Benzodiazepine Addiction: Symptoms and Treatment

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Benzodiazepines, commonly known as โ€œbenzos,โ€ are a widely prescribed class of medications that act on the central nervous system (CNS) by enhancing the effects of the inhibitory neurotransmitter GABA. These drugs are often used to treat conditions such as anxiety, insomnia, muscle spasms, and seizures due to their rapid onset of action and effective symptom relief.

Despite their therapeutic benefits, benzodiazepines carry a high risk of dependence, mainly when used regularly over extended periods. This dependence can lead to severe psychological and physical withdrawal symptoms, some of which can be life-threatening.

Recent statistics show that in 2020 alone, 5.3 million adults in the U.S. reported misusing these medications. As the misuse of benzodiazepines can become a severe health issue, keep reading to learn about the risks associated with these drugs and explore safe, effective treatment options for benzodiazepine addiction.

What Are Benzodiazepines?

Benzodiazepines are a class of prescription medications that exert their effects on benzodiazepine receptors in the central nervous system (CNS). Benzodiazepines boost the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that helps calm the brain.

By binding to specific sites on GABA receptors, these drugs increase the activity of GABA, making nerve cells in the brain less likely to emit signals. This results in a calming, sedative effect, which is why benzodiazepines are effective in reducing anxiety and promoting sleep.

Benzodiazepines are commonly prescribed for a wide range of medical conditions, including but not limited to:

  • Insomnia
  • Acute status epilepticus
  • Agitation
  • Anxiety (panic disorder and generalized anxiety disorder)
  • Various spastic or seizure disorders

Additionally, they are often used off-label in psychiatry to manage conditions such as Tourette syndrome, delirium, sleep disorders, and movement disorders like tremors, tics, tardive dyskinesia, or chorea.

Benzodiazepines are usually given orally or through an IV. They can also be administered rectally, intranasally, or intramuscularly, especially in cases where IV or oral routes aren’t possible, such as during seizures. The medication is given in incremental doses until effects like sedation or seizure control are achieved. It’s essential to allow time between doses to avoid over-sedation.

Types of Benzodiazepines

Benzodiazepines are known by their chemical (generic) or brand name. They are all listed as DEA Schedule IV controlled substances due to their potential for abuse, addiction, and diversion.

There are three types of benzodiazepines: long-acting (half-life of 40โ€“250 hours), intermediate-acting (half-life of 12โ€“40 hours), and short-acting (half-life of less than 24 hours). Short-acting benzodiazepines have stronger withdrawal or โ€œcome downโ€ effects and can be more addictive than long-acting ones.

Some common benzodiazepines are:

Generic Name Brand Name Indicated For Type
Alprazolam Xanaxยฎ Anxiety disorders, panic disorders Short-acting
Chlordiazepoxide Libriumยฎ Alcohol withdrawal syndrome Long-acting
Clobazam Onfiยฎ Seizures associated with Lennox-Gastaut syndrome Long-acting
Clonazepam Klonopinยฎ Panic disorder, agoraphobia, myoclonic, and absence seizures Long-acting
Clorazepate Tranxeneยฎ Anxiety disorders, focal (partial) onset seizures Long-acting
Diazepam Valiumยฎ Alcohol withdrawal, febrile seizures (rapid control) Long-acting
Estazolam ProSomยฎ Insomnia Intermediate-acting
Flurazepam Dalmaneยฎ Insomnia Long-acting
Lorazepam Ativanยฎ Anxiety disorders, convulsive status epilepticus Intermediate-acting
Midazolam Versedยฎ Convulsive status epilepticus, procedural sedation Short-acting
Oxazepam Seraxยฎ Anxiety disorders, alcohol withdrawal syndrome Intermediate-acting
Quazepam Doralยฎ Chronic insomnia in adults Long-acting
Temazepam Restorilยฎ Sleep onset and maintenance of insomnia Intermediate-acting
Triazolam Halcionยฎ Sleep-onset insomnia Short-acting
Remimazolam Byfavoยฎ Short procedural sedation in adults (<30 mins) Short-acting

Benzodiazepine half-life determines its specific use. For example, long-acting benzodiazepines are more effective for treating conditions like anxiety and seizures because they provide a steady, sustained drug level in the blood, ensuring continuous symptom relief.

On the other hand, short-acting benzodiazepines are often preferred for treating sleep disorders, as they do not require maintaining a constant drug level, allowing patients to fall asleep without lingering effects the next day.

Side Effects of Benzodiazepines

When used as prescribed and for short-term periods (average of 2 weeks), benzodiazepines are generally safe and effective. However, side effects can occur, which can become more severe with misuse. Common benzodiazepine side effects include drowsiness, fatigue, and lethargy.

At higher doses, additional adverse effects may occur, such as:

  • Impaired motor coordination
  • Slurred speech
  • Blurred vision
  • Dizziness
  • Vertigo
  • Mood changes
  • Hostile or erratic behavior

While benzodiazepines alone are unlikely to cause fatal overdoses, combining them with opioids or other central nervous system (CNS) depressants, such as alcohol, prescription sleeping pills, or other sedatives, can significantly increase the risk of overdose and death.

Benzodiazepine Drug Addiction

Are benzodiazepines addictive? Yes, these medications have the potential to cause both physical and psychological dependence, mainly when used for extended periods (defined as two or more months at a therapeutic dose) or in higher doses than prescribed.

Benzodiazepinesโ€™ calming effects can quickly lead to repeated use. Over time, the brain adapts, leading to tolerance, where higher doses are needed to achieve the same effect. This increased dosage heightens the risk of physical dependence, where the body relies on the drug to function normally.

Additionally, psychological dependence can develop, where users feel they need the drug to cope with daily life. If use is stopped suddenly, benzodiazepine withdrawal symptoms can occur, making it challenging to quit without medical assistance.

Benzodiazepine Addiction Symptoms

According to the American Psychiatric Associationโ€™s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), addiction is characterized by a range of criteria that indicate a problematic pattern of substance use leading to significant impairment or distress.

For an accurate benzo addiction diagnosis, at least two of the following symptoms occurring within one year must be present:

  • More of the drug is needed to achieve the same effect.
  • Difficulty cutting down or stopping use despite wanting to.
  • Persisting with the drug even when it causes problems in relationships, work, or health.
  • Strong urges or desires to use benzodiazepines.
  • Experiencing physical or psychological symptoms when not using the drug.
  • Using more benzodiazepines or for longer than intended.
  • Failing to fulfill obligations at work, school, or home due to drug use.
  • Investing a significant amount of time in obtaining, using, or recovering from the drug’s effects.
  • Giving up or reducing participation in activities because of drug use.
  • Using benzodiazepines in physically hazardous situations, such as driving.

Itโ€™s essential to tell apart between addiction and normal physical dependence on benzodiazepines. Addiction usually occurs in individuals with polydrug use, with benzodiazepines often used to enhance the effects of another drug. Addiction is rare in those using benzodiazepines as prescribed.

Physical dependence, however, is a natural response in patients taking therapeutic doses over time and can lead to withdrawal symptoms if the medication is suddenly stopped. This dependence can be managed by gradually tapering the dose or switching medications. To minimize the risk, prescriptions are typically limited to 1โ€“2 weeks.

Benzodiazepine Addiction Treatment

Addressing benzodiazepine addiction involves a multi-faceted approach tailored to individual needs. Each phase of treatment is designed to address different aspects of recovery, promoting a holistic rehab approach to overcoming benzodiazepine addiction.

Standard treatment for benzodiazepine addiction may include:

Contact a Benzodiazepine Addiction Specialist

Benzodiazepine withdrawal symptoms can be uncomfortable, often leading patients to resume use to stop them.

For a successful and safe recovery, consult a specialist in benzodiazepine addiction, who can create a personalized tapering plan that will gradually reduce the dosage over time, minimizing withdrawal symptoms and health risks. The plan typically spans mid to long-term, ensuring 100% cessation of benzodiazepine use under a safe scenario.

Detoxification and Withdrawal Management

Although drug cessation is usually done progressively, the first step in treating benzodiazepine addiction is often drug detox. Detox should be conducted under medical supervision because benzodiazepine withdrawal can be severe and, in some cases, life-threatening.

Medical professionals in detox facilities monitor the patient 24/7 and may administer medications to help manage withdrawal symptoms and ensure safety.

Inpatient and Outpatient Rehabilitation

Inpatient rehab involves staying at a treatment facility where individuals receive intensive therapy and support, making it ideal for those with severe addictions or co-occurring mental health conditions. This structured environment is free from external triggers and allows individuals to concentrate solely on their recovery.

In contrast, outpatient rehab allows individuals to live at home while attending scheduled therapy sessions at a treatment center. This option is suitable for those with less severe addictions or those who have completed inpatient treatment.

Behavioral Therapy

Behavioral therapies are a core component of benzodiazepine addiction treatment. Common approaches include:

Cognitive-behavioral therapy (CBT) helps individuals identify and change negative thought patterns and behaviors associated with drug use. CBT also focuses on developing coping strategies and relapse prevention techniques.

As well motivational enhancement therapy (MET) focuses on personalized assessment, feedback, and individualized plans for patients to explore their motivation behind benzodiazepine use. Contingency management (CM) provides tangible rewards for positive behaviors, such as attending therapy sessions or remaining drug-free.

Aftercare and Ongoing Support

After completing a formal treatment program, ongoing support is crucial for maintaining sobriety. Aftercare may include participation in support groups, continued therapy, and sober living homes. These resources help individuals stay connected to a recovery community and provide the support needed to prevent relapse.

Benzodiazepine Addiction โ€“ Bottom Line

While benzodiazepines are effective for managing various conditions, their long-term use can lead to dependency, cognitive decline, and increased risk of falls. Preventing and recognizing benzodiazepine dependence is essential for guiding optimal management, which may involve gradual withdrawal or maintenance therapy.

Switching to long-acting benzodiazepines, when appropriate, and tapering doses slowly can help mitigate withdrawal risks. Effective management often combines prescribing interventions, substitution therapies, psychotherapies, and pharmacotherapies.

If you or a loved one is struggling with benzodiazepine addiction, consider reaching out to a local rehab center or healthcare provider for personalized treatment options.

People Also Ask

Is benzodiazepine addictive?

Yes, benzodiazepines can be addictive. They have a high potential for dependence due to their calming effects on the brain, leading to tolerance, withdrawal symptoms, and compulsive use.

Are benzos hard to get off of?

Yes, benzodiazepines can be challenging to discontinue. Withdrawal symptoms can be severe, including anxiety, tremors, and seizures. Gradual tapering under medical supervision is crucial to minimize discomfort and risks.

How long is it safe to use benzodiazepines?

Benzodiazepines are generally safe for short-term use, typically up to 2-4 weeks. Long-term use increases the risk of dependence, cognitive decline, and other side effects. Always follow your doctor’s guidance on duration.

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Page Sources

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Retrieved on September 3, 2024.

Published on: March 15th, 2017

Updated on: September 3rd, 2024

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