Benzodiazepine Addiction and Treatment
Benzodiazepines have been used for decades to treat many different physical and psychological conditions. In fact, these drugs are some of the most commonly prescribed depressants in the United States, according to the Center For Substance Abuse Research (CESAR).
Yet prescriptions for benzodiazepines increase every year, and with increased prescription rates has come increased rates of abuse and addiction. Unfortunately, the nation has only just started paying attention to this problem. As CESAR explains, “abuse of benzodiazepines was not specifically addressed until the 1980s, when they became among the most prescribed medications in the United States.”
Today, prescriptions written for benzodiazepines total in the hundreds of millions. In 2011 alone, prescriptions written for five of the most commonly prescribed benzodiazepines—alprazolam, clonazepam, diazepam, lorazepam, and temazepam—totaled over 126 million, according to data reported by the Drug Enforcement Administration (DEA)
The best defense we have against benzodiazepine abuse and addiction is treatment. If we can recognize the signs of abuse and addiction, and know the consequences or harm addiction can cause, we can help people find hope and healing with treatment modalities that are right for them.
What Are Benzos And Why Are They Abused?
Benzodiazepines, commonly called benzos, are a class of drugs that cause central nervous system depression (depressants). They work by slowing certain functions in the brain and body. In the U.S. these medications are prescribed for the following uses:
- Muscle relaxant
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More than 15 types of benzodiazepines are currently on the market. The sedative properties of the drugs make them high targets of abuse. Many people combine benzos with other substances, like alcohol or opioids, to enhance the effects of each.
However, combining the drugs is extremely dangerous, as mixing benzodiazepines with alcohol, another depressant, can enhance the sedative effects to extreme levels. Mixing with opioids, which are stimulants, can cause extreme contrasting effects. Both of these combinations greatly increase the affected person’s chance of overdose.
Benzodiazepines are typically available in capsule or tablet form. When abused, the person might crush them, and snort the powder, or mix with water to make a solution and inject it, creating faster effects.
Benzos are available in short-acting (faster onset of effects) and long-acting (extended release of effects) forms. Short-acting benzos tend to be abused more often because of the quicker release of effects, but all benzos show rates of abuse and addiction.
People who abuse benzodiazepines also tend to abuse them with other substances. For example, the drugs are abused with cocaine to help relieve the side effects, with methadone to enhance the euphoric effects, and with alcohol to heighten the sedative effects or help fight withdrawal, according to the DEA.
Benzodiazepine Addiction In The United States
The DEA explains, “individuals abusing benzodiazepines obtain them by getting prescriptions from several doctors, forging prescriptions, or buying diverted pharmaceutical products on the illicit market.” Alprazolam (Xanax) is listed as one of the top three benzodiazepines sold illicitly.
In terms of numbers, the DEA reports there were over 345,000 emergency visits due to benzodiazepines in 2010, a drastic increase from the more than 271,000 in 2008. In 2011, the National Survey For Drug Use And Health reported that an estimated 20.4 million people have abused benzodiazepines in their lifetime. This number includes those ages 12 and above.
The overwhelming majority of these numbers are due to alprazolam abuse, but clonazepam, diazepam, lorazepam, and temazepam also play a large role.
Why is benzodiazepine abuse so rampant in our nation? The drugs, though with proven numbers of abuse and addiction, are still a Schedule IV under the Controlled Substances Act. This means they are considered to have low risk of abuse in comparison to other drugs.
The exception to this is flunitrazepam (Rohypnol), commonly known as the “date-rape” drug. While this is also classified as a Schedule IV substance, abuse of it carries penalties of a Schedule I.
The overdose numbers and emergency visits show that benzodiazepines may have mild effects, but can cause extreme results. According to the National Institute On Drug Abuse (NIDA), “from 2002 to 2015, there was a 4.3-fold increase in the total number of deaths” due to benzodiazepine overdose.
Whether or not benzodiazepines are considered dangerous drugs doesn’t really matter. What matters is the harm they can cause when abused, the addiction that can trap you into a cycle of harmful effects to your health, and the risk of overdose associated with abuse of them.
The ray of hope, though, is that treatment for benzodiazepine addiction is available and it can help. Treatment can help you overcome abuse, build a better life, and learn to manage withdrawal and avoid relapse.
