Benzodiazepines: Everything You Need To Know
Benzodiazepines belong to a class of drugs called depressants. They slow down messages traveling between a person’s brain and their body. Typically, benzodiazepines are prescribed by doctors as minor tranquilizers.
They’re commonly used to relieve stress and anxiety and have many trade names and brands that people can get them under. In addition to these many trade names, several types of benzodiazepines are used to treat illnesses.
Unfortunately, as is the case with most drugs, there are some questions regarding their addictive properties. When people are prescribed benzodiazepines and find themselves dependent on them, the fallout can be dangerous, leading to illness or even, in some cases, death.
The National Institute on Drug Abuse (NIDA) mentions that 16% of drug overdose deaths in 2016 were due to benzodiazepines.
However, people who overdose on benzodiazepines usually take the drug without a proper prescription from a doctor. They might have been prescribed the medication sometime in the past but became dependent (and possibly addicted) to the substance through its continued use.
As with most other drugs, dependence comes from using a drug continually, leading to the brain’s chemistry changing to adapt to drug intake. Eventually, this leads to the person’s body being unable to function without the substance in their bloodstream.
Despite the common knowledge about benzodiazepines, most people don’t know where it comes from or what it does to the human body.
For most people, its efficacy with anxiety, stress, and other nervous disorders is enough to recommend it. However, there have been several studies that have shown the nefarious nature of benzodiazepine use.
Over time, the human body becomes dependent on it, leading to lapses in judgment from the individual. Knowing what benzodiazepines are and how they work on the body will help a person understand what they’re signing on for, the risks associated with it, and how to deal with the potential for abuse.
Origins of Benzodiazepines
The history of benzodiazepines starts in the 1950s. In 1955, a chemist named Leo Sternbach isolated and identified the first-ever compound of this nature. It was called chlordiazepoxide and was marketed under the trade name Librium. Valium came next in 1963.
The chemical used in this pill is diazepam, and it’s still the same compound we find today in the drugs we get from the pharmacy under this trade name.
When Sternbach discovered the first benzodiazepine, the medical community was excited. This was a compound that would do what its predecessors could while at the same time being less toxic, or so it seemed on the surface.
Because of the open acceptance of benzodiazepines by the medical practice, end-users had been prescribed the drug enthusiastically. In the mid-1970s, benzodiazepines were at the top of the “most prescribed drugs” list.
Doctors who had depended on drugs in the past that had hit-or-miss effectiveness were blown away by how useful (and seemingly non-toxic) benzodiazepines could be. Users, trusting their doctors’ judgment, went out and stocked up on the pills month after month. Unfortunately, after a decade, the truth started to come out.
Studies were done on the long-term addictiveness and impact of benzodiazepines on users. The results showed the drug was not as harmless as the medical profession first believed.
The 80s saw a rapid shift away from the “wonder drug” because of increasing findings that showed users had a high probability of becoming addicted to benzodiazepines through daily use.
When these studies were published, doctors looked for guidance. Legislators also got involved, developing strict suggestions about how medical professionals should prescribe the drug.
This attention resulted in individual benzodiazepines and even the entire class of drugs appearing with warnings about its use and distribution. However, the genuinely damning evidence didn’t come until the 90s.
During the late 80s and early 90s, the “war on drugs” that the US had begun with President Nixon went into full swing with renewed focus on addictive compounds. The American Psychological Association (APA) raised a task force whose research found that over 80% of individuals who were prescribed benzodiazepines saw withdrawal symptoms when they stopped using the drug.
Unfortunately, the public was enamored with benzodiazepines, and the study found little traction in popular culture. Despite the massive body of research, the government was slow to act.
It wasn’t until 2016 that the government took notice of the use and abuse of benzodiazepines. Several state bodies have issues warnings about long-term prescription of the drug. The FDA now issues a “black box” warning on benzodiazepines, warning against combining them with opiates. Today, the number of users continues to skyrocket despite physicians being fully aware of how dangerous the drug is.
Unfortunately, most of these users don’t get their supply from legitimate sources. The illicit benzodiazepine market is a lucrative one. However, when it is used to treat conditions legitimately, benzodiazepine can be a powerful tool.
Clinical Usage of Benzodiazepines
What are Benzodiazepines used to treat? Benzodiazepines have been approved for the treatment of several clinical ailments. Among the most common conditions that benzodiazepines are used to treat are:
Generalized Anxiety Disorder
Physicians use benzodiazepines in different dosages to treat generalized anxiety because of the calming effect it promotes. In many cases, antidepressants are used to lead a frontline treatment on anxiety, supported by benzodiazepines. In this setting, short-term (between two and six weeks typically) benzodiazepine doses are administered. If the person being treated has a history of drug abuse, the doctor usually avoids prescribing benzodiazepines.
Because of its calming impact on individuals, benzodiazepines see extensive use in treating insomnia. However, the type of drug used will vary. Physicians tend to administer drugs for insomnia that have a lower life span within the bloodstream. The idea is that the shorter their active window, the less chance there is of the person becoming addicted. Even so, regimens of using benzodiazepines to treat insomnia usually only run for two to four weeks. Physicians suggest that patients that want these drugs for the long-term treatment of insomnia may be better served by reassessing their sleep habits. Drugs are only temporary solutions at best for this disorder.
Individuals with panic disorders typically have panic attacks where they deal with intense fear and worry. The mental symptoms are usually accompanied by physical symptoms based on the body’s “fight-or-flight” mechanism. Panic attacks may happen in isolation or accompany other disorders such as depression or mood swings. Medication such as benzodiazepines can help to limit these symptoms and the frequency of attacks. Benzodiazepines are usually used at the start of treatment, with antidepressants for long-term management. These treatment windows range from two to four weeks to limit exposure and avoid dependence.
Seizures can be dangerous, and for prolonged or acute seizures, treatment can be complex. Benzodiazepines can be administered rectally or intravenously to deal with acute or prolonged seizures. Seizures can sometimes devolve into something more dangerous.
A continuous seizure that lasts over thirty minutes is known as status epilepticus. In addition to this situation, other conditions such as Lennox-Gestaut syndrome (chronic, severe epilepsy) can also be successfully treated with the drug.
In addition to these significant uses, it also sees some minor applications to deal with alcohol withdrawal symptoms and sleep disorders. Since physicians are well aware of the risks of prescribing benzodiazepines over the long term, the regimens for these treatments tend to be primarily short-term.
How do Benzodiazepines Work?
Benzodiazepines function by enhancing the effect of a neurotransmitter called gamma-aminobutyric acid (GABA). GABA is a well-known inhibitory neurotransmitter. These chemicals attach to specific sites in the brain and block (or inhibit) signals from other receptors. GABA tends to give individuals a calming effect when it’s released. On benzodiazepines, the feeling is multiplied, making it seem more effective.
Since anxiety comes from overstimulation, taking benzodiazepines will allow for a more serene, calming effect on the person’s mind.
Negative Side Effects of Benzodiazepines
One of the most common side-effects associated with this class of drugs is drowsiness. Since the drug tends to calm the brain down, it’s evident that drowsiness would follow soon after.
As with other medicines that cause drowsiness, there are certain things that individuals should not do while under the influence. Driving and operating heavy machinery all fall under the blanket of actions that someone shouldn’t do while using this class of medications.
Typically, when they’re used alone, benzodiazepines have low toxicity. Unfortunately, they are rarely ever used on their own and are usually administered alongside other drugs.
The other drugs may enhance the toxic effects of this class of medications. One of the most well-known interactions is that of selective serotonin reuptake inhibitors (SSRIs) and diazepam. When they’re used together, the SSRIs cause an increase in the concentration of diazepam in the bloodstream.
There have been some reports of memory impairment in individuals taking benzodiazepines. Research has shown that the use of benzodiazepines can lead to anterograde amnesia.
In non-specialist terms, people lost some of their memory capacity on occasion when they took the drug. The memory associated with a person’s most recent events (known as episodic memory) is most inhibited. In patients that have taken therapeutic doses for over a year, other problems are shown up.
Some of them may display problems in visuospatial ability and may also show a lowered attention span thanks to their use of the drug.
With some patients, taking benzodiazepines can increase their aggression and hostility to others. In some people, this can lead to them lashing out violently, endangering people near to them.
While this is a behavior that one may see in patients who take the drug, it is confined in its impact. The most commonly impacted patients are children, the elderly, and persons with social development disabilities. Scientists think that this side effect may be linked to a person’s ability to understand and use social restraints.
One of the more dangerous fallouts from benzodiazepine use is depression and emotional blunting.
Some studies have shown that continued use of the drug can lead to suicidal ideation. However, further research suggests that these side effects may be related to dosage, and discontinuing the treatment may lead to a better outcome.
“Emotional anesthesia” may also show up where a person cannot tolerate their emotions and the stresses of everyday life. This condition is most commonly noticed in individuals who are dependent or addicted to benzodiazepines.
Benzodiazepine Addiction Risk Factors
Addiction to benzodiazepines starts with tolerance and dependence. Most of the research on the topic suggests that tolerance to the class of medication progresses at different degrees. The amount of progress depends on the specific drug and the time over which it was used.
If used to treat insomnia, tolerance may develop very quickly. Usually, patients may realize that they need more of the drug to maintain the same effects within a few weeks. In contrast, usage for the treatment of anxiety-related conditions develops very slowly.
However, even with the slowed tolerance, studies suggest that the efficacy of the drug tapers up to six months, after which it stops being useful.
Dependency usually comes after tolerance. When someone uses benzodiazepines over a long period, their body and brain adapt themselves to using them. Because of this, the body starts getting withdrawal symptoms if the individual stops using the substance. Dependence tends to develop sooner in high-dosage cases than in low-dosage cases. However, as long as someone keeps using the drug, they will eventually become dependent on it.
When dependence leads to other types of behaviors such as drug-seeking or risky behavior in search of the drug, the patient may be classified as addicted. Other risky behaviors include combining alcohol with benzodiazepines to get the desired effect.
How are Benzodiazepines Taken?
When prescribed by a doctor, these drugs are usually dispensed as pills. In illicit circles, individuals may opt to inject (shoot) the drug into their bloodstream. This approach raises the risk of an overdose significantly. There have also been cases where individuals have crushed and snorted benzodiazepine pills, particularly Xanax. This approach also leads to a faster onset of euphoria, but may also carry a significant risk of overdose.
Withdrawal and Recovery
If someone uses benzodiazepines over a long period, they may become addicted to it. To deal with this addiction, individuals may need to go through detoxification. The body’s physical and mental rewiring will be put to the test, and the cravings for the substance may be too much for some to avoid. Withdrawal usually begins within the first few hours of taking the drug. Once the initial feeling wears off, the body starts craving another helping.
Short-term withdrawal symptoms are primarily anxiety-based. Additionally, patients may have a faster heartbeat, insomnia, and sensory hypersensitivity. In extreme cases, abrupt discontinuation may lead to delirium tremens.
The short-term withdrawal symptoms tend to be the most intense and usually taper off within a few days to a week. However, long-term withdrawal is also something to consider.
Prolonged symptoms from weaning oneself off benzodiazepines include depression, anxiety, and insomnia. Withdrawal symptoms can be reduced by tapering the drug from high dosages to lower ones. However, even in tapered dosages, these long-term withdrawal symptoms may linger for some time. Long-term treatment options should include some form of therapy (such as cognitive behavioral therapy) to help manage these symptoms and the urges that may follow them.
Types of Benzodiazepines
Within the United States, there are several major manufacturers of benzodiazepines. These drugs can be used to deal with different classes of disorders. A disorder may be related to several brand names. Among the most common benzodiazepines used in treatment are:
- alprazolam (Xanax, Xanax XR): usually used in treating panic and anxiety disorders
- chlordiazepoxide (Librium): Alcohol withdrawal treatment and anxiety medication
- diazepam (Valium, Valtoco): seizure disorder treatment, anxiety management, sedation, and alcohol withdrawal management
- flurazepam (Dalmane): insomnia treatment
- clonazepam (Klonopin): seizure and neuralgia treatment
- lorazepam (Ativan): insomnia and sedation
- temazepam (Restoril): insomnia treatment
These are a small cross-section of benzodiazepines in circulation, but it shows how widespread this drug is and the number of things it can treat.
Street Names for Benzodiazepines
Because the illicit trade in benzodiazepines deals in several different types of the drug, those dealing in it have made easier to pronounce analogs that they use in their trade. Among the street names for benzodiazepines are:
- Sleeping Pills
- Nerve Pills
These slang terms may apply to the general class of drugs or may focus on a particular benzodiazepine brand name. For example, Downers and Tranks are usually used to refer to Valium.
Benzodiazepines and Alcohol Use
When individuals are addicted to benzodiazepines, they start combining them with other drugs to increase the feelings it gives. One of the most common combinations that happen is with alcohol. Every commercial benzodiazepine product cautions against the use of alcohol while on the drug.
By themselves, both this drug and alcohol have their own associated risks of abuse. In combination, the chances are magnified. Taking them in concert creates a fertile ground for dependency that usually leads to addiction.
Both alcohol and benzodiazepines are central nervous system depressants. By combining them, there’s a much higher chance of an overdose. Additionally, since the human body usually metabolizes alcohol before other things, benzodiazepines stay in the bloodstream for longer.
Both alcohol and benzodiazepines can cause drowsiness in isolation. Together, they make it even more dangerous for someone to drive a car or operate heavy machinery. This also means that reflex reactions are also impaired. When someone is on both of these substances together, they risk their lives in multiple ways.
There are a lot of side effects that are unstudied in individuals that combine these substances. When using both of them in combination, the side effects that each produce can linger, making it much more uncomfortable for the individual.
Finding a Way to Overcome Benzodiazepine Dependency
When someone is dependent on benzodiazepines, it may seem as though everything is against them. Getting out of the dependency cycle starts with deciding to go to a rehabilitation center.
Divine Detox is one of the best-regarded centers in California. We provide customized treatment options for each visitor, along with the necessary tools to overcome substance dependence.
If you’re looking for a place to safely and securely detox, from benzodiazepines or other substances, contact us today to make an appointment. Let us help you overcome the grip of addiction and live a healthier, more rewarding life.