Risks of Benzodiazepines, Uses, Side Effects, and Drug Abuse

What are Benzodiazepines Used For? What are Benzodiazepines Drugs?

What do benzodiazepines do? Benzodiazepines, also known as “benzos,” are a class of drugs used to treat various conditions. Conditions commonly treated with benzos include insomnia, anxiety, sleep disorders, and even alcohol withdrawal. These substances act on the GABA receptors in the brain as they produce a very calming effect. Unfortunately, benzo addiction can develop in as little as a month. High-risk patients or those with unstable medical conditions or a significant seizure history may benefit from admission to an inpatient service for benzodiazepine detox to manage the risks of benzodiazepines withdrawal symptoms safely. [1]

Gamma-aminobutyric acid or GABA is a naturally occurring amino acid that works as a neurotransmitter in your brain.***

Benzodiazepines Addiction Statistics

While benzodiazepines are important therapies for many Americans, they are also commonly abused and misused, often together with opioid pain relievers and other medicines, alcohol, and illicit drugs. Benzodiazepines, such as Xanax, Ativan, and other benzo sedatives, are often used for the short-term treatment of anxiety and insomnia. While benzodiazepine use is highly prevalent among U.S. adults, public health experts have not known what proportion of benzodiazepine users misuse them or meet the criteria for benzodiazepine use disorders. Nevertheless, benzodiazepine use was associated with emergency room visits, mental disorders, suicidal ideation, and substance use.

Physical dependence can occur when benzodiazepines are taken steadily for several days to weeks. Patients who have been taking a benzodiazepine for weeks or months can have withdrawal signs and symptoms when the medicine is discontinued abruptly or continued in lower doses to avoid withdrawal. Stopping benzodiazepines abruptly or reducing the dosage too quickly can result in acute withdrawal reactions, including seizures, which can be life-threatening. Prior to stopping benzodiazepines, patients should talk to their healthcare provider to develop a plan for slowly tapering the medication.

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How Much Xanax Does It Take To Overdose?

It’s possible to overdose on Xanax, especially if you take Xanax with other drugs or medications. The amount that could potentially lead to an overdose varies widely from person to person. It depends on many factors, including:

• How your body metabolizes the medication
• Your weight
• Your age
• If you have any preexisting conditions, like a heart, kidney, or liver condition
• If you took it with alcohol or other drugs (including antidepressants)

Mixing Xanax and alcohol can also be fatal. Xanax is in a class of drugs known as benzodiazepines. These drugs work by boosting the activity of a chemical called gamma-aminobutyric acid (GABA) in the brain. GABA helps calm the nerves by inducing feelings of relaxation. Most severe or fatal overdoses happen when Xanax is taken with other drugs — especially opioid pain medications — or alcohol.

If you’re taking Xanax dosages, be sure to tell your doctor about any other medications you’re taking. They may recommend an alternative medication.

Oxazepam (Serax, Alepam, Murelax)

• Oxazepam is used to relieve anxiety, including anxiety caused by alcohol withdrawal (symptoms that may develop in people who stop drinking alcohol after drinking large amounts for a long time). Oxazepam is in a class of medications called benzos. It works by slowing activity in the brain to allow for relaxation.
• Oxazepam may cause physical dependence (a condition in which unpleasant physical symptoms occur if a medication is suddenly stopped or taken in smaller doses), especially if you take it for several days to several weeks. [6]

Lorazepam (Ativan)

Ativan is used to relieve anxiety. Ativan is in a class of medications called benzos. It works by slowing activity in the brain to allow for relaxation. Ativan is also used to treat irritable bowel syndrome, epilepsy, insomnia, nausea, and vomiting from cancer treatment and to control agitation caused by alcohol withdrawal.

Physiological dependence on benzodiazepines can occur following prolonged treatment with therapeutic doses, but it is not clear what proportion of patients are likely to experience withdrawal syndrome. It is also unknown to what extent the risk of physiological dependence is dependent upon a minimum duration of exposure or dosage of these drugs. Withdrawal phenomena appear to be more severe following withdrawal from high doses of short-acting benzodiazepines. Dependence on alcohol or other sedatives may increase the risk of benzodiazepine dependence.

