Benzodiazepines (benzos) are a class of drugs that are used to treat anxiety, and in some cases, seizures and convulsions. When introduced in the 1960s, benzodiazepines were hailed as a safe substitute for barbiturates, which, at the time, were claiming an alarming number of lives. Unfortunately, while benzodiazepines were safer for use than their predecessors, they are far from a perfect fix.
You may know some benzodiazepine drugs by name: Xanax (alprazolam), Klonopin (clonazepam), and Valium (diazepam) are some of the more well-known benzo drugs.
These medications can all help anxiety and panic temporarily. Unfortunately, they are also highly addictive, and they lead to both a physical and psychological dependence. These medications are not intended for everyday or long-term use. Despite this, doctors are not always as strict as they should be when prescribing, and people can find these drugs illegally.
Every year, well-meaning patients fall victim to any one of a number of benzodiazepine mistakes, including:
- Mixing the medication with alcohol or other substances and causing a medical emergency or overdose
- Attempting to drive while under the influence and getting into an accident
- Taking too much of the medication when given an as-needed prescription designed to treat acute panic attacks
- Taking larger and larger doses of the drug and becoming dependent upon it both physically and psychologically
How Do Benzodiazepines Work?
Benzodiazepines are anxiolytics (anti-anxiety), hypnotics, sedatives, and muscle relaxants. They are effective for those who suffer from anxiety disorders, seizures, or insomnia.
Benzos work by attaching to the gamma amino butyric acid (GABA) receptors in the brain. That system is important as this is the part of the brain that calms us down when we are anxious or under stress. In those circumstances, the brain produces extra GABA molecules to calm us. Benzos produce that effect artificially, making them effective in treatment for patients who suffer from anxiety, panic, phobias, obsessive-compulsive disorder, and even PTSD.
Effects of Recreational Benzodiazepine Use
Those who abuse other drugs – especially stimulant drugs like cocaine or crystal meth – sometimes use benzos to counteract the effects of stimulants; the benzos are used in the “coming-down” phase.
- Temporary relaxation
- Mild euphoria
- Counter-balance of stimulant drugs, which feels good at first, but can be deadly
Unfortunately, once the effects of the benzodiazepine wears off, the person using it may experience a surge of anxiety or irritability, which makes it tempting to take more.
Those effects, generally relatively mild in themselves, make benzodiazepines extremely habit-forming. Benzos are intended for short-term use only, and they should not be regularly refilled in order to prevent the onset of addiction. Unfortunately, too many users develop a taste too soon and, if denied by one physician, simply shop around until they find another doctor willing to write another script. Before long, the habit has set in and addiction becomes inevitable.
Like most addictive substances, benzo use and abuse quickly leads to a higher tolerance for these drugs. Higher and higher doses are required for the desired effects.
Symptoms developing from long-term use and abuse of benzos include some or all of the following:
- Panic attacks
- Impaired memory
These symptoms often lead to social and work-related problems that make things worse. People often go on to increase their doses in an effort to cope.
Benzodiazepines and Other Addictions
In addition, owing to the similarity of benzos’ effects to those of alcohol, it is not uncommon for patients to struggle with alcoholism co-occurring with benzo addiction. In fact, many experts report that benzodiazepines are not usually the sole drug of choice. Usually, they have a partner drug, often alcohol. Both of these drugs can temporarily subdue anxiety, so it makes sense that they occur together.
When fatal cases of alcohol poisoning happen, they usually result from drinking large amounts of alcohol. Fatal overdoses of benzos alone – unlike the barbiturates they have replaced – are very rare. Yet, when benzodiazepines and alcohol are taken together, the two are much more likely to result in fatal or near-fatal overdoses than when either is taken alone.
During the course of benzo addiction, the body basically stops producing its own GABA molecules, depriving itself of the natural ability to instill calm and relaxation. Quite expectedly, therefore, if the addicted person stops taking the benzodiazepine, or even tries to taper off use without support, he or she may begin to experience severe anxiety.
The real power of benzodiazepines can be fully felt once you begin to experience withdrawal symptoms that include cravings. Characteristically, withdrawal symptoms are much like those of chronic, long-time abuse, except much stronger in most cases.
They can include:
- Sleep disturbance
- Heightened anxiety
- Panic attacks
- Excessive perspiration
- Inability to concentrate
- Impaired memory
- Vomiting and nausea
- Hallucinations, seizures, psychosis and attempts at suicide
These symptoms can persist for months after the individual’s body is rid of the drug.
Most importantly, withdrawal symptoms need to be managed carefully.
Because benzodiazepine detox is can be complicated and distressing, specialized detox programs have been developed to assist patients in need. Traditional detox facilities may not have knowledge of the intricacies of benzodiazepine withdrawal. Attempting to quit the drug completely after a long-time stint of abuse can be difficult if not disastrous.
An outpatient detox and addiction treatment, when done comprehensively, can be quite effective. There are ways to manage the discomfort associated from weening off of these drugs, and the support of a team who understands and can offer applicable ways to help and manage your life going forward can make all the difference in the world.
Slow or Fast: Still a Long Haul
Most people who become addicted to benzodiazepines never imagined they could become addicted to a drug. Oftentimes, all that most people originally wanted was an escape from anxiety and panic attacks. These drugs are quite good at providing that help, yet they have a dark side – they are strongly and quickly addictive.
There is no cure for benzodiazepine addiction and no shortcuts to its effective treatment. They can be difficult drugs to kick. But it can be done, with patience, confidence and motivation.
Further Reading About Outpatient Benzodiazepine Addiction Treatment
David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton