What are Benzodiazepines?

Benzodiazepines (BZD) are considered a depressant, which means they slow down the messaging between the brain and the body. Generally, benzodiazepines are prescribed by a physician to treat a variety of conditions, including but not limited to anxiety, sleep disturbances, and epilepsy. Whether prescribed by a treating physician or not, benzodiazepines are highly addictive.

Benzodiazepines are divided into three categories: long, intermediate, and short-acting. Ironically, short-acting benzodiazepines have “stronger withdrawal symptoms and can be more addictive than long-acting ones.” These BZD drugs are also referred to as benzos.

Common brand names include Valium, Diazepam, Librium, Tranxene, Ativan, Murelax, Serepax, Xanax, and Klonopin. All these benzo drugs should be used in conjunction with other therapies: psychological treatments and antidepressants, and lifestyle changes. In general, they are not recommended for use over time. Depending on the type of benzodiazepine prescribed, use can range from a few days to, at most, a few weeks.

Do not be lulled into complacency because your physician prescribed you medication. Sadly, many primary physicians are unaware of the addictive nature of many prescribed drugs. Your prescribing physician needs to understand other drugs you may be taking—this information can avoid negative interactions between drugs.

How Do Benzodiazepines (BZD) Work?

BZDs act as sedatives. They slow down the central nervous system while decreasing brain activity (the brain’s ability to send messages to the body). In 2020, over 93,000 people lost their lives to a drug overdose. Further, 16 percent of overdose deaths involving opioids also involved benzodiazepines. Some researchers are now finding benzodiazepines in illicit street opioids, the chemical composition of which are unknown to the consumer.

Depressants cause physical depression, muscular relaxation, and sedation. Sedatives depress most body functions, so activities that require alertness and muscular coordination should be avoided.

Some of the effects of sedatives are:

  • Feeling of relaxation
  • Reduced anxiety
  • Lowered inhibitions
  • Reduced intensity of physical sensations
  • Lightheadedness
  • Drowsiness
  • Slurred speech
  • Shallow breathing
  • Slowed heart rate
  • Muscle incoordination
  • Constipation
  • Reduced dexterity
  • Impaired learning during the period the sedative is active
  • Interruptions in memory

Mixing Benzodiazepines and Other Substances

Taking more than one drug within the same category, such as benzos and alcohol (also a depressant), can lead to overdose and death. As stated above, depressants slow bodily functions, this includes breathing. Fatal AND non-fatal overdoses increased from 2019-2020 in the US and worldwide. Many cases involved illicit benzos; though drug deaths from prescribed drugs still outnumber deaths from illicit benzos. There is evidence that this may be changing. The number of people taking Novel benzodiazepines (illicit benzos) has been increasing worldwide.

“Globally, benzodiazepines are among the most widely prescribed psychotropic drugs with over 30 different variations, each with common mechanisms of action which produce a range of similar effects for individuals.”

Street drugs, in combination, are always dangerous, as the chemicals in the drugs are questionable. But taking a variety of prescribed drugs is dangerous as well. “Abuse of benzodiazepines is often associated with multiple-substance abuse. Users of diazepam and alprazolam combine methadone to potentiate [increase or prolong] methadone’s euphoric effect. Cocaine addicts use benzodiazepine to relieve the side effects (irritability and agitation) associated with cocaine binges…”

Addiction can happen to anyone, whether the drugs are prescribed or not. Remember that drugs must be taken as directed, not increased or decreased at will. Adding medications prescribed by another provider unaware of the additional drugs you are taking is also unwise. Research has shown that long-term use of BZDs can create the need for increased usage.

Symptoms of too many drugs, including benzodiazepines, are;

  • Over-sedation or sleep
  • Jitteriness and excitability
  • Mood swings
  • Aggression
  • Shallow breathing
  • Unconsciousness

“There is some evidence that long-term, heavy use of benzodiazepines is a risk factor for epilepsy, stroke, and brain tumors.” Additionally, benzos are associated with “amnesia, hostility, irritability, and vivid or disturbing dreams.”

In the U.S. during 2017, there were 45 million alprazolam, 26.4 million lorazepam

29.2 million clonazepam, 12.6 million diazepam, and 7 million temazepam prescribed and dispensed. (This does not include many other types of benzodiazepines prescribed or attained illegally.)

“[D]evelopment of tolerance is variable from one person to the next, but certainly can occur after just 3–4 weeks of use. Dependence can be considered in physiological and psychological terms. Physiological dependence refers to the experience of withdrawal symptoms on stopping the drug. Symptoms range from relatively minor (for example, headache, tremor, or sweating) to very serious and potentially life threatening (for example, seizures, psychosis, or delirium tremens). With psychological dependence, patients increasingly require their drug in order to cope with life events. Other negative effects resulting from long-term use include memory impairment in older patients, diminished sleep quality, daytime drowsiness, decreased reaction time, increased risk of accidents, and aggravation of existing depression or initiation of new-onset depression.”

Benzodiazepines are turning up in Opioids making withdrawal more dangerous. These drugs are known as benzo dope and purple heroin, (though purple heroin is considered an opioid) it includes fentanyl and black-market benzodiazepines. These drugs are linked to growing drug deaths in Canada, the U.S., the UK, AU and other European countries. “Fatal overdoses are more likely to occur after using benzo dope because the life-saving opioid overdose reversal drug, naloxone, is not effective against benzos.”

Gender Bias in Prescribing Benzodiazepines

Sadly, a recent study by the CDC demonstrated an 830 percent jump in mortality rates among women 30-64 years of age between 1999-2017 involving benzodiazepines. “Women are more likely to be prescribed these medication…[they} are more likely to come into the clinic to be treated for anxiety and depression…benzodiazepines tend to be one of the medications [prescribed].”

Treatment Can Break the Cycle of Addiction

Treatment works regardless of how or why you or a loved one has become addicted to benzodiazepines or multiple drugs. The first step in recovery is to go through a medically supervised detox. A licensed detox facility’s addiction expert, including an addiction physician, develop an individualized detox plan for you or your loved one. Once completing detox, entering a licensed substance abuse treatment program is best practice. Personalized treatment is necessary to address individual problems. Call now and speak with one of our staff to help you find the right program for your needs. Don’t hesitate; help is a phone call away. You or your loved one can break the addiction cycle and start his/her/their life again clean and sober.