We've seen the opioid epidemic cut through our families, communities and country. Slowly, we're gaining the collective knowledge, resources and wherewithal to protect ourselves from its plight. But other drugs continue to fly dangerously under the radar. Drugs like benzodiazepines, whose popularity and rates of prescription continue to climb, are lesser known but potentially fatal, especially when mixed with other drugs.
Benzodiazepines have surged in popularity alongside opioids and are actually involved in more than 30 percent of opioid overdoses.1 Benzos were involved in more than 12,000 overdose deaths in 2020 alone. And still benzodiazepines are being prescribed at alarming levels that only continue to climb, with 66 million prescriptions handed out annually.2 That's nearly one in every three doctor visits that results in a prescription for benzodiazepines. If we aren't extremely careful, the number of people addicted to and potentially dying in part due to benzos will continue to rise.
But what are benzodiazepines? Why are benzos so dangerous, and why are they prescribed so frequently? When does withdrawal happen, and what are the symptoms? In this article, we'll cover all the details regarding benzodiazepine addiction, side effects, symptoms of withdrawal and treatment. You deserve to know the whole truth about benzodiazepine addiction so you can protect yourself and loved ones from its dangers.
Benzodiazepines, commonly referred to as benzos, are a Schedule IV controlled substance that depresses or slows the central nervous system (CNS) and its pursuant brain functioning. The brain and spinal cord are the two parts of the CNS, so anything that affects the CNS affects the entire mind and body. Specifically, benzodiazepines act upon the brain receptors known as GABA-A (gamma-aminobutyric acid-A, for those curious) and produce a calming effect that proves helpful for people who struggle with insomnia, anxiety, seizures, panic attacks or alcohol withdrawal.
Similar to opioids, cannabinoids and the club drug hydroxybutyrate (better known as GHB), benzodiazepines create a noticeable and addictive surge of dopamine levels. Dopamine is the brain chemical responsible for feelings of pleasure. Whereas an unmedicated brain would control the release of dopamine, benzodiazepines strip away the brain's mechanism for dopamine regulation and allow the feel-good chemical to then flood the brain.
Each medication may vary by its intended length of prescription, with some serving as long-term solutions while others are only meant for a very short term. Benzodiazepines have a number of intended medical uses. And although they can prove rather effective, it's important to keep in mind the dangers we outlined at the article's start because they can absolutely prove fatal when mixed with opioids or alcohol. Benzodiazepines are also one of the few drugs that can prove life-threatening during the withdrawal process, so please bear that in mind if you decide to start or already have a prescription for benzodiazepines.
Here are the most frequent diagnoses that result in a prescription for benzodiazepines:
Epilepsy and other seizure-related disorders
There are a number of intended uses, and the prescriptions will vary widely based on a person's diagnosis. For example, someone who experiences panic attacks or other disordered anxiety could be prescribed Xanax or Valium (brand names for alprazolam and diazepam) whereas a person who struggles with insomnia might be prescribed Ativan (a brand name for lorazepam). Each of the following medications are benzodiazepines, but each may affect different subtype receptors of GABA-A to produce slightly different results:
|Alprazolam||Niravam, Xanax, Xanax XR
||anxiety, panic disorders
||anxiety, alcohol withdrawal
||seizures, panic disorders, nerve pain
||anxiety, sedation, alcohol withdrawal, muscle spasms, seizures
||anxiety, insomnia, seizures, sedation
||anxiety, alcohol withdrawal
Benzodiazepines' side effects and symptoms usually revolve around drowsiness, sleepiness and dizziness because they belong to the depressant class of drugs, but there are a number of other side effects that may contribute to feelings of discomfort and a generalized risk for accident or injury. Here are the most commonly reported side effects of benzodiazepines:
All a part of the depressant class of drugs, benzodiazepines produce very similar results on the body to alcohol and opioids because of their shared relationship to and effects on the CNS. When paired with other depressants, the side effects of benzos can become disastrous and deadly because the side effects of each drug are enhanced, meaning the drugs interact and produce more severe side effects. Additionally, benzo withdrawal is one of the only withdrawal syndromes that can prove life-threatening.
Symptoms and Enhanced Side Effects of Combining Benzos with Other Depressants
Because the benzodiazepine withdrawal process can prove deadly, it's important for anyone who's potentially dependent or addicted to consult medical professionals or visit a medical detox facility before they begin to experience withdrawal. Medical professionals can prescribe medications to manage a withdrawal, oversee the withdrawal and intervene if anything goes awry. They can also provide a safe environment for withdrawal free from the temptation of mind-altering substances that might complicate or delay the process of quitting.
Here we have listed the most commonly reported withdrawal symptoms for benzodiazepines:
Ironically, the withdrawal symptoms can bring about the same side effects that drove someone to medicate in the first place. This is because the body and mind have adapted to the presence of the drug, and the withdrawal symptoms are the body's adjustment process to the absence of those chemicals. The body and mind have to reacclimate to their new realities, where the brain doesn't naturally produce as many chemicals as the benzodiazepine produced.
Obviously, benzodiazepines have their time and place. Not everyone who's prescribed a benzo will overdose and die. But not everyone who wants relief needs a medication, which we're all so quick to gravitate toward—a nice, simple pill. But there are alternatives that come without the strings attached: better sleep, physical exercise, more nutritional meals and fun hobbies can be naturally de-stressing, and come without the risk of dependence or withdrawal. Add in some sleep hygiene techniques, and the same can be said for many sleep disturbances.
At the end of the day, you get to decide what's best. Evaluate your situation, and consider the alternatives. If you decide that a medication is right for you to begin or continue, that's great. Just be sure to avoid the mixture of benzodiazepines with alcohol and opioids, and be watchful of any dependence that may be forming. Remember, benzos are usually a short-term solution for long-term problems.
If you or someone you know is struggling with maintained sobriety, please reach out to Hazelden Betty Ford for answers and help at 1-844-860-5255. You don't need to manage the situation alone. Substance use disorders of all varieties are common and treatable, and there is no shame in needing help with addiction. We're here for you.
Learn more with our What You Need to Know series. This program is ideal for educating patients and their families, school faculty and staff, behavioral and mental health professionals, and more.