What are Benzodiazepines? Understanding the Addiction
Benzodiazepines belong to the prescription tranquilizers or sedative class of drugs and are the most commonly prescribed controlled substances drugs in the U.S. In 2023, more than 30 million adults reported taking a benzodiazepine within the past year. Of this, misuse accounts for 17.2%.
They are prescribed for many conditions, including:
- Insomnia
- Seizures
- Muscle spasms
- Anxiety disorder
- Panic disorder
The most commonly prescribed benzodiazepines according to a 2016 study are:
- Lorazepam (51%).
- Clonazepam (20%).
- Diazepam (14%).
- Alprazolam (14%).
There are many street names but the most common is Benzos. Others are: xannies, vallies, roofies, tranks, downers, goofballs, Mexican, roach, heavenly blues, valo, stupefi, anxiety drugs, date rape drugs, or club drugs.
Benzodiazepines release the neurotransmitter GABA (gamma-aminobutyric acid), slowing down your central nervous system resulting in muscle relaxing, anti-anxiety, sedative and hypnotic characteristics. They also temporarily block the formation of new memories.
Because of these qualities, they can create severe dependence with psychological cravings and be difficult and dangerous to withdraw from.
Benzo Addiction Diagnosis: What are the Signs?
Benzodiazepine misuse has many complications:
- Benzos have a potential for misuse which is widespread.
- They can be habit-forming from long-term use or misuse.
- There’s a risk of overdose. Misusing benzos can be dangerous and an overdose can stop your breathing.
- They can interact dangerously with alcohol and certain drugs.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, used by psychiatrists to diagnose mental health conditions, describes benzodiazepine abuse or addiction as Hypnotic, Sedative, or Anxiolytic Use Disorder.
At least two of a possible 11 symptoms must show within a 12-month period. The diagnostic criteria include:
- Often taking larger amounts of sedatives, hypnotics, or anxiolytics than planned
- Considerable time is spent getting the drug, using it, and recovering from its effects.
- When the drug is not in a person’s system, the person experiences withdrawal, which can include cravings for the drug.
- Experiencing strong cravings for the substances
- A persistent desire or unsuccessful attempts to cut down on the use
- Over time, more of the drug is needed to achieve the familiar desired effects (i.e., tolerance).
- The person experiences impaired performance at home, work, or school due to the drug’s effects.
Addicts may be secretive and go doctor shopping, seeking to fill prescriptions with multiple doctors.
Physical signs that indicate addiction include:
- Drowsiness or apparent disorientation
- Slurred speech or unsteady walk
- Poor judgment and decision-making abilities
- Feeling unsteady, having slow reflexes
Benzodiazepine Overdose & Abuse Symptoms
Benzodiazepine overdose symptoms can appear suddenly and can vary in intensity. Immediate medical attention is required. The key symptoms include:
- Extreme drowsiness or being unable to stay awake
- Confusion and cognitive impairment
- Slurred speech and difficulty speaking
- Unsteady or impaired coordination
- Muscle weakness
- Shallow or slow breathing
- Blurred or double vision
- Dilated pupils
- Rapid heartbeat or irregular pulse
- Sweating profusely
- Low blood pressure
- Nausea and vomiting
- Seizures
- Loss of consciousness
Those who abuse benzos typically take higher than prescribed doses and often mix them with other substances such as alcohol or opiates because of their fast-acting nature and euphoric effects. About 75% of deaths that involve benzodiazepines also involve an opioid drug.
When used alone, benzodiazepines carry an extremely low risk of acute toxicity. However, when taken with other drugs with abuse potential, these drugs can enhance the toxic effects of benzodiazepines. The latter interacts with other central nervous system depressants and leads to fatal overdoses.
Withdrawal Symptoms
Acute withdrawal symptoms are many. Here are the main ones
Physical
- Headache
- Palpitations
- Sweating
- Tremor
- Muscle pain, stiffness and aches (limbs, back, neck, jaw)
Neurological
- Dizziness, light-headedness
- Shooting pains in neck and spine
- Blurred vision and other visual problems
- Confusion, disorientation
- Delusions, paranoia
- Hallucinations (visual, auditory)
- Grand mal seizures 1–12 days after discontinuing benzodiazepines
Gastrointestinal
- Nausea
- Anorexia
- Diarrhea (may resemble irritable bowel syndrome)
Psychological
- Insomnia, nightmares
- Anxiety, panic attacks
- Irritability, restlessness, agitation
- Poor memory and concentration
- Depression, dysphoria
Protracted withdrawal symptoms occur in patients who have withdrawn from benzodiazepines and remain with long-term withdrawal effects. It describes withdrawal symptoms which persist for months and even many years after benzodiazepine cessation. These may include:
- Anxiety
- Depression
- Insomnia
- Sensory symptoms
- Motor symptoms
- Poor memory and cognition
- Gastrointestinal symptoms
Risks of Benzo Addiction
Long term benzo use may not only lead to physical dependence (addiction). They can also lead to psychological dependence where people may feel they need the drug to cope with daily life. This can lead to memory loss, emotional instability and an increased risk of developing depression or other mental health disorders.
An internet survey of current and former benzodiazepine users revealed the following symptoms:
- Low energy
- Difficulty focusing, distractedness
- Memory loss
- Nervous, anxiety
- Sleep disturbances
- Sensitivity to sights and sounds
- Digestive issues
- Muscle weakness
- Body aches and pains
In addition there may be important social consequences including strained family and friendship relationships, job loss and economic hardship and possible legal problems related to obtaining drugs.
Available Treatment for Benzo Addiction
Medical Detox: The first step is medically supervised detox to prevent withdrawal symptoms, including seizures. This can be done in a residential treatment facility, a hospital, or at home with the guidance of your doctor. This tapering-off process may take 10 weeks or more.
Inpatient Residential Treatment: No medication has been shown to be effective for treating benzodiazepine use disorder. An addiction treatment center with trained therapists and medical professionals provides the best setting for working through your addiction on your journey to recovery.
Therapies: There are a number of therapeutic approaches which may be used. Trauma-focused Cognitive Behavioral Therapy (CBT) helps by reframing your negative thoughts and setting goals to work towards. Other therapies include: Dialectical behavior therapy (DBT), Acceptance and commitment therapy (ACT), Somatic Experiencing and Body Work, and Grief Recovery.
Outpatient: With medical supervision, you may be able to recover at home if your symptoms are less severe. You would attend group and individual counseling with others in recovery, led by trained counselors and therapists.
Relapse Prevention: Support from family and friends or others who have been addicted and are now in recovery is essential to help prevent relapse. Support groups such as community-based outpatient groups or 12-step programs are advised to have help on an ongoing basis.
Choosing The Encino Recovery and Detox Center for your detox and Inpatient Rehab in Encino, CA means opting for a holistic, compassionate, and effective approach to your well-being.
Our inpatient rehab program is meticulously designed to navigate the unique challenges encountered by individuals dealing with benzo addiction and concurrent mental health issues. This ensures a tailored strategy that addresses your specific needs and fosters a sustainable recovery.
Sources
Robertson S, et al. 2023. Benzodiazepine Use Disorder: Common Questions and Answers.Am Fam Physician. 2023;108(3):260-266
Benzodiazepines (Benzos). 2023. Cleveland Clinic.
Longo, L B. Johnson. 2000. Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. Am Fam Physician. 2000;61(7):2121-2128
What Is Benzodiazepine Protracted Withdrawal? Benzodiazepine Information Coalition.
