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Benzodiazepines, commonly referred to as benzos, often go unnoticed in national health discussions, overshadowed by opioids, alcohol, and marijuana. However, benzos can be highly dangerous, particularly during withdrawal or when mixed with other substances. Read on to learn everything you need to know about benzodiazepine addiction, side effects, symptoms, withdrawal, and effective strategies for recovery and prevention.
Benzos are commonly prescribed medications used to manage a variety of legitimate medical conditions, including generalized anxiety disorder, panic disorder, seizures, insomnia, and alcohol use disorder. These psychoactive drugs function by slowing down the central nervous system (CNS), creating a calming or sedative effect. This is achieved through their interaction with specific receptors in the brain called gamma-aminobutyric acid (GABA) receptors, which help to reduce brain activity and induce relaxation or sleepiness. Despite their therapeutic benefits, these medications should be used cautiously due to the risk of physical dependence and the potential for misuse.
Benzodiazepines are classified as Schedule IV controlled substances by the U.S. Drug Enforcement Administration (DEA). The scheduling system is used to classify drugs, substances, and certain chemicals used to make drugs into five distinct categories or “schedules” depending upon the drug’s acceptable medical use and its abuse or dependency potential.
Being listed as a Schedule IV controlled substance means that benzodiazepines have a lower risk of drug abuse and dependence compared to other drugs listed in Schedules I, II, and III. However, it’s important to note that this doesn’t mean the risk is nonexistent. Despite having a recognized medical purpose and being legally prescribed by healthcare providers, the use of benzodiazepines still carries a potential for chronic misuse and can lead to physical or psychological dependence, especially with prolonged use or misuse. Therefore, these medications should always be used under the guidance and supervision of a healthcare provider.
The prescription length for each benzodiazepine medication may differ based on its specific use, with some intended for long-term use and others for short-term treatment. These drugs have various medical applications and can be highly effective when used properly. However, it’s crucial to be aware of the potential risks associated with their use. When mixed with opioids or alcohol, benzodiazepines can be fatal. It’s worth noting that benzodiazepines are among the few drugs that can pose life-threatening risks during withdrawal, an important consideration if you’re planning to start or are already using these medications.
The following are the most common conditions that may result in a benzodiazepine prescription:
Benzodiazepine prescriptions depend on individual medical conditions. For instance, Xanax or Valium (known scientifically as alprazolam and diazepam) might be prescribed for those experiencing panic attacks or various anxiety disorders. On the other hand, Ativan (lorazepam) might be given to those dealing with insomnia.
All of the following are commonly prescribed benzodiazepines that interact differently with GABA-A subtype receptors to produce different outcomes.
Benzodiazepines are generally prescribed in pill or tablet form. They can also be given intravenously in hospital settings for immediate effect. The duration of their effect varies depending on the specific drug, the dosage, and the individual’s metabolism. For instance, short-acting benzodiazepines like Xanax take effect quickly but last only a few hours. Whereas long-acting benzodiazepines, such as Valium, may take longer to take effect but can last in the body for up to several days.
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Individuals who abuse benzodiazepines often exhibit signs of drowsiness, fatigue, and disorientation. There are also other side effects, which can potentially cause discomfort and heighten the risk of accidental injuries. Behavioral symptoms such as confusion, poor judgment, and short-term memory loss are also common. The most commonly observed physical, psychological, and behavioral symptoms and side effects of benzodiazepines include:
Just like opioids, cannabinoids, and the club drug hydroxybutyrate (commonly known as GHB), benzodiazepines act on the brain’s reward and pleasure centers to create a feeling of euphoria and muscle relaxation. During which they trigger a significant and addictive rise in dopamine levels. Dopamine is a neurotransmitter in the brain that’s associated with sensations of pleasure. Under normal conditions, the brain regulates the release of dopamine. However, when benzodiazepines are introduced, they interfere with the brain’s ability to control this process, leading to an uncontrolled surge of this pleasure-inducing chemical.
The brain may adapt to the presence of the drug and start depending on it to function normally. This is called physical dependence. Once the brain develops a physical dependence on the drug, a person may experience symptoms of withdrawal when they try to stop using it, which often drives them to continue taking the drug, leading to addiction or substance use disorder.
With prolonged benzodiazepine abuse, a significant tolerance can develop, which means larger or more frequent doses are needed to achieve the initial effects, leading to patterns of compulsive benzodiazepine abuse over time. Additionally, the pleasure or relief from anxiety that benzodiazepines can provide may also lead to psychological dependence. Users may begin to crave these feelings and continue using the drugs, even when they’re harmful, furthering the cycle of benzo addiction.
Benzodiazepine tolerance can gradually build when these drugs are consumed over extended periods. Many individuals prescribed these medications, particularly for anxiety, appreciate them because of their as-needed usage, and a majority of these patients can use them responsibly. However, prolonged use, exceeding the prescribed dosage, or an escalated frequency of use can instigate benzodiazepine dependence and tolerance.
It’s essential to remember that everyone’s body chemistry differs, and hence the duration it takes for an individual to develop benzodiazepine tolerance can vary greatly. The number of benzodiazepines consumed and various other factors, such as the presence of co-occurring disorders, can also contribute to the speed at which tolerance develops.
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines a sedative, hypnotic, or anxiolytic use disorder as a consistent pattern of usage that results in considerable distress or hampers daily functioning. According to this definition, at least two of the specified symptoms must occur within a span of one year for the disorder to be diagnosed.
If you or a loved one is exhibiting any signs and symptoms indicating drug abuse problems or other mental health conditions, it’s recommended to seek treatment as soon as possible. When benzo addiction is left untreated, it can lead to serious physical and psychological health complications.
Benzodiazepines function similarly to other depressants, like alcohol and opioids, by reducing the activity in the central nervous system. This slowing effect is why benzodiazepines are often prescribed medications for treating conditions such as anxiety and insomnia. However, the same characteristics that make them effective in treating these conditions also contribute to their risk factors.
When used on their own and under proper medical supervision, benzodiazepines can be safe, effective, and carry a low risk of acute toxicity. But, when combined with other depressants, they can be deadly. The combination of benzodiazepines and opioids is especially dangerous, as it causes a synergistic effect that increases the risk of severe health implications, polydrug abuse, and even death. Common side effects and potential consequences of benzodiazepine use with other drugs include:
An overdose can happen when a person consumes a dose of a drug large enough to provoke severe, potentially fatal symptoms. When it comes to benzodiazepines, the signs of an overdose may include:
While a benzodiazepine overdose alone doesn’t always result in a fatality, the danger significantly amplifies when they’re misused in conjunction with other drugs, particularly prescription or illicit opioids. This combination can escalate the risk of harmful drug reactions, multiple substance toxicity and can even prove deadly.
Benzo withdrawal refers to the unsettling symptoms that might appear if you suddenly stop using benzodiazepines after prolonged use. Benzodiazepine withdrawal can pose serious risks and, in some cases, can be life-threatening. Therefore, it’s essential for anyone struggling with benzodiazepine addiction to seek medical attention from a substance abuse treatment center. This could involve visiting a detox facility or consulting with health professionals before experiencing the onset of withdrawal symptoms.
Benzodiazepines can also cause your body to develop a physical dependency, meaning your body starts to need the drug to function normally. When a person has developed a dependency on benzodiazepines, abrupt discontinuation can lead to uncomfortable withdrawal symptoms, which is why it’s crucial to seek medical guidance during this process. Additionally, severe benzodiazepine dependence can trigger a condition called benzodiazepine withdrawal syndrome, which is characterized by severe and potentially dangerous physical, psychological, and psychosocial symptoms. Symptoms/signs can range from increased anxiety and restlessness to more serious symptoms like seizures. Managing benzodiazepine withdrawal syndrome requires professional medical help from a substance use treatment center to ensure the individual’s safety and comfort throughout the process.
If you’re experiencing benzodiazepine withdrawal, it’s an indicator that your body has become physically dependent on them. This dependency can develop even if you’re taking benzos exactly as your doctor prescribed. This is one of the many reasons why it’s usually not advised to use benzos for a long time. Moreover, long-term use of benzos can lead to benzo misuse, which is a type of sedative use disorder. In such cases, it increases the likelihood of cognitive problems and the risk of an overdose.
Benzodiazepine discontinuation after prolonged benzodiazepine use may result in withdrawal symptoms, including:
Some benzodiazepine withdrawal symptoms can be more severe than those listed above. These include more critical manifestations like seizures and psychiatric comorbidity – hallucinations or delusions. In order adults, the risk factors are even higher, with a potential for falls and cardiac complications, such as heart attacks.
Ironically, the process of withdrawal can provoke the very symptoms that led individuals to misuse these commonly abused drugs in the first place. Benzodiazepine addiction affects both physical and emotional health, causing the brain to adapt to reduced chemical production, which was previously boosted by benzodiazepine abuse. The toxic effects and associated risk factors of benzodiazepine misuse remain even after discontinuation, emphasizing the severity of benzodiazepine addiction and the importance of proper withdrawal management. Experiencing any of these critical symptoms is a clear sign you have abused benzodiazepines and that you should seek immediate medical attention.
There are many evidence-based treatments available to address benzo addiction, benzodiazepine abuse, and associated mental health conditions such as anxiety disorders. While the methods outlined below have all proven effective for countless people struggling with benzodiazepine abuse, it’s crucial to understand that what works for one person may not be as effective for another. The journey to recovery from drug addiction hardly ever follows a straight line so it’s important to explore different substance abuse treatment approaches until you discover the one that works best for you.
