Benzodiazepines are a class of powerful central nervous system depressants physicians primarily prescribe to patients with anxiety. However, patients can easily abuse these drugs, which can quickly lead to addiction and dependence.
When people use and abuse the medication for long periods, quitting cold turkey can even be dangerous. In these situations, seeking treatment at an accredited medical detox facility is always best before moving on to long-term clinical services.
Types of Benzodiazepines
Various benzodiazepines differ in strength, potency, and use cases. A physician may prescribe one over the other based on pre-existing conditions, potential allergies or negative reactions, or the severity of the symptoms they must address. Here are a few of the more common benzodiazepines widely prescribed and often abused.
Ativan (lorazepam) is a controlled substance prescribed by a doctor and used to treat the symptoms of anxiety, sleep disorders, alcohol withdrawal, and epilepsy. It is one of the most effective and safe medications in the healthcare system. However, it is not exempt from causing benzodiazepine addiction. Ativan is also the most common benzodiazepine used to ease alcohol withdrawal.
Oxazepam is a sedative in the benzodiazepine drug class that treats anxiety disorders with depression and symptoms of alcohol withdrawal. It targets the brain chemicals that cause anxiety symptoms.
Halcion (triazolam) is a brand-name sedative-hypnotic similar to the ones listed here. The specific use of this medication is to treat sleep disorders; however, it can also be prescribed to treat anxiety and epilepsy. Halcion can become highly addictive if not taken as prescribed or for long periods.
Klonopin (clonazepam) is like Ativan. It is a controlled substance for seizures, panic, and anxiety disorders. Klonopin is highly addictive, and it is a fast-acting medication. Since benzodiazepine addiction is common in fast-acting drugs like Klonopin, it is recommended only for short-term use. Klonopin is also another commonly prescribed benzo.
Xanax (alprazolam) is the most recreationally abused benzodiazepine. It also treats anxiety and panic disorder. Xanax should not be used for long periods. However, many people do. It causes dependence and addiction quickly, like most drugs in this class. Xanax is also commonly used in ways other than prescribed. This drug can be dangerous, especially if obtained on the street. Xanax pills are sometimes combined with the powerful opioid fentanyl in a process called “pill pressing” with fatal results.
Librium (chlordiazepoxide) treats anxiety disorders, alcohol withdrawal symptoms, and tremors. Librium is habit-forming and can cause addiction, just like other benzos. Librium is prescribed for short-term use due to its highly addictive properties. It is also commonly used before medical and dental procedures.
Valium (diazepam) commonly treats anxiety disorders, muscle spasms, and seizures. Like other drugs in its class, it has a high abuse potential and a high risk for addiction. Valium is also commonly used to ease symptoms of withdrawal from alcohol or opioids.
What Do Benzodiazepines Treat?
Benzodiazepines, like other sedative-hypnotic drugs, are made up of sedative-psychoactive properties. If you abuse this drug class, you will inevitably develop a benzodiazepine addiction. Benzodiazepine addiction results from a tolerance buildup and dependence on the drug, eventually leading to withdrawal.
Benzodiazepines are commonly used to treat symptoms such as:
- Withdrawal from alcohol
- Muscle spasms
Signs and Symptoms of Benzodiazepine Addiction
Benzodiazepines affect the major inhibitory neurotransmitters in the central nervous system, creating an influx of dopamine in the brain – rewarding the pleasure receptors. Unfortunately, when this occurs for long durations, the brain gets used to the overabundance of pleasure.
Eventually, the brain stops producing its own – only relying on dopamine from an outside force.
Long-term use of benzos has been linked to brain damage. Since these drugs affect the brain’s GABA receptors, neurons do not fire as often as they need to. Benzodiazepines reduce the symptoms of fear and anxiety, and continuous use can lead to the inability to prevent these symptoms without using a substance. Dependency forms easily when it comes to benzodiazepines. Benzodiazepine addiction stems from the inability to stop using the drugs on your own and being entirely reliant on them to function properly.
Over time, benzodiazepines are not as effective on the brain and the body due to their high effectiveness in short-term use only. Short-term use of benzos is recommended to prevent benzodiazepine addiction and severe withdrawal symptoms.
Benzodiazepines are viewed as safe and effective for short-term use only. Long-term benzos use causes addiction and can lead to other physical and psychological effects. Benzodiazepines are highly addictive and known to cause severe withdrawal symptoms.
