Often prescribed for anxiety and panic disorders, benzodiazepines are nervous system depressants that slow the activity of the central nervous system. These sedative effects make benzodiazepine abuse fairly common.
What are benzodiazepines?
Benzodiazepines, or benzos, are sedatives that reduce nervous system activity in the body, alleviating symptoms such as convulsions, insomnia, anxiety, and muscle spasms for which they are frequently prescribed. When taken without a prescription, they produce sensations of extreme calm and well-being.
Despite their utility in treating many disorders such as anxiety, seizures, and intense pain, these desirable effects underlie the drug’s high potential for abuse and addiction. A common misconception is that addiction to benzodiazepines is not possible if it is taken as prescribed, but long-term use can lead to physical dependence, which can form the basis of addiction.
How benzodiazepines affect the brain
Benzodiazepines affect the parts of the brain that are involved in the sensation of pleasure through dopamine. The availability of the neurotransmitter dopamine in the brain affects the reward pathway, creating desirable sensations that are pleasurable and desirable. When benzodiazepines enter the body, they inhibit neurons that regulate the release of dopamine. While these neurons are inhibited, more dopamine becomes available and the individual feels a sensation of pleasure or mild euphoria.
This effect creates a motivation for individuals to continue using benzodiazepines. In this way, benzodiazepines can lead to addiction in the same way opioids or cannabinoids can. Over time, it’s possible to develop tolerance to benzodiazepines, wherein the same dosage no longer causes the same potent effects and results in the release of less and less dopamine. This could lead individuals to take larger or more frequent doses than prescribed, which could become full-blown addiction.
One of the dangers of benzodiazepines is that they are so readily available. It’s no surprise that the most commonly abused benzodiazepines are the ones that are prescribed most often.
Xanax
Xanax, or alprazolam, is an important benzodiazepine for treating anxiety and panic disorders. It is sold in both fast-acting and extended-release versions. Fast-acting Xanax can treat panic attacks quickly since they come on suddenly. This immediate effect also lends itself to problematic use since it has an instantly rewarding mechanism.
Valium
Valium, or diazepam, was one of the first marketed benzodiazepines. It can be prescribed for a variety of conditions including insomnia, seizures, and anxiety. Though its effects do not come on quickly, Valium may stay longer in the body and can be dangerous when mixed with other substances.
Klonopin
Klonopin, or clonazepam, is also frequently prescribed for anxiety, insomnia, and seizures. It is an intermediate-acting benzodiazepine, so it does not come on as quickly as Xanax but faster than Valium. When Klonopin is taken along with other depressants, the effects can be compounded, increasing the likelihood of overdose.
Ativan
Known also as lorazepam, Ativan is an intermediate-acting benzodiazepine that frequently treats panic and anxiety disorder. Its effects in the nervous system build up over time so it improves the symptoms it’s prescribed to treat after several days. In addition to its potential for addiction, it can also cause problematic side effects like impaired motor coordination and drowsiness.
Ambien
Ambien, or zolpidem, is one of the most commonly prescribed medications for insomnia. It’s a sedative hypnotic that slows down the nervous system and immediately causes a feeling of sedation and drowsiness. Ambien can easily lead to tolerance and addiction because individuals who use it regularly may stop being able to fall asleep without the medication.
Benzodiazepines may be helpful in treating many conditions, but their sedative and calming properties also create undesirable side effects. These include:
- Fatigue
- Drowsiness
- Confusion
- Nausea
- Vomiting
- Constipation or diarrhea
- Impaired motor function
- Slurred speech
- Tremors
- Vertigo
- Slowed respiration
These side effects may be exacerbated if benzodiazepines are misused and taken in high doses. Prolonged misuse may also lead to more severe symptoms such as:
- Aggression
- Mood swings
- Impaired reflexes
- Erratic behavior
- Overdose
Benzodiazepine overdose
The effects of benzodiazepines are wide-ranging, so in addition to treating symptoms like anxiety, it affects heart rate and breathing. Because it can slow down these functions, taking benzodiazepines at dangerously high doses can cause respiratory depression that can cut off oxygen availability to the brain. This can lead to lethal overdose. These symptoms can cause visible changes like bluish lips and fingernails.
Benzodiazepine overdose is also likelier when these kinds of medications are used concurrently with other depressants such as alcohol. Two or more depressant substances acting on the body simultaneously have a more potent effect, so it may be easier to accidentally overdose, even when taking a benzodiazepine dose that is safe on its own.
Benzodiazepine withdrawal symptoms
Benzodiazepine withdrawal occurs when physical dependence has developed. This is common when medication is taken for long periods of time and the body adjusts to the chemical changes brought on by the medication. Subsequently, if benzodiazepine use is terminated suddenly, individuals will experience withdrawal symptoms that include:
- Agitation
- Anxiety
- Elevated heart rate
- Elevated blood pressure
- Insomnia
- Tremors
- Seizures
- Hallucinations
Benzodiazepine addiction FAQs
Is it possible to become addicted to benzodiazepines if I take them as prescribed?
Addiction does not necessarily require illicit misuse of a drug to develop. Even if you take benzodiazepines as prescribed, you may develop addiction over time. It’s important to disclose cravings and other problematic signs of addiction with your doctor so they can adjust your prescription if necessary.
How can I safely detox from benzodiazepines?
Since withdrawal symptoms may lead to continued benzodiazepine use, the detox period is an important time in the addiction recovery journey. Medically supervised detox may be recommended to treat unpleasant withdrawal and help you safely eliminate benzodiazepines.
How is benzodiazepine addiction treated?
Effective benzodiazepine addiction treatment is individualized to the person and requires understanding the physical or psychological circumstances behind their drug use. This may involve treating underlying conditions such as anxiety. Through a combination of psychological and physical interventions, the person is treated as a whole to improve their quality of life and overall well-being.
