Benzodiazepine Use, Side Effects, and Risks

Benzodiazepines are a class of medicinal drugs which are used as controlled legal substances by the medical industry.  Unfortunately, it is also a type of drug that can easily lead to dependency. For that reason, the drug has been researched intensely over decades and several rehabilitation techniques have been developed and refined over that period. According to an article published by SADAG, Prescription drug abuse is responsible for 60% of overdose-related deaths. Opioid painkillers are responsible for the most deaths followed by benzodiazepines.

Although they have various other uses, benzodiazepine medications, or “benzos”, are mainly prescribed as short-term solutions for reducing anxieties, including panic disorder, phobias and trauma responses. They are also popular for combating insomnia. Apart from their useful functions, they have adverse side-effects.

Some of the better-known benzodiazepine derivatives have proprietary names like Ativan, Lexotan, Librium, Urbanol and Valium, but there is a long list of other commercially produced derivates.

Though it is a controlled substance, benzodiazepine products have found their way onto the black market because it is such a highly addictive drug. Some people become dependent while using it on prescription and continue using it after the normal medical requirement expires, while others start using it simply for recreational purposes.

The potencies of the various benzodiazepine derivatives differ. The potency is important because you need to know how much, and how often, to take when you switch from one to another. They are also metabolised and excreted from the body at different speeds.

They all have very similar effects and side effects. They differ, however, in how they are absorbed, how long the effect lasts, how potent they are and what type of disorder they are best suited for.

With some, the effect lasts for 6 to 8 hours and with others, it lasts for several days. Though all derivatives are effective, to a greater or lesser extent, for treatment of anxiety and insomnia, some target additional disorders.

Despite the adverse side-effects, it is a popular drug. Due to its rapid calming effect, it is abused as a mechanism to escape from the stress and turbulence of daily life – all of which are unhealthy coping mechanisms and only provide a “plaster” to a wound which will resurface in more intensity. As it is legally produced, society does not see it as a “hard” drug. The widespread legal distribution makes it even more difficult for authorities to effectively control its improper prevalence.

Benzodiazepine usage can lead to dependence within weeks and cause severe problems in every sphere of a person’s life. The tablets are usually taken orally, but some abusers inject themselves. Stopping the medication causes some of the most withdrawal symptoms. Benzodiazepines are one of the most difficult drugs to stop using.

Unlike some drugs, it is extremely risky to stop taking benzodiazepines without medical supervision.

The Benzo addiction pattern

There are many things that contribute to benzodiazepine addiction, but the following scenario is a typical example of how users end up in a compromised situation.

Initially, patients obtain legitimately prescribed benzodiazepines. After a while, their bodies develop a tolerance for the drug and they start asking for more frequent prescriptions, but when it exceeds reasonable limits, the doctor refuses. The patient then visits various doctors at random to obtain more prescriptions. Eventually, the patient starts buying it on the black market.

Other people start using the drug purely for so-called recreation. Some use the drug as it is, but others mix it with illicit drugs to increase the impact. People who were treated with benzodiazepines during alcohol detoxification afterwards continue using it in large doses as a substitute drug.

Benzodiazepine abusers share some of the following characteristics:

  • They suffer(ed) from anxiety, stress and/or depression.
  • They had used the drug in fairly low, legally prescribed doses for some time.
  • They gradually came to rely on the drug to carry out normal daily obligations.
  • They continued to take the drug when the original need for it had passed.
  • They can not stop or reduce the dosage, because of the withdrawal symptoms.
  • They develop anxiety symptoms between doses or feel a craving for the next dose.
  • They contact their doctors frequently to obtain repeat prescriptions.
  • They become anxious if a prescription is not instantly available.
  • If a prescription is not available, they panic and buy the drug on the street.
  • They keep the tablets close at hand and take obsessive care to safeguard it.
  • They take an extra dose or an emergency supply before going anywhere.
  • They have gradually increased the dosage since the original prescription.
  • They persist with taking the drug, despite problems caused by it.

Clinical benzodiazepine applications

Examples of ways in which the medication is used by the health industry:

  • Anxiolytic – Reduction of anxiety (including panic disorders and phobias)
  • Hypnotic – Promotion of sleep (Relief from insomnia)
  • Myorelaxant – Muscle relaxation (spasms, spastic disorders)
  • Anticonvulsant – Stopping fits, convulsions, seizures (due to drugs or epilepsy)
  • Anterogade Amnesia – Induced short-term memory loss in surgical procedures
  • Premedication – Sedation for minor surgical procedures
  • General anaesthesia – A medically induced state of unconsciousness
  • Alcohol detoxification – For overcoming alcoholism withdrawal symptoms
  • Acute psychosis treatment – For hyperexcitability and aggressiveness

Side effects and dangers of benzodiazepines

  • Aftermath: When taken in the evening, a listless, foggy feeling may persist the next day.
  • Tolerance: The body quickly becomes less responsive to the drug and, over time, ever larger doses must be taken to obtain the same effect.
  • Dependence: Mental and physical dependence (addiction) develops within a few weeks. Severe withdrawals arise when the drug is reduced.
  • Complacency: Reliance on benzodiazepine inhibits the learning of healthier coping skills.
  • Drug interactions: Negative interaction with many other drugs, like tranquilisers, antidepressants, antihistamines, pain relievers, alcohol, illicit drugs, herbal supplements. – Note: Consult your doctor if you are using any other medication for advice about conflicting substances.
  • Memory impairment: Forgetfulness, “blackouts”, loss of awareness, leading to unintentional shoplifting, mislaying items, forgetting names, getting lost.
  • Trauma retention: Prevents normal emotional recovery following a traumatic event. Mental distress is suppressed, but remains unresolved when drug is stopped.
  • Paradoxical reactions: Sometimes causes behaviour that is contrary to tranquility, such as irritability, anger and violence.
  • Depression: Benzodiazepine is known to cause or aggravate depression after prolonged use.
  • Emotional blunting: Restricted emotions – mentally detached or passionless. Person has almost no negative or positive feelings. Lacks empathy for others.
  • Age tendency: Older people are more severely affected. It causes confusion, night wandering, amnesia, loss of balance and other dysfunctions.
  • Pregnancy effects: Babies look sedated, with slack muscles and weak suckling. After about 14 days they have withdrawals (breathing problems, sleep dysfunctions, crying, tremors).
  • Domestic and social disharmony: Breakdown of relationships due to impaired social behaviour.
  • Employment loss: Due to poor productivity, errors, depression, absenteeism.
  • Accident risk: Impaired physical and mental state leads to traffic, home, work accidents.
  • Medical expenses: Ongoing doctors’ visits, medical prescriptions. Hospitalisation due to oversedation, other disorders, accidents.
  • Other expenses: Costs of litigation due to accidents and other damaging events. Exhorbitant prices paid for illegal purchases of the drug.
  • Suicide risk: Benzodiazepines are known aggravators of depression, which is a major suicide catalyst.
  • Oversedation: Accidental oversedation is common. Causes heavy sleep, dizziness, confusion, unconsciousness.
  • Overdosing: High volume causes cardiac and/or respiratory arrest and rapid death.
  • Discontinuance: Reduction should be gradual and under medical supervision. Psychotherapy required to remedy root causes.

Signs of benzodiazepine overdoses

Signs of overdosing include:

  • Drowsiness, Blurred vision
  • Dizziness, Confusion, Agitation
  • Inability to talk or respond, Tremors
  • Uncoordinated muscle movement
  • Weakness, Low blood pressure
  • Respiratory depression
  • Hallucinations, Stupor, Coma
  • Brain damage, Death

Note: Due to the large range of benzodiazepines, only the most common signs are listed here.

