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Klonopin is the brand name for the benzodiazepine clonazepam. This medication, which is a CNS depressant, is an anticonvulsant used to treat anxiety, seizures, and panic disorders. In some cases, it is also used to treat insomnia or substance withdrawal, especially alcohol withdrawal.
When used as prescribed, this medication can be very beneficial. However, in larger doses or combined with other drugs, Klonopin can induce euphoric effects that can lead to abuse, addiction, and dependence. The Centers for Disease Control and Prevention noted that, between 2004 and 2008, the number of emergency department visits involving nonmedical use or abuse of benzodiazepines increased 89 percent. These overdoses typically involved nonmedical abuse of Klonopin or other benzodiazepines with narcotics or alcohol.
Because Klonopin is a prescription medication with clear therapeutic use, but with a chance of addiction or dependence, it is a Schedule IV drug, according to the Drug Enforcement Administration.
Even at regular doses, Klonopin can have side effects. Some of these include:
Klonopin’s effects are similar to those of other CNS depressants, such as alcohol or opioid painkillers. If these medications are abused together, they can compound each other’s effects, leading to intoxication and overdose much more quickly.
More people are using benzodiazepines like Klonopin for nonmedical purposes, which can be dangerous. A study from the Substance Abuse and Mental Health Services Administration (SAMHSA) found that, between 1998 and 2008, substance abuse treatment admissions for people ages 12 and older involving benzodiazepines rose from 1.3 percent to 3.2 percent. The study also found that 95 percent of these admissions involved another drug and benzodiazepines, and in over 81 percent of the admissions, benzodiazepines were the secondary drug of abuse, not the primary.
Benzodiazepines are some of the most frequently prescribed medications on the market, so many people who struggle with addiction to these substances began with a legitimate prescription. One study found that the majority of the people who became addicted through a prescription were older women. Although diazepam (Valium) and alprazolam (Xanax) are more often the targets for addictive behaviors and diversion, Klonopin is becoming more popular. According to the DEA, teenagers and young adults are also likely to obtain Klonopin and abuse the drug, typically by crushing it and then snorting it. People who struggle with cocaine or heroin addiction are also more likely to abuse Klonopin than other demographic groups.
Because benzodiazepines are prescribed to treat serious alcohol dependence in order to prevent side effects like seizures, people who struggle with alcohol use disorder might become addicted to Klonopin or other benzodiazepines. The drugs have similar effects. As a result, if Klonopin, or other benzos, is used during alcohol addiction recovery, it’s imperative that use is monitored closely by medical professionals.
In some instances, Klonopin and other benzodiazepines have been used as date rape drugs. When mixed with alcohol, these drugs reduce the victim’s resistance and inhibitions, and they can also lead to unconsciousness.
Even though Klonopin interacts with many drugs, especially alcohol, polydrug abuse involving Klonopin is very common and sends many individuals to the emergency room. A publication from SAMHSA in 2014 showed that 32 percent of hospital emergency visits that involved benzodiazepines also involved another addictive substance, particularly opioid painkillers or alcohol. Serious outcomes for people who overdosed on a combination of benzodiazepines and other drugs rose considerably; for example, the combination of opioid painkillers and benzodiazepines increased the risk of a serious outcome by 44 percent, as did the combination of benzodiazepines and alcohol. All three raised a person’s risk by 50 percent.
The World Health Organization defines addiction syndromes as the strong desire or compulsion to ingest a substance, difficulty controlling use of the substance, tolerance or dependence, and withdrawal symptoms if the regular dose is not taken. People who take benzodiazepines like Klonopin can develop benzodiazepine dependence syndrome.
Like other addictive substances, Klonopin triggers the risk/reward system in the brain by creating a dopamine surge that floods the brain with neurotransmitters associated with pleasure. By acting on the GABA receptors in this system, Klonopin and other benzodiazepines make neurons respond more readily to future dopamine surges.
The half-life of Klonopin is between 18 and 50 hours. While this can seem like a long time, as the effects wear off, the individual may begin to panic and take another dose. This can be a sign of addiction to Klonopin.
When a person takes Klonopin for a long time, the body may develop a dependency on the medication, whether the person has struggled with addictive behaviors or not. Dependence basically means that the person will experience withdrawal symptoms if they attempt to stop taking Klonopin. People who struggle with addiction to Klonopin may suffer from psychological withdrawal symptoms in addition to physical symptoms. The Australian NPS MedicineWise suggests that 30-40 percent of people who take Klonopin for over a month will develop a dependence on this drug, which can lead to withdrawal symptoms.
Withdrawal symptoms include:
Withdrawal symptoms typically begin within 48 hours after the last dose of Klonopin. The symptoms generally last for up to two weeks. Sometimes, withdrawal symptoms last for weeks or months though. These symptoms may include:
For people who have developed a dependence on a doctor-prescribed dose, symptoms are likely to be mild; however, for people who have increased their dose or used Klonopin nonmedically at high doses, there could be more intense withdrawal symptoms. These may include:
Medical detox is required to withdraw from benzodiazepines, due to the potential for life-threatening withdrawal symptoms. When a person attempts to detox from Klonopin without help, they are more likely to relapse, because they do not have social support and psychological tools to help them. People who relapse during withdrawal might take what they consider to be a standard dose, but there is less of the drug in their system after a period of abstinence, and this can lead to overdose.
In cases of polydrug abuse, Klonopin and other drugs can increase each other’s effects more quickly and spiral the individual into an overdose. Klonopin overdose symptoms include:
If a person overdoses on Klonopin and must be transported to the emergency room, doctors may administer flumazenil. This medication is a benzodiazepine agonist, so it binds to the same receptors in the brain as benzodiazepines, and this can temporarily halt a Klonopin overdose. Flumazenil begins to reverse the benzodiazepine overdose within 10 minutes of administration, but it will not stop it, just delay the overdose symptoms for long enough for medical professionals to arrive.
The Royal College of Psychiatrists recommends that, if a person has taken benzodiazepines like Klonopin every day for three weeks, they should not stop taking the medication suddenly or without speaking to their doctor. Instead, it is recommended that they work with their doctor to taper their drug use every 2-4 weeks until they do not have physical cravings for the drug any longer. However, they also note that some patients may need longer to taper off the drug successfully.
To help the tapering process, a medical professional may switch the individual to a longer-acting benzodiazepine. The long-acting benzodiazepine can help ease withdrawal symptoms for longer, allowing the individual to reduce their cravings and engage in psychological treatment to address substance abuse and addiction issues. The overseeing doctor may also prescribe other medications, such as antidepressants or beta blockers, to ease some of the psychological symptoms of withdrawal.
Getting off Klonopin is just one part of the treatment process, and detox is not addiction treatment on its own. Instead, medical detox must be followed with comprehensive addiction treatment. Research-based treatment should offer social support in the form of individual and group therapy. Therapy helps people struggling with Klonopin addiction to know that they are not alone, to work on overcoming the root causes of their addiction, and to develop better coping mechanisms for triggers to use substances. As a result, when people exit an addiction treatment program, they are well equipped to continue in sobriety on a long-term basis.