Benzodiazepine addiction, the number of written prescriptions and overdose mortality have increased considerably. Fatal overdoses involving benzodiazepines have plateaued overall; however, no evidence of decreases was found in any group. Interventions to reduce the use of benzodiazepines or improve their safety are needed.
What Are Benzodiazepines?
Benzodiazepines, commonly known as benzos, are a class of pharmaceutical drugs prescribed to address a range of mental disorders and ailments. These powerful medications are primarily used to treat moderate to severe anxiety, panic attacks, epileptic seizures, and withdrawal symptoms associated with other Central Nervous System (CNS) Depressants, such as alcohol. However, due to their high potential for addiction, benzodiazepines are typically prescribed for short-term use.
Under the Controlled Substances Act, benzodiazepines are categorized as Schedule IV drugs, subject to strict regulation by the US government. This classification reflects the need for caution and responsible usage of these medications.
According to NIDA;
In 2021, nearly 14% of overdose deaths involving opioids also involved benzodiazepines, a type of prescription sedative commonly prescribed for anxiety or to help with insomnia.3 Benzodiazepines work to calm or sedate a person, by raising the level of the inhibitory neurotransmitter GABA in the brain. Common benzodiazepines include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin), among others.
How do Benzodiazepines work?
Benzodiazepines possess a potent ability to alter the neurochemistry of the brain. With continued use, these drugs accumulate within the body, leading to both physical and psychological addiction. It is important to note that benzodiazepine addiction can develop even under the care of a physician and within prescribed doses, as these medications are frequently prescribed as anti-anxiety agents across various demographics.
Types of Benzodiazepines
Benzodiazepines are commonly available in the form of pills or tablets, designed for oral consumption. In some cases, certain brands, like Valium can also be administered intravenously as a clear, odorless liquid. While the legal use of benzodiazepines requires a valid prescription, it is important to acknowledge the existence of a black market for these drugs.
Street Names of Benzos
On the illicit market, benzodiazepines may be referred to by various street names such as;
- Tranks,
- Downers,
- Bars,
- Sticks,
- French Fries,
- Ladders,
- or simply Benzos.
Effects of Benzodiazepine Drugs
Benzodiazepine drugs interact with specialized neurons called GABA receptors, slowing down excessive brain activity and providing relief from severe mental distress. However, when these drugs are abused, individuals may seek a euphoric high or a sensation similar to being under the influence of alcohol, depending on the specific benzodiazepine being misused. These effects are followed by an extended period of sedation.
Benzodiazepines List
There are a lot of different Benzodiazepines, with different strengths, for different purposes, and in versions that are meant to be used long- and short-term.
Here’s a list of benzodiazepines currently in use:
Commonly Prescribed Benzodiazepines
Lorazepam (Ativan)
Clonazepam (Klonopin)
Alprazolam (Xanax)
Short-Term Benzodiazepines
Etizolam (ProSom®)
Flurazepam (Dalmane®)
Temazepam (Restoril®)
Triazolam (Halcion®)
Midazolam (Versed®)
Long-Term Benzodiazepines
Chlordiazepoxide (Librium®)
Clorazepate (Tranxene®)
Diazepam (Valium®)
Halazepam (Paxipam®)
Oxazepam (Serax®)
Prazepam (Centrax®)
Quazepam (Doral®)
Benzodiazepines encompass a range of medications that address specific needs and conditions. They can help aid insomnia, reduce anxiety and restlessness, and induce amnesia when administered with anesthesia during surgical procedures. However, it is important to acknowledge that despite being taken as prescribed, benzodiazepines can still lead to addiction. Additionally, using benzodiazepines for off-label purposes may entail similar risks and side effects as their intended use.
The most abused benzodiazepines in the United States are;
- Alprazolam,
- Clonazepam,
- Lorazepam and Diazepam.
Physical Signs of Benzodiazepine Addiction
- Doctor Shopping
- Drowsiness and Sedation
- Coordination and Balance Issues
- Slurred Speech
- Changes in Appetite
Behavioral Signs of Benzodiazepine Addiction
- Social Isolation
- Neglected Responsibilities
- Risky Behavior
- Secretive Behavior
- Financial Problems
Emotional Signs of Benzodiazepine Addiction
- Depression
- Anxiety & Panic Attacks
- Mood swings
- Increased Sensitivity
- Cravings
Benzo Withdrawal Symptoms and Timeline
Day 1 – 3
During the first three days of benzo withdrawal, individuals may experience a range of challenging symptoms. These can include rebound anxiety, which is a heightened sense of anxiety compared to baseline levels. Sleep disturbances are common, with difficulties falling asleep or staying asleep. Mood swings, irritability, and restlessness may also be present during this initial phase.
Day 4 – 7
Between day four and day seven of withdrawal, symptoms may intensify. Headaches, nausea, and gastrointestinal discomfort could become more pronounced. Muscle pain and weakness might also manifest during this time, making physical discomfort more prominent.
Week 2 – 4
During weeks two to four, the withdrawal process may still be challenging. Intense cravings for the drug can arise, and individuals may experience heightened anxiety and depression. It is essential to seek support and medical guidance during this period to manage these emotional and psychological symptoms effectively.
