7 Things You Should Know Before Taking Benzodiazepines
What Are Benzodiazepines?
Benzodiazepines are a class of drugs prescribed by a medical professional and are used primarily for treating anxiety but are also effective in treating several other health conditions, including seizures and spasms. They can also be used in substance abuse treatment to help with drug and alcohol withdrawal. It is unknown how exactly they work, but it is thought to work by affecting neurotransmitters in the brain. One of these neurotransmitters is gamma-aminobutyric acid (GABA), which suppresses the activity of nerves. Excessive activity of nerves may cause anxiety and other psychological disorders, and benzos may help increase the effects of GABA, which reduces the activity of these nerves.
There are several generic and name brand benzodiazepines, and they differ in how quickly they start working, how long they work, and what they are prescribed for. Some of the more common ones are:
- Diazepam (Valium) and clorazepate (Tranxene) have fast onsets of action and start working within 30 to 60 minutes
- Clorazepate (Tranxene), midazolam (Versed), and triazolam (Halcion) have short durations of 3 to 8 hours
- Lorazepam (Ativan), alprazolam (Xanax), and clonazepam (Klonopin) have intermediate onsets of action.
- Oxazepam (Serax) has slow onset
- Alprazolam (Xanax), temazepam (Restoril), estazolam (ProSom), and lorazepam (Ativan) are immediate-acting with intermediate lasting action of 11 to 20 hours.
- Diazepam (Valium), flurazepam (Dalmane), clonazepam (Klonopin), Chlordiazepoxide (Librium), and quazepam are long lasting agents with duration of 1 to 3 days.
What Makes Benzos So Addictive?
Like other drugs, benzos boost dopamine levels in the brain’s pleasure-reward areas creating pleasurable sensations. This process makes them effective in treating anxiety. The sedative effect of these drugs, plus their addiction-forming chemical properties, can make them easily abused. Some people start taking these medications for legitimate medical reasons but will develop a benzodiazepine dependence over time.
Any type of benzodiazepine is addictive, and you can become physically dependent on them as you would on heroin or tobacco. You can build up a tolerance, meaning that the same dose no longer gives you the same effect causing you to take larger and larger amounts. People can experience adverse effects like breakthrough anxiety between doses, and with continued use, they become physically dependent on it, creating a combination of substance abuse and mental health disorder. Physical dependence can occur quickly, causing withdrawal symptoms when you stop taking them. You are more likely to develop a substance abuse disorder with long-term benzodiazepine use.
Dangers of Mixing Benzos With Alcohol
Mixing benzodiazepines with alcohol or other medications can be dangerous and even deadly and increases the risk of a drug overdose. Benzos rarely cause death by themselves but can be deadly when mixed with other substances such as alcohol or opioids. About 30% of people who overdose on opioids also had benzos in their system, a combination that can cause a person to stop breathing.
According to the National Institute on Drug Abuse (NIDA), benzos are not the primary drug of abuse. They are most often used in conjunction with other drugs or alcohol. Benzodiazepines are sedative, so when mixed with other sedative substances like alcohol, they can create dangerous conditions in the body. Benzodiazepine misuse can increase the chances of bodily harm, destructive behavior, and even death. Most people assume that it is safer to use because it is a prescription drug. Mixing benzos with alcohol heightens the effects of both substances and is unsafe for several reasons. The most serious potential risk is coma or lethal overdose. Benzodiazepine abusers are at increased risk for addiction to both substances.
There is also a risk of physical dependence and drug addiction with benzodiazepines. Suddenly stopping after a few months can cause withdrawal symptoms and be dangerous, especially if other health conditions are present. Because they cause excessive sedation, they can interact with other medications that slow the brain’s processes. They are especially dangerous to mix with prescription painkillers, which may lead to an opioid overdose.
Benzo Withdrawal Symptoms
Many people often develop a tolerance to benzodiazepines after taking a high dosage for an extended period. With tolerance, the user needs a higher dosage to feel their effects. When they suddenly stop taking the medication, withdrawal symptoms appear. Withdrawal symptoms can affect people who have been prescribed them just as much as those abusing them.