What Are The Side Effects of Benzodiazepine Abuse?
People largely abuse benzodiazepines for the feelings of calm and relaxation, and the relief from anxiety and tension. With those effects come other, adverse side effects, such as:
- Drowsiness, fatigue, or lethargy
- Dry mouth
- Loss of appetite
- Nausea, constipation, diarrhea, or vomiting
- Respiratory depression
- Speech troubles: slurring words or stuttering
- Stomach cramps
- Vision impairment
Abuse of benzodiazepines, which means changing the method of administration, taking more frequent or higher doses than prescribed, or taking it for reasons other than prescribed, can cause effects more dire than those above. These can include euphoria, erratic and/or hostile behavior, mood swings, and a slowness to reflexes.
The CESAR warns that some benzodiazepines are processed and released slowly from the body. This means that, “ingesting multiple doses over long periods of time can lead to significant accumulation in fatty tissues.” In turn, this excess buildup can contribute to overdose risk. Signs of oversedation may not appear for a few days, and may include the following:
- Impairments to memory, thought process, and decision-making
- Muscle weakness or lack of coordination
- Slurred speech
What Are The Consequences?
In addition to side effects, benzodiazepine abuse can result in a number of consequences. These can include tolerance, dependence, addiction, and overdose.
Tolerance occurs when your body becomes accustomed to the effects of a substance, and you no longer feel the same effects when you take the drug. For people taking benzodiazepines as prescribed, tolerance may occur after six months of use or more. For those abusing benzos, tolerance may occur more quickly.
After you build up a tolerance, you may experience dependence on benzos. This happens when your body becomes addicted to the effects of the drug, and you start feeling physical symptoms when not taking it. These symptoms are known as withdrawal, and may include anxiety, dysphoria (being uneasy or constantly feeling dissatisfied), insomnia, seizures, and tremors.
Perhaps the biggest risk of benzodiazepine abuse, though, is the tendency to lead to addiction. You may get hooked on taking benzodiazepine for the relaxing, calming effects, but you may continue to abuse them because addiction leaves you no choice.
Withdrawal symptoms may be mild at first, but they can cause enough discomfort to keep you abusing benzos even when you want to stop. This is especially true if you abuse the drugs with another substance, as many people do. Benzodiazepines have mild effects in comparison to many drugs, so many people abuse them in combination with other substances to create greater effects.
Yet it’s this polysubstance abuse that is most dangerous to you. For example, if you abuse alcohol and benzodiazepines, you may have a fair amount of cross-tolerance, or tolerance to one substance due to tolerance of the other. What this means is if you are abusing benzodiazepines, and begin abusing alcohol, you may quickly develop tolerance to alcohol because your body is already used to the sedative effects of a depressant.
Why is this so dangerous? Tolerance, in general, is dangerous because it increases your risk of overdose. Abuse of any drug is risky, but abusing drugs in high doses or frequent doses is more risky, and that’s what tolerance pushes you to do.
In truth, there are no limits to the toll addiction can take on your life. That’s why it’s best to recognize addiction as it starts, and find help in treatment.
Commonly Abused Benzodiazepines
The most commonly abused benzodiazepines, according to high numbers of prescriptions written, are alprazolam, clonazepam, diazepam, lorazepam, and temazepam, according to the DEA.
Alprazolam is typically used for treating anxiety and panic disorders. Brand names of the drug are Xanax and Xanax XR. As one of the most prescribed medications for anxiety-related conditions, alprazolam is highly abused.
This medication is used most to treat seizures, but is also prescribed for panic disorders. According to the U.S. National Library Of Medicine, “it works by decreasing abnormal electrical activity in the brain.” The brand name for this drug is Klonopin. The Citizens Commision On Human Rights (CCHR) states, “no ‘benzo’ has been more lethal to millions of Americans” than Klonopin.
Diazepam, known by the brand name Valium, is used to treat several conditions including anxiety, muscle spasms, seizures, and alcohol withdrawal symptoms. Combining it with other substances, especially alcohol, can cause dangerously slowed breathing or even fatal overdose.
Lorazepam is mainly used for anxiety, working by slowing brain activity, which results in relaxation. The common brand name for it is Ativan. As with other benzodiazepines, dependence and addiction to lorazepam can occur even if used as directed for a short time.
This medication is typically prescribed for people with insomnia. It works by slowing brain activity so you can sleep. This drug can become addictive especially because after use of it, you may have an even harder time seeking sleep, especially if you develop addiction to it.
Can You Overdose On Benzodiazepines?
Benzodiazepines are a class of drugs on which you can experience overdose. Given the mild effects of the drugs, perhaps that doesn’t always seem possible, but it’s true.
As previously stated, many people who abuse benzodiazepines take them with other illicit substances. Whether used in combination with other substances to enhance the effects of each, or to counteract or balance the effects of other substances, polydrug abuse with benzos is dangerous.
Depressants work by slowing different parts of brain activity. In turn, body functions, like breathing, are slowed. Combine the similar effects of two depressants (like benzos and alcohol) and your breathing could slow to extremely low levels.
Abusing benzodiazepines with stimulants like cocaine or opioids, which work to enhance brain productivity, can be just as risky. Cocaine works by giving you energy surges and euphoria, quite the opposite effects of benzos.
To produce these bursts of energy, cocaine works in the body by quickening functions like breathing and heart rate. The opposing extremes of stimulants like cocaine and benzodiazepines can create a catastrophe, ending in overdose.
Even if you don’t engage in polydrug abuse, addiction to benzodiazepines can result in overdose. Dependence can result even if you take the drugs for a short time, and then you may experience tolerance, begin taking more, and risk overdose.
Why Is Detoxification Important?
A supervised, medical detoxification is necessary for individuals addicted to benzodiazepines due to high risk of seizures during withdrawal. It is important to never try and stop taking benzodiazepines on your own.
Medical monitoring of detox can help you in several ways. First, with medical supervision, your health status will be regularly monitored. This is highly important during detox from benzos, as regulation of breathing and heart rate when coming off use of benzos is necessary.
Also, with medication-assisted treatment, you can receive medication if you need it during detox. Why would you need medication to wean off use of another medication? Withdrawal symptoms may become quite uncomfortable.
You may need medication to help quell the symptoms of withdrawal long enough to make it through detoxification. Contrary to what some people believe, not all medications for withdrawal symptom relief cause addiction. Instead, these medications help you safely taper off use of benzodiazepines until you can quit use of them and begin the rest of your treatment program.
What Treatment Methods Are Most Effective?
Treating a benzodiazepine addiction is complex and a good treatment program treats each client on an individualized basis.
Addiction affects all aspects of your health: mental, emotional, and physical. In turn, your behavior, thoughts, body, and life are changed. Treatment helps you reverse some of these changes, build positive new behaviors, learn skills and mindfulness, and teaches you ways to seek fulfillment from life without addiction.
Accomplishing all of these treatment goals is no easy feat, and that’s why utilizing a number of different treatment methods is so important. The best rehab centers will provide a number of treatment modalities from which you can build a program that’s right for you.
All of our treatment centers recognize the need for treatment that is tailored to the individual. Our treatment methods are as varied as the individuals we help treat. When you find hope and healing with us, you’ll have access to custom, individualized treatment programs that fit your specific needs.
The following are just a few of our science-backed programs that cater to the varying needs of those who enter our rehab centers:
- Treatment specific to men
- Treatment specific to women
- Dual diagnosis treatment: treating more than one disorder at a time
- Mental health treatment
- Medication assisted therapy
- Dialectical Behavioral Therapy (DBT)
- Cognitive Behavioral Therapy (CBT)
- Nutritional support and exercise guidance
- Skill building
- Mindfulness techniques
- Adventure and wilderness therapy
- Holistic healing
- Motivational interviewing
- Aftercare support
When you’re ready for help with benzodiazepine addiction you’ll want a rehab center that works for you and understands all of your unique needs. Addiction Campuses provides resources to the best rehab centers who will do just that.
Break Free From Addiction: Seek Help Today
If you or someone you know is walking the underestimated line of benzodiazepine addiction, we would like to help you break free. Contact us today at Addiction Campuses.
Center For Substance Abuse Research—Benzodiazepines
Drug Enforcement Administration—Benzodiazepines
Substance Abuse And Mental Health Services Administration—Benzodiazepine Abuse Treatment Admissions Have Tripled From 1998 To 2008
U.S. National Library Of Medicine—Alprazolam, Clonazepam, Diazepam, Lorazepam, Temazepam