Benzodiazepine withdrawal symptoms

  • Headache, Muscle pain
  • Weakness, Fatigue
  • Sweating, Tremors, Nausea
  • Numbness and Tingling
  • Restlessness, Sleep disorder
  • Poor concentration, Memory gaps
  • Dilated pupils, Blurred vision
  • Nightmares, Diarrhea, Chest Pain
  • Palpitations, High blood pressure
  • Depression, Irritability, Tension
  • Anxiety, Panic attacks. Violence
  • Confusion, Delusions, Psychosis
  • Delirium tremens, Hallucinations
  • Seizures, Suicidal thoughts

Note: Due to the large range of benzodiazepines, only the most common symptoms are listed here.

Benzodiazepine derivatives

Generic Name (Brand Name) – Usage

  • Alprazolam (Alzam, Azor, Xanax, Xanor, Zopax) – Anxiety, panic disorders
  • Bromazepam (Brazepam, Lexomil, Lexotan) – Anxiety, panic disorders, insomnia
  • Brotizolam (Goodmin, Lendormin, Sintonal) – Insomnia, anxiety, panic attacks
  • Chlordiazepoxide (Librax, Librium, Limbitrol) – Anxiety, alcohol withdrawal
  • Clobazam (Frisium, Onfi, Urbanol) – Anxiety, insomnia, seizures, epilepsy
  • Clonazepam (Klonopin, Rivotril) – Seizures, panic disorder, neuralgia
  • Clorazepate (Tranxene) – Anxiety, alcohol withdrawal, partial seizures
  • Diazepam (Benzopin, Betapam, Diastat, Pax, Valium) – Anxiety, seizures, more
  • Estazolam (Eurodin, ProSom) – Insomnia
  • Flunitrazepam (Hypnodorm, Hypnor, Insom, Rohypnol) – Insomina, anaesthetic
  • Flurazepam (Dalmadorm, Dalmane) – Insomnia
  • Halazepam (Pacinone, Paxipam) – Anxiety
  • Ketazolam (Anxon, Loftran, Solatran) – Anxiety, irritability
  • Loprazolam (Dormonoct, Somnovit, Sonin) – Insomnia, muscle relaxant,
  • Lorazepam (Ativan, Tranqipam, Tran-Qil) – Anxiety, insomnia, sedation, seizure
  • Lormetazepam (Dormagen, Loramet, Noctamid) – Insomnia, muscle relaxant
  • Medazepam (Ansilan, Nobrium, Rudotel) – Anxiety
  • Midazolam (Dormicum, Midacum, Versed) – Anxiey, anaesthetic, seizures
  • Nitrazepam (Arem, Mogadon, Normison, Paxadorm, Protaz) – Insomnia, seizures
  • Nordazepam (Calmday, Madar, Nordaz) – Anxiety, seizures
  • Oxazepam (Medopam, Serax, Serenid, Serepax) – Alcohol withdrawal, anxiety
  • Prazepam (Centrax, Demetrin) – Anxiety
  • Quazepam (Doral, Dorme) – Insomnia
  • Temazepam (Euhypnos, Levanol, Normison, Restoril, Z-pam) – Insomnia
  • Triazolam (Halcion) – Insomnia
  • Zolpidem (Ivedal, Stilnox, Zolpihexal) – Insomnia (sleep initiation)
  • Zopiclone (Alchera, Imovane, Zimovane, Zopimed, Zopivane) – Insomnia

Benzodiazepine treatment

Most patients are afraid of withdrawal symptoms but when the withdrawal procedure is done correctly, users report a less dramatic experience than they expected and emerge feeling better than ever after they had been weaned off the drug.

Modern psychotherapy addiction treatment techniques empower patients to start a fresh chapter of life. During the process, they are also armed with skills to handle awkward or embarrassing situations that may crop up after treatment.

If you are unsure whether you or someone else is in need of treatment, pick up the phone and request an evaluation interview with a mental health provider. Anybody can beat benzodiazepine addiction. The option is yours.

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