Benzodiazepines are a class of drugs that depress the central nervous system and are prescribed to treat the symptoms of anxiety disorders as well as insomnia and other sleep problems.
When first introduced to the drug market, benzos were initially celebrated as a safer alternative to barbiturates, which were previously used to treat anxiety and insomnia but had a wide range of dangerous side effects as well as a high risk of abuse and addiction.
Unfortunately, it eventually became clear that benzodiazepines had similar potential for abuse, addiction, and overdose, as well as their own set of serious health problems associated with misuse.
Despite these dangers, benzos remain the most overprescribed medications in the United States, providing too many opportunities for misuse that can quickly escalate to abuse and eventually addiction.
Currently, more than 2,000 different benzodiazepines have been produced, but only 15 have been approved by the U.S. Food and Drug Administration (FDA), the most frequently prescribed of which include:
While benzodiazepines are a broad class of medication, as central nervous system depressants, they all work in basically the same way, creating intense feelings of sedation and relaxation as well as induce sleep by creating an excess of a neurotransmitter called gamma-Aminobutyric acid (GABA).
GABA is responsible for slowing down activity in the central nervous system to regulate feelings of anxiety and stress, keeping the nerve signals that carry those feelings from reaching the brain.
Benzodiazepines mimic the GABA produced by your body to bind with what are known as GABA receptors.
Binding with the receptors activates them, which the benzos do over and over until the brain and nervous system are flooded with an excess of GABA.
It can sometimes be difficult to spot the signs of benzodiazepine abuse, even if you’re the one engaging in the abuse. Misuse can quickly slide into abuse, and you may not recognize that there is a growing problem until the signs of benzo addiction have become too significant to miss.
The signs of addiction do not appear all at once, and it is often only after someone’s benzodiazepine addiction has become too severe to manage that the pattern of behavior becomes obvious in hindsight.
However, there are some noticeable common side effects of regular, long-term benzo abuse that can act as signs of a growing dependence on benzodiazepines.
Some of these side effects include:
The main trait that distinguishes abuse from addiction is the user’s total loss of control over their benzo use. Once they have reached the point of addiction, they will abuse benzos compulsively and obsessively, and doing so will become the motivation for the majority of their decisions and actions, edging out every other priority in their life.
As benzo addiction exerts its control over someone’s life, the person will begin to behave in ways that are consistent not just with benzo dependence but with substance use disorders in general. Benzodiazepine addiction signs include:
If you have seen these signs in a family member or friend or recognize them in your own behavior, it is of the utmost importance that you seek out professional addiction treatment services as soon as you can. The sooner you get help, the more likely you are to avoid a potentially fatal overdose.
Medical detoxification is an important first step when it comes to the treatment of nearly an addictive substance. Detox is the process of flushing out any alcohol, drugs, and associated toxins out from the system to treat acute intoxication and help a person in substance abuse recovery get physically and mentally stabilized.
Medical detox is especially crucial when it comes to benzodiazepine addiction treatment, as benzo detox should never be attempted alone or without an experienced medical team. Benzodiazepine withdrawal is one of the most dangerous and potentially life-threatening withdrawal experiences to go through.
The withdrawal symptoms associated with benzo detox include delirium, hallucinations, suicidal behavior, grand mal seizures, and sometimes even total psychosis. That’s without even considering some of the potential complications that can happen during the benzodiazepine withdrawal process, including benzodiazepine withdrawal syndrome.
Benzodiazepine withdrawal syndrome can manifest unpredictable symptoms not typically associated with benzo withdrawal and involves an overall worsening of symptoms as well.
Common symptoms such as anxiety or insomnia can intensify into debilitating panic attacks and inability to sleep for days at a time. People who have abused large amounts of benzos within a fairly short window of time are highly likely to experience benzodiazepine withdrawal syndrome.
A medical detox professional can provide certain medications to help lessen the discomfort caused by withdrawal symptoms and are prepared to handle any possible complications that might arise during detox.
Once detox has been safely completed, the next part of benzodiazepine addiction treatment is ongoing addiction recovery treatment, either in an inpatient or outpatient program. There are several subtypes for both treatment types, but the major difference between the two is that an inpatient program involves living onsite at the facility for the duration of treatment, while an outpatient program allows for someone to remain living at home or a sober living house and regularly commute to the treatment center for their sessions.
Choosing one or the other depends on the unique needs of the individual. Those with more severe addictions, a history of relapse or a home environment with many distractions or potential triggers would probably benefit from inpatient care, whereas someone in the early stages of addiction who is in good physical health and has the benefit of a strong outside support system might get all they need from outpatient care.
Whichever someone chooses, an addiction rehabilitation program involves treating the physical and psychological aspects of their benzodiazepine addiction. In addiction therapy, clients learn how to understand the underlying issues behind it so that they can address and manage their addictive behaviors in a healthy and positive manner and maintain long-term sobriety.
Even though the various addictive dangers and health risks of benzos are widely known, some people, especially young teens, are still under the mistaken impression that because it is a prescription medication, it is safer to misuse and abuse than an illicit drug. But there is no such thing as “safe” substance abuse, and that includes benzodiazepines.
In fact, the reason benzos are generally prescribed with very strict timelines of use is because of how quickly someone can become dependent on and addicted to them, sometimes in as little as a couple of weeks. This can happen even faster if someone abuses these drugs in large amounts.
Benzodiazepine abuse can also lead to a phenomenon known as rebounding, which is when someone has become so tolerant to the effects of benzos that the medication stops working and the user’s original symptoms of anxiety or insomnia return. However, when they return, they are usually much stronger and more difficult to deal with than before.
Because of this, benzos are often mixed with other depressants, such as alcohol and opioids, to heighten their sedative effects. This only increases the risk of a rapid progression of overdose, coma, and death.
But it is more than possible to overdose on benzodiazepines on their own, the signs of which include:
If someone is exhibiting the symptoms of a benzo overdose, it is vital that they receive emergency medical attention as soon as possible to avoid death. Even if someone is treated soon enough to avoid a fatal overdose, they may still be left dealing with resulting health complications like pneumonia as well as brain, muscle, and organ damage.
Dodds, T. J. (2017, March 02). Prescribed Benzodiazepines and Suicide Risk: A Review of the Literature. from https://www.psychiatrist.com/PCC/article/Pages/2017/v19n02/16r02037.aspx
Kennard, J. (2012, April 02). Rebound Anxiety – Talk Therapy – Anxiety | HealthCentral. from https://www.healthcentral.com/article/rebound-anxiety
National Institute on Drug Abuse. (2018, August). Overdose Death Rates. from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates