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What Are Benzodiazepines and Are Benzos Addictive?

Last Updated: June 13, 2022

Authored by Sharon Levy, MD, MPH

Reviewed by Michael Espelin APRN

Benzodiazepines, commonly referred to as benzos, are substances designed to treat various conditions of the nervous system, and these prescription drugs are mostly used for anxiety therapy. Even though this drug is associated with a lot of discomforting benzo side effects, in 2019, around 11.3 million patients in the United States were given benzo prescriptions. While there are many types of benzodiazepines, all act by causing mild to severe depression of the central nervous system. When used correctly, they can help offer short-term treatment of numerous medical conditions. However, problems arise when they are used for too long or used incorrectly, as they may become habit-forming, leading to benzodiazepine abuse and dependence.

What Are Benzos?

Benzodiazepines are psychoactive drugs labeled as sedatives and are most commonly prescribed to people who struggle with anxiety, seizures, insomnia, and alcohol withdrawal. Generally, these drugs work by facilitating the binding of GABA at various GABA receptors throughout the CNS, leading to the slowing down of the body and brain’s functions. Furthermore, according to the FDA, benzodiazepine drugs are controlled substances. They belong to Schedule IV of the controlled substances act.

Types of Benzodiazepines

Because all types of benzo drugs depress the central nervous system, they are used in the treatment of both physical and mental nervous system disorders such as anxiety and insomnia.

Moreover, there are three types of Benzodiazepines and these are classified according to how long they act in the body:

  • Short-Acting Benzodiazepines: These benzo drugs stay in the body for a short period. Then, they are either converted to other compounds or eliminated ultimately. Examples include Tranxene, Versed, and Halcion. Typically, they show the beneficial effects for 3 to 8 hours.
  • Intermediate-Acting Benzodiazepines: Under normal conditions, their duration of effects is 11 to 20 hours. Xanax, Ativan, and Restoril are some well-known medications of this class.
  • Long-Acting Benzodiazepines: Medications like Librium, Klonopin, Valium, and Dalmane have an extended presence in the body. They may stay inside the body in the original form for up to 3 days.

The duration of effects inside the body is a major factor that determines their use. For instance, long-acting benzos are more useful to treat anxiety and seizures. To address these problems, one needs a consistently maintained drug level in the blood. Similarly, according to a report published in the journal of Sleep Science and Practice, doctors prefer short-acting benzos to treat sleep problems. In this case, one does not need to maintain a continuous drug level in the blood.

A yellow bottle with benzodiazepines drugs.

Benzodiazepines Uses: What Do Benzos Treat?

Benzodiazepines or simply benzos are a class of medications that depress CNS. These effects make them a very useful medication. Doctors use them to treat a wide range of mental health and physical disorders. Some benzodiazepine uses include insomnia, anxiety, panic attacks, abnormal muscle contractions, alcohol, and drug withdrawal.

The benzodiazepines list that is most commonly prescribed are:

  • Ativan is one of the most prescribed types of benzodiazepines. It is used for treating common ailments alleviated by benzo use, as well as a few unique conditions, such as chemotherapy-induced vomiting. It has the potential to develop many adverse effects, including low blood pressure and memory loss.
  • Halcion is considered by many to be the strongest in the benzodiazepine class as it has the most psychoactive effects by mass, making it highly addictive. As such, doctors tend to be more hesitant to prescribe it. It is rare to see it used to treat anything other than severe physical illnesses, though on occasion it is used to jumpstart therapy of insomnia.
  • Klonopin was once commonly used to treat anxiety disorders, but now such use has fallen out of popularity. Now, it is primarily used in the treatment of seizures and movement disorders. It is also highly addictive; one out of every three patients will become addicted to the medication if they take it for four weeks or longer.
  • Librium is commonly used in the treatment of drug and alcohol withdrawal symptoms. Many doctors also use it to ease anxiety and eliminate insomnia. While it is not as well known or as widely used as other benzos, it was the first to be synthesized.
  • Valium is perhaps the most well-known benzo in existence. The drug is known to have a significant calming effect, which is often described as euphoric, which contributes to its misuse. Abuse of Valium is highly problematic for many reasons, including its ability to cause long-term cognitive health impairment.
  • Xanax has become the most prescribed benzodiazepine in recent years. Heavy reliance on the drug has also seen it become one of the most common benzos to be addicted to and significantly contributing to the spike in benzo addiction and deaths. While it is considered to be weaker than many other benzos, It belongs to benzos with a long half-life, making it favored by both doctors and those who misuse the drug.

While the benzodiazepines list above is the most common, this is not the complete benzodiazepines list. There are many others on the market in the US and worldwide, including Onfi, Tranxene, Phenazepam, and Restoril.

Benzo Addiction And Abuse Overview

Are benzodiazepine drugs addictive? Yes, all benzos, when abused, have the potential to lead to addiction, and the risk increases the longer the drug is taken. As cited in the study of psychologists and psychiatrists from the USA, in 2017, benzodiazepines and other tranquilizers were the third most commonly used prescription drugs in the United States, and around 6 million US citizens ages 12 and above misuse these medications. Furthermore, most patients will go through benzo withdrawal when they stop the use of benzos unless monitored by a medical team. The exact risks vary with different types of benzodiazepines, but the risk is always there.