• Is lorazepam a benzodiazepine? Yes. Lorazepam is a benzodiazepine medication commonly used as the sedative and anxiolytic of choice in the inpatient setting owing to its fast (1 to 3 minute) onset of action when administered intravenously. [11]
• Serious adverse effects of lorazepam include dependence and Ativan abuse.

Diazepam (Valium, Antenex, Ducene, Ranzepan, Valpam)

Certain prescription drugs are more addictive than others, such as Valium. Most addictive medicines work by flooding your brain’s reward system with dopamine. This produces a pleasurable “high” that may entice you to use the substance again. You may grow dependent on the drug to feel “good” or “normal” over time, and you may also build a tolerance to the substance. This may cause you to take higher dosages.

Benzodiazepine Equivalency Table & Benzodiazepine Comparison Chart

Below is the benzodiazepines list in order of strength. Many benzos have long half-lives and these drugs undergo various types of hepatic metabolism (the type of benzodiazepine metabolism and rates depend on the individual drug). Benzodiazepines contraindications include a known case of angle-closure glaucoma. Benzos have muscle relaxant effects that can affect the function of the sphincter pupillae muscle of the iris. Benzos are also contraindicated in patients with prior hypersensitivity reactions. Anaphylaxis and angioedema have been reported. Remimazolam is contraindicated in patients with a history of hypersensitivity reaction to dextran 40.

Box Warning:  Concomitant use of benzos with opioids can lead to sedation, severe respiratory depression, coma, and death. Avoid combination.

Benzodiazepines for Anxiety

Benzos are among the most commonly prescribed drugs for anxiety disorders. While they are indicated as an adjunctive medication for short-term use according to clinical practice guidelines, previous studies have shown patterns of long-term use of benzos, which is problematic due to side effects, dependence, and the potential for substance abuse.

While benzos have also demonstrated efficacy for some anxiety disorders treatment, they are generally recommended in CPGs (clinical practice guidelines) as adjunctive short-term options, preferably with regular dosing, either to help relieve patients with acute anxiety and agitation or pending a response to antidepressants. With their rapid anxiolytic and sedative/hypnotic effects, benzos provide effective short-term relief for insomnia and anxiety.

Despite knowledge of the risks of the long-term use of benzos, this remains a pervasive problem. Clinicians need to be mindful of patterns and risk factors leading to the long-term use of benzodiazepines in patients with anxiety disorders. Are you searching for “benzodiazepine friendly doctors near me?” How to get a doctor to prescribe benzodiazepines for anxiety? Contact an accredited mental health treatment center that is aware of the risks of medications and substance abuse. It is best to get help with treatment facilities that offer dual diagnosis treatment, offering simultaneous treatment for substance use and mental health problems.

Alternatives to Benzodiazepines for Anxiety

Anxiety disorders are among the most prevalent mental disorders experienced in the general population. Evidence-based treatment options for anxiety disorders comprise psychological and pharmacological treatments. According to clinical practice guidelines (CPGs), selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are generally first-line pharmacological treatments for anxiety disorders since they present advantageous safety and tolerability profiles.

The following medications are all options for anxiety that are alternatives to addictive benzodiazepines. Drugs like Xanax that aren’t addictive are SSRIs, SNRIs, buspirone, beta-blockers, pregabalin, gabapentin, hydroxyzine, Panax, and diphenhydramine.

Benzodiazepines for Seizures

Benzodiazepines are also used to relax muscles and prevent seizures. They increase the effect of a chemical in the brain called GABA, which is a neurotransmitter (a substance that nerves use to send messages to one another). This causes brain activity to slow down. Benzodiazepines are a type of CNS depressant.

Benzodiazepines remain important agents in the management of epilepsy. They are drugs of first choice for status epilepticus and seizures associated with post-anoxic insult and are also frequently used in the treatment of febrile, acute repetitive, and alcohol withdrawal seizures. Clinical advantages of these drugs include rapid onset of action, high efficacy rates, and minimal toxicity. Benzodiazepines are used in a variety of clinical situations because they have a broad spectrum of clinical activity and can be administered via several routes. Potential shortcomings of benzos include tolerance, withdrawal symptoms, adverse events, such as cognitive impairment and sedation, and drug interactions. 