The withdrawal symptoms are physically and emotionally painful and can even be life-threatening if the user suddenly stops. The severity and length of withdrawal symptoms are worse with those with a more extended history of use or higher dosage.
The most common symptoms are called “rebound” symptoms and appear within one to four days after stopping use. These symptoms will usually last up to ten days and include:
- Sleep disturbances
- Heart palpitations
- Difficulty concentrating
- Anxiety and panic attacks
- Muscular stiffness or discomfort
- Hand tremors
- Mild to moderate changes in perception
- Excessive sweating
There are also more severe symptoms but are less common and include:
- Psychosis or psychotic reactions
- Increased risk of suicidal ideation
Learn more about the benzo withdrawal timeline here:
The Risk of Benzo Overdose
Death from Benzodiazepines is highly uncommon through the effects of benzodiazepines alone. Most overdose deaths happen due to mixing benzos with other respiratory depressants, such as alcohol and opioids, causing a drug overdose. Many drug abusers actually use benzodiazepines in conjunction with their other substances to heighten their effects. Other risks of a drug overdose include taking large doses of the drug, taking it more frequently than prescribed, or injecting it. During a drug overdose, the central nervous system is depressed and can slow down breathing to dangerous levels. A drug overdose with benzos will cause the person to stop breathing. Knowing the signs and symptoms of a drug overdose can save a person’s life.
Questions to Ask Your Doctor
Doctors are prescribing benzos regularly for many mental health reasons. Most people take a doctor’s prescription and medical advice at face value without asking about cautions, alternative therapies, or possible side effects. Some questions you should ask your primary care physician if they prescribe benzos and to avoid benzodiazepine misuse are:
What are my other options?
There are safer options than Benzodiazepines, such as Selective Serotonin Reuptake Inhibitors (SSRIs) and behavioral therapy. There are also holistic therapies such as mediation and acupuncture that can help with anxiety disorders. These alternatives can take longer, so a benzo prescription can be used short-term while the other therapy takes effect.
What’s our follow-up?
Your doctor should monitor you closely when prescribing benzodiazepines. You should know when you and your doctor will check in next.
What is the exit strategy?
Benzos should only be used short-term; you should ask your doctor how and when you will be able to get off them.
Can I drink alcohol while taking benzodiazepine?
Alcohol and benzodiazepines are a dangerous combination and should not be mixed.
Could it interact with any of my other existing medications?
Benzos are most dangerous when combined with other drugs. It would help if you made your doctor aware of all your prescriptions, over-the-counter medications, and supplements to check that there are no dangerous interactions. You may be at risk of an opioid overdose if you take pain medication.
Drug Rehab for Benzodiazepines at Muse
If you or someone you love has developed a dependence or addiction to benzodiazepines, you should never quit cold turkey. Stopping benzo use (or benzodiazepine detox) should always be done under medical supervision, whether that is inpatient or outpatient. As an outpatient, tapering down the dosage can take several weeks or months to complete.
When in inpatient drug detox for substance abuse, tapering down can be done in as short as two weeks with medication-assisted treatment. Your inpatient physician can monitor for seizures and administer other medications to provide comfort during the withdrawal process, including symptoms of anxiety and insomnia.
Realizing you have an addiction to benzodiazepines is the first step, and you may need help for substance use disorders. There is no shame in reaching out for help, and many people with addiction to benzos started from a prescription. Long-term benzodiazepine use can lead to an abuse disorder or a drug overdose. At Muse Treatment Center, we offer benzodiazepine detox with our health professionals as our first step in your recovery to ensure your safety and comfort during the withdrawal process. Our dual diagnosis program can help you overcome anxiety disorders that may have been the cause of starting a benzodiazepine prescription. You can leave our drug abuse treatment center free from benzodiazepines and better understand your mental health to manage your anxiety disorder in a healthier and more effective way.
If you or someone you love is suffering from benzodiazepine dependence, please call us today to see if our program fits your needs. Even if you see the warning signs of addiction, it can be time to get help for potential benzodiazepine misuse. Call us at (800) 426-1818 today; one of our addiction specialists will be happy to assist you and provide additional information on our behavioral health center.