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Benzodiazepine Abuse & Addiction: Signs and Treatment

Last Updated: December 21, 2023

Editorial Policy | Research Policy

Benzodiazepines are prescription medications that have abuse potential. When someone is struggling with benzo abuse, addiction or dependence, treatment is available.

Benzodiazepines are one of the most widely misused types of prescription drugs. They do have legitimate medical uses but also a high potential for abuse and addiction. These psychoactive drugs affect the central nervous system. This makes it critical to follow healthcare provider instructions. Only use them as directed.

What Are Benzodiazepines?

Benzodiazepines are psychoactive drugs. They are commonly prescribed for their anxiety-reducing, sedative and hypnotic properties. Benzos also act as muscle relaxants and anticonvulsants. They’re prescribed to treat conditions like:

  • Anxiety and panic disorders
  • Seizures
  • Insomnia
  • Muscle spasms
  • Alcohol withdrawal

These medications enhance the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is an inhibitory brain chemical (neurotransmitter). This means it slows down activity in the nervous system. Therefore, benzos have a calming or sedating effect.

Most Prescribed Benzos

Some commonly prescribed benzos include:

  • Diazepam (Valium)
  • Lorazepam (Ativan)
  • Alprazolam (Xanax)
  • Clonazepam (Klonopin)
  • Oxazepam (Serax)
  • Temazepam (Restoril)

Benzodiazepine Side Effects

Some of the side effects most commonly associated with benzodiazepines include:

  • Drowsiness and sedation
  • Impaired cognitive and motor skills
  • Dizziness
  • Lightheadedness
  • Difficulty concentrating
  • Memory problems
  • Slow reaction times
  • Nausea, vomiting or constipation
  • Changes in appetite
  • Blurred vision
  • Dry mouth
  • Tolerance with prolonged use
  • Dependence
  • Addiction

Why Are Benzodiazepines Addictive?

When someone uses benzos, they affect the brain and central nervous system. This enhances GABA activity. As a result, benzo leads to anxiety-reducing and muscle-relaxant effects. The effects of benzodiazepines can trigger addiction for a variety of reasons, including:

  • Activation of the brain’s reward pathway through the increase of dopamine. Dopamine is a neurotransmitter linked with pleasure and reinforcement.
  • Some benzos have a rapid onset of action. Fast-acting drugs tend to be more addictive.
  • The development of tolerance means higher doses are needed over time.
  • Physical dependence is where the body adapts to the presence of benzos. Stopping suddenly can lead to withdrawal symptoms. To avoid discomfort, the person may keep using benzos.

Benzodiazepine Addiction Statistics

Benzodiazepine use is growing, with over 5% of the U.S. population having benzo prescriptions. From 2019 to 2020, benzodiazepine overdose visits to emergency departments went up 23.7%. Prescription and illicit benzodiazepine-involved overdose deaths went up 21.8% and 519.6%, respectively, between 2019 and 2020. The number of benzodiazepine deaths increased by almost 43% from the second quarter of 2019 through the second quarter of 2020.

Benzodiazepine Addiction Signs

Potential signs of benzodiazepine abuse or addiction include:

  • Increased tolerance
  • Loss of control over use
  • Cravings
  • Physical health issues
  • Risk-taking behaviors
  • Psychological symptoms like anxiety or mood swings
  • Physical dependence
  • Preoccupation with use
  • Social and occupational problems
  • Neglecting responsibilities
  • Reduced interest in other activities
  • Changes in social circle
  • Deception and secrecy
  • Financial issues
  • Failed attempts to quit

Benzodiazepine Withdrawal Symptoms

Withdrawal symptoms of benzodiazepines can vary in intensity and duration. They can range from severe to life-threatening. The symptoms of withdrawal from benzos can include:

  • Anxiety
  • Insomnia
  • Irritability
  • Tremors
  • Muscle tension and pain
  • Headache
  • Sweating
  • Nausea and vomiting
  • Dizziness
  • Stimuli hypersensitivity
  • Problems concentrating
  • Memory impairment
  • Depersonalization
  • Hallucinations
  • Depression
  • Panic attacks
  • Seizures in heavy users

Benzodiazepine Overdose Signs and Symptoms

A benzo overdose can be severe and life-threatening. If the signs of an overdose are recognized, emergency treatment is necessary. Signs and symptoms of a benzo overdose can include:

  • Extreme drowsiness
  • Lack of responsiveness
  • Confusion or cognitive impairment
  • Slurred speech
  • Loss of coordination
  • Muscle weakness
  • Slow or shallow breathing
  • Low blood pressure
  • Bluish fingernails or lips
  • Weak pulse
  • Coma

Risks of Mixing Benzos with Other Substances

Overdosing on benzos can happen without mixing them with other substances. However, the risk is much higher when these substances are combined with alcohol or opioids. 

Mixing Benzos with Alcohol

Alcohol and benzodiazepines are both depressants. They slow the brain’s activity, and the risks associated with mixing the two include:

  • Extreme sleepiness, drowsiness and a decrease in thinking skills.
  • Risk of respiratory depression, with symptoms of slow or shallow breathing. In severe instances, this can lead to respiratory failure.
  • Impaired coordination and motor skills. This can increase the risk of injuries, falls and accidents.
  • Memory problems.
  • Increased risk of overdose.
  • Risk of unconsciousness or coma.
  • Worsening of mental health symptoms.

Mixing Benzos with Opioids

Like alcohol and benzos, opioids are also central nervous system depressants. All of these drugs slow down the brain and central nervous system. When opioids and benzos are combined, they each increase the effects of the other.

Mixing benzos with opioids can be very dangerous. One of the biggest risks is that it can slow down your breathing, which can be life-threatening. It can also make you very drowsy, increase the chances of overdose and negatively affect decision-making. Be aware of these risks and avoid mixing these two types of drugs.

Benzodiazepine Addiction Treatment Options

Addiction to benzodiazepines is a severe health concern that requires expert medical attention. Treatment options can include:

  • Medical detoxification: This is usually the first step in a continuum of care, where you go through benzo withdrawal under medical supervision.
  • Residential rehab: A structured residential addiction treatment program lets you focus on your recovery while living on-site at a treatment center. Residential rehabilitation usually includes a combination of counseling, medical support and therapeutic activities.
  • Partial hospitalization program (PHP): In a PHP, you live onsite. However, treatment is less intensive than that of a residential rehab program. 
  • Outpatient rehab: These programs are known for their flexibility. They allow you to receive treatment for benzo addiction while living at home. Outpatient rehab may include counseling, medical monitoring and group therapy. (Currently unavailable at The Recovery Village Kansas City Drug and Alcohol Rehab.)
  • Aftercare: Aftercare services support a successful recovery post-rehab with various recovery resources. These may include a custom relapse prevention plan. You may also get referrals for medical providers, therapists or local support groups.

Addiction treatment programs often involve individual counseling, group therapy and family therapy. These sessions help people to cope with addiction, share experiences and receive support from others.

If you’d like to learn more about benzodiazepine addiction and available treatment options, please reach out to our Recovery Advocates at The Recovery Village Kansas City Drug and Alcohol Rehab today.

Sources

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