There is no accurate, generally accepted prescription guideline for benzodiazepines. These medications are prescribed at about 66 million doctors’ appointments a year in the U.S., according to a report by the U.S. National Center for Health Statistics. A recent study showed that benzodiazepine prescribing had nearly doubled from 2003 through 2015 for ambulatory care visits.

For every 100 adults that visit an office-based doctor over the course of a year, 27 visits will result in a prescription for a benzodiazepine. Opioid overdose deaths that included benzos increased an astounding 1082% between 1999 and 2020, and 30% of overdose deaths involve BZD use. The overdose mortality rate involving benzodiazepines for women between the ages of 30 and 64 has increased by 830 percent between 1996 and 2017. Four-fifths of those prescribed benzos indicate use for more than six months, far beyond the “short-term” use recommendation of the FDA.

Drug-Drug Interactions

• Benzodiazepines may interact with ethanol, other benzodiazepines, and sedatives such as barbiturates, resulting in increased respiratory depression via a synergistic effect. Therefore, concomitant administration of benzodiazepines with patients under the influence of the preceding drugs should be carefully performed, with respiratory monitoring in place.
• Lorazepam and oxazepam are metabolized by UGT (Uridine diphosphate glucuronosyltransferases). Inducers of UGT, such as carbamazepine, phenobarbital, phenytoin, and rifampin, may induce the metabolism and decrease the efficacy.
• Excessive sedation can result from concurrent administration of benzodiazepine-like midazolam, triazolam, alprazolam, or diazepam administered with strong CYP3A4 inhibitors like itraconazole, ketoconazole, grapefruit juice, clarithromycin, nefazodone, ritonavir. Avoid concurrent administration.

What Can Show Up as Benzodiazepine in a Urine Test?

False-positive screens for drugs of abuse can potentially hamper diagnosis and treatment. If a patient’s clinical presentation is prematurely ascribed to a substance disorder, a medical workup may be less aggressively pursued, potentially forestalling the correct diagnosis and early treatment. Moreover, when patients are misdiagnosed with a substance-related disorder based on false test results—despite their truthful denial of substance use—the crucial therapeutic alliance may be damaged. Such potential consequences underscore the importance of knowing the validity of screening tests for drugs of abuse.

• False Negative Benzodiazepines Urine Test – False-negative benzodiazepines urine test can arise when the drug concentration in the urine is less than the amount specified by the laboratory performing the test. False negatives may be affected by diluted urine, the amount of time between drug consumption and testing, and the amount of substance taken.
• False Positive Drug Test Benzodiazepines – False-positive results might be more common than many clinicians realize. If you use OTC NSAIDs, your urine test may come up positive for barbiturates (a form of sedative) or THC. Oxaprozin (Daypro), another NSAID, can be used to relieve arthritic pain. Consuming oxaprozin may cause a false positive benzodiazepine test. Barbiturates are not benzos. Barbiturates are a group of drugs in the class of drugs known as sedative-hypnotics. Unfortunately, both benzodiazepines and barbiturates drug classes can be highly addictive.

Benzodiazepines and Alcohol

Concomitant excessive consumption of alcohol and benzodiazepines use is associated with adverse health outcomes. When benzodiazepines and alcohol are used concurrently, their sedative effects significantly increase the risk of adverse events, including fatal overdose. Long-term consequences of combined benzodiazepine and alcohol use include cardiovascular, gastrointestinal, hepatic, kidney, and neurologic injury and exacerbation of psychiatric conditions. Despite this drug-drug interaction, benzodiazepines have the largest and the best evidence base in the treatment of alcohol withdrawal and are considered the gold standard.

Benzodiazepines for Alcohol Withdrawal

Alcohol withdrawal syndrome ranges from mild to severe. The severe complicated alcohol withdrawal may present with hallucinations, seizures, or delirium tremens. Over the years, the treatment for alcohol detoxification has evolved from the use of a gradual weaning schedule of alcohol itself to the use of benzodiazepines and newer miscellaneous drugs.