Benzodiazepine withdrawal of any type can be fatal if you detox cold turkey. Benzodiazepine addiction and withdrawal can cause serious medical issues. Symptoms that emerge from an abrupt and reduced benzo use:
- Anxiety or panic attacks
- Cognitive impairment
- Visual disturbances
- Muscle spasms that can result in death
- Post-traumatic stress disorder
- Respiratory depression
- Suicidal thoughts
- Manic episodes
- Increased heart rate
Although this drug class is dangerous, to a degree, they are beneficial for individuals who truly need it and take it as prescribed. However, since benzodiazepines have a high risk for abuse, it is hard to categorize these drugs as safe, especially for people who might be more at risk for complications, such as elderly patients. When people abuse benzodiazepines, often, it leads to negative consequences.
Benzodiazepine Addiction Statistics in the U.S.
- 66 million doctor’s appointments (or 27% of all doctors’ visits) end with a benzodiazepine prescription each year.
- In 2015 and 2016, 20% of benzodiazepine use was not according to a doctor’s instructions.
- According to the National Institute on Drug Abuse (NIDA), 11,537 overdose deaths involved benzodiazepines in 2017.
What Are the Treatment Options for Benzodiazepine Addiction?
No matter what your level of benzodiazepine addiction or dependence is, trying to beat it on your own is never advisable. Getting treatment at an accredited medical and clinical substance abuse treatment facility will result in a safer and more comfortable detox, a greater support network, and lasting results.
If you choose to go to treatment for benzodiazepine abuse, the first step will be to go through a medically supervised detox. Because of the chemical imbalance that quitting benzodiazepines cold turkey causes, detoxing without medical care can be dangerous.
During detox, your healthcare professionals will develop a benzodiazepine tapering schedule based on your body type, dependence severity, history, and underlying conditions. Your intake will be reduced day after day until your brain chemistry has reduced its tolerance and you can function without the drug. Once you’ve been stabilized, a longer-term clinical treatment plan can be put in place.
Benzodiazepine Inpatient Treatment
Dealing with the physical withdrawal symptoms alone isn’t enough to see lasting freedom from benzodiazepine addiction. After detox, the next step will be to go through an inpatient or residential treatment program. During this, you will live at the facility and participate in daily therapy sessions on both a group and individual basis. Clinicians will work alongside you to help you address the root cause of the addiction and find ways to improve your mental health so that you can have the tools you need to combat benzodiazepine abuse and cravings after the program.
Benzodiazepine Outpatient Treatment
Once inpatient treatment is complete, treatment is far from over. In an outpatient program, you will transition to living at home and commuting to treatment for a certain amount of time each week. You’ll participate in many of the same therapy sessions and groups you did during inpatient treatment. Still, you can practice managing your addiction while returning to your normal environment and obligations.
Benzodiazepine Addiction Frequently Asked Questions (FAQs)
Which Benzodiazepine Is Most Likely to Cause Dependence?
While the likelihood and speed of addiction are dependent on the person taking the benzodiazepine, each has different potency levels and staying power. Klonopin (clonazepam), for example, is one of the most potent benzodiazepines and stays in your system the longest. Xanax and Ativan are also extremely potent but are short-acting. Benzodiazepines such as Valium and Restoril are less potent and don’t stay in the system very long, ostensibly reducing the chance of addiction.
Are There Non-Addictive Benzodiazepines?
While some benzodiazepines are more addictive than others based on their potency, and your body might react to one more than another, all drugs in the benzodiazepine class are addictive. However, some ways to manage anxiety do not require using addictive prescription medication, and these will be vital to your long-term recovery success.
How Long Does It Take to Become Addicted to Benzodiazepines?
This heavily depends on the individual using the benzodiazepine. Some have personalities and dispositions more inclined toward addiction than others. Some people can develop an addiction in as little as just one or two doses, while for others, it may take longer. It’s always best to follow your physician’s instructions for taking a prescribed benzodiazepine.
NewScientist. Benzodiazepine prescriptions reach ‘disturbing’ levels in the US. (n.d.) Retrieved https://www.newscientist.com/article/2230379-benzodiazepine-prescriptions-reach-disturbing-levels-in-the-us/
National Library of Medicine. Benzodiazepine Use and Misuse Among Adults in the United States (February 2019) Retrieved https://pubmed.ncbi.nlm.nih.gov/30554562/
National Institute on Drug Abuse. Drug Overdose Death Rates. (n.d.) Retrieved https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
DEA Intelligence Brief. Counterfeit Prescription Pills Containing Fentanyls: A Global Threat. (July 2016) Retrieved chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/http://content.govdelivery.com/attachments/USDOJDEA/2016/07/22/file_attachments/590360/fentanyl%2Bpills%2Breport.pdf