been shown to have suicidal thoughts. Over time, some people may have “emotional blunting,” or struggle to feel any emotion at all.
Additional dangers of benzodiazepine abuse include the increased risk of:
- birth defects
- dementia and Alzheimer’s disease
- falls in elderly drug abusers
- motor vehicle accidents
- sexual assault (Rohypnol is used as a date-rape drug)
Signs Of A Benzodiazepine Overdose
In 2013, nearly one in three of all overdose deaths in the nation were caused by a benzodiazepine drug. In the period between 1999 and 2013, fatalities from a benzodiazepine overdose more than quadrupled. The deaths caused by benzodiazepines are second only to opioids.
Benzodiazepines create their effect by depressing or slowing, the central nervous system (CNS). The higher the dose, the greater these effects are felt. When too high of doses are taken within too short of a period of time, a person’s central nervous system slows to dangerous, and even fatal, levels. This is called overdose.
Signs of benzodiazepine overdose include:
- bluish lips and fingernails
- blurry vision
- double vision
- extreme tiredness
- slowed, labored or stopped breathing
- slurred speech
- stomach troubles
The exact signs of overdose may vary by drug and according to the person taking it.
The risk of overdose skyrockets when these drugs are abused with alcohol, opioids or other CNS depressants. This is called polydrug abuse. According to a CNN report, recent research found that 75 percent of benzodiazepine overdose deaths involved an opioid drug.
If a person appears to be overdosing, contact emergency medical services immediately.
Signs Of Benzodiazepine Withdrawal
Most people who are physically dependent to a benzodiazepine drug will exhibit symptoms of withdrawal when they abruptly stop using it or significantly decrease the amount abused.
Symptoms of withdrawal can become highly uncomfortable and debilitating and may include:
- altered perception
- difficulty concentrating
- heart palpitations
- extreme sensory stimulation
- increased blood pressure
- increased heart rate
- muscle pain and stiffness
- nausea and dry heaving
- panic attacks
- rebound anxiety
- rebound insomnia
In the most serious cases, these symptoms may be accompanied by seizures and delirium tremens.
Medically-Supervised Benzodiazepine Detoxification
A medically-supervised detox supports both the body and mind as the drug’s toxins are flushed out of a person’s system. Withdrawal can become overwhelming, and in certain cases, medications are necessary to ease these symptoms. Highly-trained clinicians and medical staff will provide compassionate support during this important transition.
When a person is benzodiazepine-dependent, they need to slowly taper off these substances so their body doesn’t react in such a harsh manner. Using a step-down method, a person’s body will become used to the removal of the drug.
Various medications may be used as needed to reduce or alleviate withdrawal symptoms. In addition, fluid hydration and nutritional supplements may be administered to help the body further stabilize.
Choosing this treatment is a critical step in the rehabilitation process. In cases of severe dependence and withdrawal, a medically-supervised detox could protect a person’s life.
Detoxification alone isn’t enough for a full recovery from benzodiazepine addiction. These treatments are merely the first step. For the greatest success and most long-lasting results, the detox program should be followed by a comprehensive inpatient rehabilitation program.
Treatment For A Benzodiazepine Addiction
The most comprehensive addiction treatment involves an individualized approach with multiple, research-based methods. Inpatient drug rehabilitation programs offer a person the most protective, healing environment in which to start building a sober life.
Every person entering into rehabilitation has a unique history and life which should inform and shape their treatment plan. Person-centric care at The Bluffs respects this and teaches recovery skills which are specific to a person’s needs and life.
Behavioral therapies are a key element of a strong treatment program. These sessions work to undo the damage caused by the addictive lifestyle. During this time, a person will also learn coping, interpersonal and relapse prevention skills which enhance their ability to live a stable, drug-free life.
Contact The Bluffs to learn more about benzodiazepine addiction treatment options.
Center for Substance Abuse Research—Benzodiazepines
U.S. National Library of Medicine—Management of Benzodiazepine Misuse And Dependence