Benzodiazepines are safe, effective, and the preferred treatment for alcohol withdrawal syndrome. The best-studied benzodiazepines for alcohol withdrawal treatment are diazepam, chlordiazepoxide, and lorazepam. The three goals of drug and alcohol detoxification as described by the American Society of Addiction Medicine (ASAM) are as follows:

1. “To provide a safe withdrawal from the drug(s) of dependence and enable the patient to become drug-free”.
2. “To provide a withdrawal that is humane and thus protects the patient’s dignity”.
3. “To prepare the patient for ongoing treatment of his or her dependence on alcohol or other drugs.”

Alcohol withdrawal syndrome results in people who are dependent on alcohol and either stop drinking or reduce their alcohol consumption. This results from a shift in the neurotransmitter levels in the brain, from GABA inhibition to glutaminergic stimulation. The symptoms are generally mild to moderate and resolve within a few days. However, severe forms of alcohol withdrawal syndrome may be associated with generalized seizures, hallucinations, and delirium tremens, which can be fatal.

Oral benzodiazepines are the best-studied and most effective drugs for preventing severe alcohol withdrawal syndrome, particularly the risk of seizures and delirium. For delirium tremens and withdrawal seizures, treatment with high-dose benzodiazepines (parenteral or oral) is recommended in the ICU setup.

Are Benzodiazepines Addictive? Benzodiazepines Uses & Abuse

Like other drug addiction effects, benzos cause a dopamine discharge. Dopamine is a chemical that contributes to how we feel pleasure. Over time, these drugs alter the way the brain releases dopamine. This affects the way people feel euphoria or happiness from all activities. As a result, people addicted to benzos can sometimes feel happy unless they take large doses of the drugs.

Addiction also alters the motivation system in the brain. The brain correlates the substances with happiness and causes cravings that drive the person to take the drugs, and withdrawal is another part of benzodiazepines dependency and addiction. People who attempt to discontinue the drugs on their own are seldom able to make it through withdrawal. Instead, the symptoms are usually so painful that people return to the benzos for relief.

Benzos can also be addictive because they momentarily alleviate specific mental health issues. For example, some people self-medicate with benzos to mitigate anxiety or sleep difficulties. The drugs can temporarily manage these illnesses, but long-term use can make people think they have to have the drugs to feel less troubled.

How Long Does It Take To Develop Benzo Addiction?

You should only be prescribed benzos for the shortest amount of time possible. Taking benzos regularly for a few weeks or more can lead to addiction. Doctors recommend that you only take them for 2-4 weeks. Intermittent use may help to avoid addiction.

One of the most significant risks of benzos and the reason to get into a benzo addiction treatment program is likely overdosing. With the capacity to develop a tolerance, the longer someone takes benzos, the greater dosage they will need to take to reach the desired effect. Hence, the greater the risk of overdosing. Moreover, sedative benzos cause breathing to slow. In turn, less oxygen is directed through the lungs to the brain and the rest of the body. Finally, once you take a larger dose, breathing delays to the point of being fatal.

Benzodiazepine Overdose Symptoms

Patients with benzodiazepine toxicity will primarily present with central nervous system depression ranging from mild drowsiness to a coma-like, stuporous state. The classic presentation of an isolated benzodiazepine overdose consists of CNS depression with normal vital signs. Cardiac-related effects and fatalities are rare in pure benzodiazepine toxicities.

Life-threatening respiratory depression can be seen with large oral ingestions with or without any substance that is congested simultaneously. Iatrogenic ( induced unintentionally by a physician or surgeon or by medical treatment or diagnostic procedures) causes of toxicity can be seen when benzodiazepines are combined with other drugs during procedural sedation, particularly with opiates such as fentanyl.

The mainstay benzodiazepine overdose treatment is supportive care, which may include endotracheal intubation to provide definitive airway management. Single-dose or multi-dose activated charcoal, hemodialysis, or whole bowel irrigation play no role in managing benzodiazepine overdose and toxicity.

While the mainstay treatment of acute benzodiazepine toxicity or overdose is supportive care, there is, however, an “antidote for benzodiazepines” that may be used in limited situations. Flumazenil is a nonspecific competitive antagonist at the benzodiazepine receptor that can reverse benzodiazepine-induced sedation. However, in most cases, the risks of a flumazenil reversal agent for benzodiazepines usually outweigh the benefits in acute toxicity, and thus flumazenil is not recommended for routine benzodiazepine reversal.