Week 5+
As time progresses beyond the first month of withdrawal, the intensity of symptoms generally begins to decrease. However, it’s important to note that some lingering effects may persist for several weeks or even months after discontinuing benzodiazepine use.
According to the National Institute on Drug Abuse (NIDA), taking opioids in combination with benzodiazepines can increase the risk of life-threatening overdose, as both types of drugs can cause sedation and suppress breathing.
Benzo Withdrawal: Risks and Recovery
Withdrawal from benzos poses significant challenges and potential dangers. When individuals cease or significantly reduce their benzodiazepine addiction by reducing the dosage, they may experience withdrawal symptoms that can be severe and even life-threatening. Benzo withdrawal is a complex process, and it is crucial to understand the risks involved and seek proper support.
One of the primary risks associated with benzo withdrawal is the potential for seizures, coma, and other serious complications. The abrupt discontinuation of benzodiazepines can disrupt the delicate balance of brain chemistry, leading to adverse neurological effects. It is vital to approach benzo withdrawal with caution and under the guidance of healthcare professionals who can provide appropriate tapering schedules and medical supervision.
Combining benzodiazepines with other substances, such as alcohol or opioids, during the withdrawal process can further heighten the risks. The interaction between benzos and these central nervous system depressants can increase the likelihood of respiratory depression and other life-threatening outcomes. It is crucial to avoid mixing substances and to seek professional guidance when withdrawing from benzos.
To safely withdraw from benzos, it is essential to develop a comprehensive plan that includes medical supervision, gradual tapering of the medication, and appropriate support. Healthcare professionals can tailor an individualized approach based on factors such as the specific benzodiazepine used, duration of use, and overall health. They can also provide strategies to manage withdrawal symptoms and minimize potential complications.
Remember, benzo withdrawal is a challenging process, and it is not recommended to attempt it alone or without proper medical guidance. Seeking support from addiction specialists, therapists, and support groups can be instrumental in navigating the withdrawal process and promoting a successful recovery.
Benzo Detox
The initial step in addressing a benzodiazepine addiction is the crucial process of benzo detox, which involves eliminating the drug from the individual’s system. However, this phase must be undertaken with caution, as improper withdrawal can lead to dangerous side effects, including potentially fatal outcomes.
Quitting Benzodiazepine Addiction Cold Turkey
Without proper supervision, it can even pose lethal risks. To ensure safety and mitigate severe symptoms such as seizures and suicidal behavior, a supervising physician should closely monitor the benzo detox process.
Approximately 20-30 percent of individuals undergoing untreated benzodiazepine withdrawal may experience grand mal seizures, highlighting the importance of medical supervision during benzo detox.
Medical detox provides a safe and healthy environment for individuals to cleanse their bodies from the drug while reducing the discomfort of withdrawal. By minimizing the chances of relapse, medical detox plays a pivotal role in the recovery journey. The duration of benzo detox can vary, lasting several months depending on the specific benzodiazepine used and the duration of prior use.
Tapering Down Benzodiazepine
Tapering down benzodiazepine use is a common approach during medical detox. This method involves gradually reducing the dose or transitioning to a less potent benzodiazepine. The specific tapering strategy is determined based on the severity of addiction and the type of benzodiazepine that was misused.
Diazepam (Valium) and Clonazepam (Klonopin)
are often utilized for tapering down during benzodiazepine detox. These medications, known for their longer-acting properties and lower potency compared to other benzodiazepines, help manage withdrawal symptoms as individuals gradually decrease their dosage.
During the detox period, certain medications can assist in alleviating withdrawal symptoms. Here are a couple of examples:
Buspirone
This medication is commonly prescribed to individuals with generalized anxiety disorder who have a history of substance abuse. Buspirone does not cause physical dependence and can help alleviate the emotional effects of withdrawal. It’s important to note that buspirone may take a couple of weeks to take full effect, so individuals in detox may start taking it as they gradually taper off their benzodiazepine doses.
Flumazenil
Primarily used for treating benzodiazepine overdoses, flumazenil has demonstrated some success in reducing withdrawal symptoms associated with long-acting benzodiazepines. By binding to the same pleasure centers in the brain as benzodiazepines, flumazenil can block their effects and provide relief from withdrawal symptoms. It may also be used in rapid detox methods to accelerate the removal of benzodiazepines from the body. However, caution should be exercised when using rapid detox methods, as they can intensify withdrawal symptoms.
Signs of Benzodiazepine Overdose
Learn the crucial signs of Benzodiazepine overdose to ensure timely detection and intervention during emergencies, which can potentially save lives.
Physical Signs of Benzodiazepine Overdose
- Dizziness and loss of coordination
- Confusion and disorientation
- Nausea and vomiting
- Slowed or shallow breathing
- Extreme drowsines
Behavioral Signs of Benzodiazepine Overdose
- Extreme drowsiness
- Uncharacteristic mood changes
- Disorientation and confusion
- Inability to focus or concentrate
- Lack of coordination
Benzodiazepine Addiction Treatment in Boca Raton, Florida
If you or a loved one is struggling with benzodiazepine addiction, take the first step towards recovery today. At Still Detox, we understand the challenges of overcoming addiction and provide comprehensive treatment specifically designed for benzodiazepine addiction.
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