Benzodiazepines and Addiction
Benzodiazepines, also known as benzos, are medications used in the treatment of anxiety, muscle tension, insomnia, and seizures. While benzos can be incredibly effective when used as prescribed, they are also prone to abuse, dependence, and addiction. As a result, those taking benzodiazepines should only do so under medical supervision and according to their prescription.
How Benzodiazepines Work
Benzodiazepines are sedative/hypnotic medications, and they can actually cause changes in the brain, according to the National Institute on Drug Abuse (NIDA). Essentially, benzos shift how chemical signals in the brain relay something pleasurable. Over time, the brain begins to rely on benzos to operate. When this happens, dependence has formed.
Not all medications in the benzo class work the same way. Some work quickly while others work more slowly. Short-acting benzos take effect quickly and also leave the body quickly. As a result, people may use these drugs in a binge pattern in order to continue feeling their effects. Long-acting benzos take longer to take effect, and they stay in the body for longer periods of time.
Common types of benzodiazepines include:
- Ativan: often used to treat panic disorders
- Ambien: used to treat insomnia and sleep issues
- Klonopin: used to treat panic disorders and seizures
- Valium: used to treat anxiety and muscle tremors
- Xanax: used to treat anxiety and panic disorders
Any type of benzodiazepine can be abused, and when abused, dependence can form quickly. As a result, benzodiazepines are not generally recommended for long-term use.
How Abuse Begins
While benzodiazepines have been in use for more than 50 years as prescription medications, researchers have long been concerned about their risk for dependence and addiction. Even so, these medications continue to be widely available, according to the National Institutes of Health.
Benzos are described as “dangerous” to misuse because of their physical effects on the brain. Medications in the benzodiazepine class can lead to permanent chemical changes within the brain, which has implications on the person’s ability to function. Depending on the medication used, over time, brain cells may no longer function at their previous levels without the aid of the drug.
Oftentimes, people may begin taking benzodiazepines as prescribed. As time passes and the body grows dependent on the medication, they may begin to up their dosage, take the medication more frequently, or combine it with other substances, such as alcohol. Once a person begins using a benzo outside the parameters of their prescription, which includes taking it for longer than prescribed, abuse is happening. Once a person abuses a benzo, it generally isn’t long before dependence and addiction follow.
Some people don’t begin abusing benzodiazepines due to a legitimate prescription. Some people simply start using these drugs recreationally, in an effort to experience the relaxation and calm that often comes with use. Some people may take benzos in an effort to soften the “comedown” from other drugs, such as to alleviate the severity of a severe hangover or to dampen the aftereffects of a cocaine binge. Still others may take benzos in combination with other substances in an effort to achieve a more intense high. Opiates and benzodiazepines are commonly abused together.
Effects of Benzo Abuse
According to WebMD, chronic abuse of benzodiazepines can lead various health issues, including:
- Muscle weakness
- Coordination issues
- Trouble breathing
Signs that a person may be addicted to benzodiazepines include:
- Visiting multiple doctors in an effort to get multiple prescriptions for benzodiazepines
- Mixing benzos with other substances, such as alcohol
- Altering the medication in any way (e.g., chewing tablets, crushing them to snort the resulting powder, etc.)
- Lying about use of benzos
- Stealing medications from family members, friends, or strangers
- Sacrificing other activities, such as spending time with friends or participating in favorite hobbies, to use benzos instead
- Declining performance at school or work
If you suspect a loved one is abusing, or addicted to, benzodiazepines, it’s important to take action before serious health effects and negative life consequences take place. While you can start with a casual conversation with the person, it may be wise to consult with a mental health professional and stage an intervention if the person doesn’t respond to your initial approach. While benzodiazepine addiction can be severe, it is fully treatable and can be effectively managed with professional help.
Benzodiazepine use can result in significant physical dependence. This means that when a person attempts to stop taking benzos, or cut down on use, withdrawal symptoms may take place. These withdrawal symptoms can be severe and even life-threatening in some cases. They include:
- Muscle tremors
- Difficulty concentrating
- Muscular pain
- Heart palpitations
- Hand tremors
- Mood swings
In rare cases, seizures and psychotic reactions may occur. As a result, people should never attempt benzodiazepine detox on their own. Detox requires professional medical supervision and a medical detox process to ensure the person’s safety and comfort.
Generally, a tapering process is recommended for benzodiazepine detox. Rather than stopping use of benzos abruptly, the person is gradually weaned off the medication over a period of weeks or months. A supervising physician will slowly lower the person’s benzo dosage over time, depending on how the person reacts to each reduction in dose. If the person has been abusing a short-acting benzo, they may be switched onto a long-acting benzo, and then the tapering process occurs off that long-acting benzo.
What Treatments Are Needed for Full Recovery?
The National Institutes of Health recommends that people receive psychological support while they are being weaned off benzodiazepines. Simply being physically weaned off a benzo will not address addiction and abuse issues, so it is not treatment in and of itself. Instead, therapy is needed to address issues that led to substance abuse.
Along with talk therapy, clients should be given educational information about benzodiazepines and how they act on the brain and body. Therapists, other treatment professionals, family members, and friends should provide regular encouragement, serving as a support system for the individual as they progress in recovery.
In addition, clients in addiction treatment should be taught alternative, nonpharmacological ways of dealing with anxiety and stress. They will identify “triggers,” such as stressful situations that have prompted them to abuse benzos in the past, and devise healthier ways to cope with those triggers. This enables them to move forward in recovery without returning to benzo use when times get tough.
If clients struggle with any co-occurring medical or mental health issues, these should be addressed during addiction treatment. Since people with anxiety or panic disorders often abuse benzodiazepines in an effort to address symptoms of their disorders, these issues must be addressed in treatment. The goal of treatment is stability on all fronts of life. It isn’t merely about treating the addiction issue but also helping the individual to heal on all levels.