Seizures and cardiac dysrhythmias can occur after flumazenil benzodiazepine antidote administration, and many fatalities have been reported. Flumazenil can precipitate acute withdrawal syndromes in those with chronic benzodiazepine dependence, which can be life-threatening. If a patient with a chronic dependence on benzodiazepines is given flumazenil as a benzodiazepines antidote dose, it can lower their seizure threshold and potentially cause life-threatening seizures. The treatment of seizures, which typically involves benzodiazepines, would be rendered useless, as the flumazenil has blocked the benzodiazepine receptors.

Flumazenil can be safely administered to non-habituated users of benzodiazepines. This situation classically occurs in the pediatric population with accidental ingestion or after procedural sedation. Flumazenil antidote of benzodiazepine is recommended that the decision to use flumazenil be based on the balance of risk versus benefit in the assessment and treatment of a patient that is a non-habituated user of benzodiazepines, as most people with a benzodiazepine overdose will do well with supportive care and time alone.

Acute Propofol and Benzodiazepine Intoxication

Propofol is an intravenous anesthetic used for procedural sedation, during monitored anesthesia care, or as an induction agent for general anesthesia. It may be administered as a bolus or an infusion, or some combination of the two. Propofol and benzodiazepines such as midazolam and lorazepam are commonly used for ICU sedation. However, Propofol causes dose-dependent respiratory depression due to the inhibition of the hypercapnic ventilatory drive. This respiratory depression is potentiated by the concurrent use of other sedative agents (benzodiazepines, opioids, central-acting alpha two agonists, or other anesthetic medications).

Once detox is complete, a new doorway in treatment opens up, which is referred to as a residential level of care. The residential care program slowly and effectively introduces the individual into an atmosphere of therapeutic growth, marked by master’s level therapists, clinicians, group counselors, psychiatrists, and a community of like-minded individuals with the same aim: to attain sobriety and live a great life.

Some of the many modalities applied and practiced within our residential treatment facility are:

Xanax Addiction

Xanax is the benzodiazepine brand name for alprazolam. Alprazolam has been widely prescribed to treat anxiety and panic disorder and falls within the class of drugs known as benzodiazepines or central nervous system depressants. Side effects from the use of alprazolam include impaired psychomotor performance, impaired memory, ataxia, anterograde amnesia, paradoxical excitement, hypomania, and birth defects.

Xanax can be addictive, especially if a person believes they would be unable to manage their stress without it. Even persons who take Xanax as prescribed may get addicted to it. Tolerance to Xanax develops quickly, necessitating more frequent and higher dosages. As the person uses Xanax over time, their body and brain can develop a dependency on the drug, meaning that when they reduce their use or stop using altogether, they can experience withdrawal symptoms.

The desire to avoid withdrawal symptoms may lead some people to keep using Xanax. It is important to note that dependency is not the same as addiction. However, many individuals who develop Xanax benzodiazepines addiction are most likely dependent on the substance of abuse.

Restoril Detox

Temazepam is a safe hypnotic for use by older adults over an 8-week treatment period. There are few adverse effects and behavioral tolerance to those effects develops over time. Temazepam may cause physical dependence (a condition in which unpleasant physical symptoms occur if a medication is suddenly stopped or taken in smaller doses), especially if you take it for several days to several weeks. it is crucial that you do not stop taking this medication or take fewer doses without talking to your doctor.

Temazepam is an addictive benzodiazepine that causes the user to quickly acquire a tolerance and harsh withdrawal symptoms when they stop using it. Due to the possibility of dependency, many doctors advise using it for no more than 10 days at a time. Individuals prescribed the medicine should also be properly watched while on it if they develop tolerance.

Before receiving Restoril addiction therapy, a person must detox from it. This involves either going through withdrawal cold turkey on their own, gradually weaning down their dosage until it exits their system, or going through a supervised detox where they receive medical treatment while going through withdrawal. It is not advised to detox cold turkey owing to the risks associated with dehydration. At We Level Up detox center, we detox patients on a medical safety basis.

What are Roofies?

Rohypnol, the trade name for the drug flunitrazepam, is a central nervous system depressant. It is also known by its slang name “roofies” or a “date rape drug.” The drug is legally manufactured and available outside the United States but is neither manufactured nor approved for sale within the United States. Since the 1990s individuals in the United States have used Rohypnol illegally, often as a means of mitigating the depression that results from using stimulants such as cocaine and methamphetamine.