Below are some of the most commonly used methods and approaches to treat benzodiazepine addiction. If you or a loved one is trying to overcome a substance use disorder, reach out to explore one of our substance abuse treatment programs.
Individuals battling benzo addiction may need to complete a phase of medical detox upon discontinuation of the drug. The more you use benzos (and other dangerous drugs), the more your body gets used to their presence. When you suddenly stop using benzos, you might experience uncomfortable symptoms as the body attempts to adjust without them. This is referred to as the withdrawal period.
This crucial first stage of benzodiazepine addiction treatment is designed to manage the physical withdrawal symptoms that can arise when someone discontinues benzo drug abuse — including cravings, fatigue, and muscular discomfort. Medical detox programs can also provide help for mental health symptoms that can come up during drug or alcohol withdrawal, such as temporary bouts of depression or episodes of psychosis.
Benzo detox requires close monitoring by healthcare professionals due to the potential severity of withdrawal symptoms. The primary objective of detoxification is to minimize discomfort and ensure the patient’s safety. This process often involves a gradual reduction in dosage rather than stopping abruptly, as this helps to reduce physical symptoms, drug-seeking behaviors, and associated risks. The detoxification process is personalized, taking into account the individual’s medical history, the severity of their benzodiazepine dependence, and other co-occurring disorders, if any.
Medication-assisted treatment (MAT) is a comprehensive approach to substance use disorder treatment that uses FDA-approved medications along with counseling and behavioral therapies. Doctors may prescribe medications to be incorporated into your benzo detox plan to address the physical, psychological, and behavioral aspects of substance use disorder for improved outcomes. MAT includes both medication and psychosocial interventions to help individuals abstain from benzodiazepine drug abuse, while also restoring their overall health and well-being.
Following benzo detox, individuals are encouraged to participate in inpatient treatment for continued care and support for benzodiazepine abuse. Inpatient treatment provides a structured environment that encourages healing and recovery. This treatment option involves patients staying at a specialized facility 24/7, where they receive round-the-clock medical care and therapeutic support. This environment can be particularly beneficial for individuals with severe benzodiazepine addiction, co-occurring mental health disorders, or those who lack a supportive home environment.
In inpatient treatment, patients have the opportunity to fully focus on their recovery without the distractions and triggers of daily life. They partake in individual and group counseling sessions, recreational activities, and other evidence-based treatments. This intensive approach to recovery often results in better outcomes than outpatient treatment because of the controlled environment and focused attention on healing.
Outpatient treatment is another viable option for those dealing with benzodiazepine addiction, particularly for individuals with less severe addictions or those who cannot commit to an inpatient program due to work, school, or family obligations. Unlike inpatient treatment, outpatient programs do not require patients to reside in a facility; instead, they attend scheduled treatment sessions while living at home.
While outpatient programs provide more flexibility, they also require a significant amount of personal commitment and a supportive and stable home environment. Similar to inpatient treatment, outpatient programs offer various therapies, including individual and group sessions, to help patients understand their addiction, develop coping strategies, and build a support network.
Behavioral therapies are a core component of benzodiazepine addiction treatment and can be implemented in both inpatient and outpatient settings. Cognitive-behavioral therapy (CBT), for instance, is commonly used to help patients understand the triggers behind their substance use and develop healthy coping mechanisms. This therapy can be particularly beneficial for those struggling with addiction and co-occurring mental health disorders such as anxiety disorders, as it can provide tools for managing anxiety without the use of benzodiazepines.
Another widely used method is motivational interviewing, which aims to bolster a patient’s motivation to change and commitment to treatment. Additionally, family therapy is often used in treatment, as the involvement of family members can contribute significantly to the recovery process by fostering understanding and offering additional support for the patient. Group therapy is also often incorporated, providing a platform for patients to share experiences, learn from others, and foster a sense of community and mutual support. By addressing addiction, and underlying issues like anxiety disorders, these therapies can significantly enhance the effectiveness of benzodiazepine addiction treatment.
Aftercare is the final step in the addiction treatment process but remains crucial to long-term recovery. It encompasses ongoing therapies, support groups, and lifestyle modifications necessary for maintaining sobriety. Following the initial treatment phase, individuals might transition to a sober living home or continue with outpatient therapy.
Continued counseling or therapy can help individuals navigate the challenges of sobriety and reinforce the skills learned during treatment. Participation in support groups, such as Narcotics Anonymous or SMART Recovery, provides a community of individuals facing similar struggles and offers a forum for ongoing shared experiences and mutual support. Lifestyle modifications like maintaining a balanced diet, regular physical activity, and good sleep hygiene techniques are encouraged to support overall health and wellness, fostering a life free from benzodiazepine addiction.
If you or a loved one is struggling with benzo addiction, don’t hesitate to reach out to our dedicated team. We are here to guide you through the treatment process and provide the support and care you deserve. Contact us today to learn more about our treatment programs and take the first step toward a healthier and brighter future.
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