Signs And Symptoms of Benzo Addiction and Abuse

Spotting the abuse of benzodiazepine is not easy. In general, the signs of benzodiazepine abuse of the medications are similar to those of standard use. However, because the user must take higher doses as their body becomes tolerant of the medication, the symptoms tend to be more severe and it can result in unintentional benzos overdose.

Physical Signs and Symptoms of Benzo Addiction and Abuse

There are secondary symptoms that may develop which are specifically related to the addiction to and long-term use of the substance.

Due to the availability of benzodiazepines uses statistics, the physical signs of benzodiazepine use include:

  • Slowed reflexes
  • Blurred vision
  • Slurred speech
  • Respiratory problems
  • Lethargy
  • A decline in performance at work or school, or being absent frequently
  • A loss of interest in activities that were once enjoyed
  • Commonly speaking about benzos or asking for benzos
  • An increase in drinking
  • Anorexia

According to medical doctors from The Netherlands, it was reported that the use of benzodiazepine drugs is associated with accident falls leading to hospitalization. In this study, it was reported that the accidents are also dose-dependent. When the dose is higher, the risk of accidents is increased.

A woman addicted to benzodiazepines looks at some pills on the table.

Psychological Signs and Symptoms of Benzo Addiction and Abuse

Aside from the physical signs and symptoms of benzodiazepine addiction and abuse, there are also psychological ones. Based on a study published in the British Journal of Clinical Pharmacology, these signs and symptoms are associated with withdrawal.

Some of these include:

  • Cognitive impairment including poor judgment and risk-taking behaviors
  • Difficulty concentrating
  • Memory impairment
  • Insomnia
  • Anxiety and other sudden changes in mood or behaviors
  • A decline in socialization
  • Suicidal thoughts or actions, including self-harming
  • Talking about reducing their use of the substance but not doing so
  • Exhibiting withdrawal signs when unable to take the medication

Symptoms of benzodiazepine use tend to mimic many other conditions. Some of the symptoms of benzodiazepine abuse are the same as the conditions the medication is meant to treat. For example, according to a study published in the American Psychological Association, those who safely stop the use of benzos after 6 months were able to experience a reduction of anxiety. On the other hand, those who remained on these drugs experienced the worsening of the anxiety symptom.

Who Is Most at Risk of Benzo Addiction?

Based on the data provided by psychiatrists from the University of Michigan, 5.3 out of 30.6 million individuals in the United States abused benzo drugs in the years 2015 and 2016. In the same report, it was stated that benzodiazepine misuse is also associated with opioid abuse. This means that those who are using benzodiazepines with other illicit medications are most likely at risk of developing benzodiazepine addiction.

Aside from this, other most at risk of benzo addiction include:

  • Individuals who are 18 to 25 years old
  • Women and non-Hispanic white
  • Presence of past-year medical illness
  • Past-year misuse and abuse of tobacco and alcohol

From the study, it was reported that the most common cause of benzodiazepine addiction and abuse is because of using the drugs without prescription, and 70% of those young people abusing it acquire the drugs from friends and families. Furthermore, the common reason for these people to use a benzo substance is that they want to achieve relaxation or relieve tension.

Benzodiazepine Addiction Treatment and Rehabs

If one suspects that a family member or a friend is using benzodiazepine drugs, it is vital to talk to them and try to explain why it is important to enter rehab. It can be done by staging an intervention. One should invite the loved one to a family meeting where family members can tell them their concerns.

The second step in the benzodiazepines rehabilitation process is detox, which should be conducted under medical supervision to avoid unpleasant withdrawal symptoms. Inpatient rehab facilities offer their patients counseling, group therapy, family therapy, and many more activities that can help a client overcome benzo addiction. Inpatient rehab takes place in a controlled environment, making it easier for patients to overcome their addiction. While there, they are given 24-hour access to medical care and support and are also supervised to ensure they cannot access benzo drugs with prescriptions in a moment of desperation. This makes inpatient care a good option for those with severe addictions and health complications.

With outpatient care, patients are permitted to work and live at home, but they still must spend significant time at the center. With these programs, 10 to 12 hours a day are spent in substance treatment. For many, this will mean reducing their work hours and needing help around the home to keep everything going. As such, whether a patient opts to receive inpatient care or outpatient care, one will need a support network.

Frequently Asked Questions

How to Get a Doctor to Prescribe Benzodiazepines?

Any patient who wishes to take a benzodiazepine substance can only acquire a medication through the instruction or recommendation of a medical doctor. A doctor will be the only one to decide if the patient needs and is suitable for the health of the patient.

How to Get Prescribed Benzos Instead of SSRI?

A patient taking SSRI drugs cannot switch to other drug classes without the recommendation of a medical doctor. Although it is possible to switch to benzo drugs from SSRI, only a doctor can give the prescription for this medication switching as some health factors are yet to be considered. Some of these include benzodiazepine sensitivities

Are Benzodiazepines Antidepressants?

Generally, benzo drugs are hypnotic medications that are used to treat anxiety disorders. However, there are times when medical doctors use them to treat patients with depression.

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Published on: March 15th, 2017

Updated on: June 13th, 2022

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.