Flunitrazepam is a benzodiazepine chemically similar to prescription sedatives such as Valium® and Xanax®. Teens and young adults tend to abuse this drug at bars, nightclubs, concerts, and parties. It has been used to commit sexual assaults due to its ability to sedate and incapacitate unsuspecting victims.

Rohypnol is a strong sedative that can be used to treat insomnia or anxiety. This benzodiazepine is extremely addictive and can cause dependency and withdrawal symptoms. Individuals who quickly discontinue Rohypnol may develop withdrawal symptoms, including seizures. You are not alone in your struggle with Rohypnol withdrawal. Contact one of our treatment professionals now to learn more about Rohypnol withdrawal symptoms and to discover a medical detox facility near you.

Klonopin Addiction Treatment

Is Klonopin a benzodiazepines? Yes. Klonopin has the generic name of Clonazepam. It is a benzodiazepine commonly used to treat different conditions, including anxiety disorders and epileptic seizures. However, due to its low price and easy availability, it has become a widely misused medication in medical and recreational contexts. Someone can develop Klonopin addiction even if they take medication as prescribed by a healthcare provider.

Klonopin is a highly addictive benzodiazepine similar to Xanax, Ativan, and Valium. The medication is FDA-approved for panic and seizure disorders and is recognized for its long-acting, relaxing properties. It can also help with muscular spasms, sleep problems, mobility problems, and vertigo. Sadly, many people misuse their prescriptions or obtain Klonopin illegally. This type of abuse can lead to addiction.

The first step in overcoming a Klonopin addiction is to get professional assistance. We Level Up can assist you in having a safe, medically supervised detox from any substances you are attempting to quit. If you have a physical dependency on Klonopin, you must proceed with extreme caution while discontinuing the medication. Klonopin withdrawal may be severe, catastrophic, and even lethal. It is necessary to seek the advice of a doctor. But, with the proper care, you may safely discontinue Klonopin and begin the recovery process.

Ativan Addiction

Is Ativan a benzodiazepine? Yes. Ativan is a class of psychoactive drugs designed to help with chemical imbalances in the brain. You might also hear it as a sedative-hypnotic or anxiolytic medication. Many have been addicted to this drug and require Ativan detox to function normally again and avoid benzodiazepine side effects that bring health risks. Ativan addiction should not be taken lightly because all forms of substance abuse can lead to serious impairment.

Although Ativan may provide the desired benefits for some, prolonged usage of four weeks or more raises the likelihood of becoming physically dependent on the medication. When someone gets dependent on Ativan, stopping or reducing the dose might induce withdrawal symptoms. Since it inhibits the central nervous system, it can have hazardous consequences. When taken with other depressants, Ativan can induce overdosing, and it can also cause seizures if stopped abruptly.

While dealing with benzos, medical detoxification is essential. The procedure will gradually wean you off Ativan and build a medical strategy to assist you in fighting for your life. Addiction treatment experts will choose the best way ahead. It will suit your unique requirements as well as the safety standard. Thankfully, treatment can be personalized to meet your most individualized requirements.

How Dangerous is Valium? Valium Withdrawals & Addiction

Valium is a Schedule IV controlled substance with the potential for abuse. Development of dependence and tolerance can occur in addiction-prone, long-term treatment or those patients taking high doses. Thus, these individuals should be under careful supervision; once an individual develops dependence, the risk of developing withdrawal symptoms increases.

No one can deny the critical function Valium plays in assisting patients suffering from anxiety disorders, sleeplessness, or other psychiatric illnesses to manage their sickness. There is nothing to worry about if you follow your doctor’s advice and take the medicine under close medical supervision. But, if you are having difficulty controlling your cravings and meet the criteria for valium abuse, it is important to seek treatment and stop this habit before it becomes a hazardous problem.

Because Valium withdrawal may be dangerous, our clinically supervised, skilled intake team will assess whether a Valium detox is a good first step for you. You’ll like knowing that we bring no judgment to whatever your issue is, but simply factual, up-to-date information to help you recover the life you want to reclaim at each level of our admissions process.

Top 10 What is a Benzodiazepine? FAQs