Learning More About Benzodiazepine Abuse and Addiction

Benzodiazepines (“benzos”) are a class of drugs that affect the central nervous system. Learn more about how benzodiazepine affect the body and how to help someone with a benzo addiction.

Nearly two million people reported misuse or abuse of benzodiazepines in the past month alone. Additionally, benzodiazepines are the sixth most misused drug in the United States, according to a 2015  survey by the Substance Abuse and Mental Health Services Administration (SAMHSA).

SAMHSA conducts the National Survey on Drug Use and Health (NSDUH) each year, compiling their detailed findings in a report. Benzodiazepines (more specifically tranquilizers) ranked sixth on a list of the 10 drugs adults in the United States misuse the most. Drugs ranking higher than benzodiazepines included only alcohol, tobacco, marijuana, painkillers, and cocaine.

But what are benzodiazepines? What does benzodiazepine abuse look like? Benzodiazepine abuse and addiction are a serious problem with the potential to be life-threatening. If you are worried a loved one might be struggling with benzodiazepine addiction, knowing what signs to look for could possibly save their life.

Continue reading to learn more about benzodiazepines, what addiction to benzodiazepines is like, and the steps to take to seek help for your loved one.

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What Are Benzodiazepines?

Benzodiazepines are a prescription medication that function by depressing the central nervous system through releasing a tranquilizing brain chemical. This means they limit the responses the central nervous system has to external stimuli, helping calm the user. For this reason, benzodiazepines are classified and referred to as a tranquilizer.

They are one of the most commonly prescribed medications in the United States, especially among the older portion of the population. Benzodiazepines are registered as Schedule IV drugs as a result of the Federal Controlled Substances Act.

Benzodiazepines are prescribed to individuals for a number of psychological and neurological disorders including:

  • Insomnia
  • Generalized anxiety disorder (GAD)
  • Panic attacks and panic disorders
  • Alcohol withdrawals

Since benzodiazepines work by depressing the central nervous system, they are especially effective for relieving anxiety, stress, and panic attacks.

There are a variety of different types of medications within the benzodiazepine class. Each has a slightly different effect on different individuals. The following descriptions should not be seen as medical advice; only a licensed medical doctor should prescribe any type of benzodiazepine or other medication to you.

Benzodiazepines can be grouped into four categories depending on the symptoms or disorder they treat.

  • Alprazolam and clonazepam are used mainly to treat panic disorders.
  • Temazepam and lorazepam help those with insomnia or other difficulties sleeping.
  • Clonazepam, clorazepate, and diazepam help mostly with seizure disorders, like epilepsy.
  • Chlordiazepoxide is often used to aid alcoholics during the withdrawal process.

Some brand name benzodiazepine medications include:

  • Restoril (Temazepam)
  • Valium (Diazepam)
  • Xanax (Alprazolam)
  • Klonopin (Clonazepam)
  • Ativan (Lorazepam)
  • Librium (Chlordiazepoxide)

Again, benzodiazepines are mainly used to treat anxiety and panic disorders, but a doctor should be the one to determine their necessity. Since there is such a high potential for addiction to benzodiazepines, taking them without a doctor’s recommendation and supervision can be dangerous.

Street Names for Benzodiazepines

While you should only take benzodiazepines under the instruction and care of a medical professional, they are also available from dealers nationwide. Benzodiazepine medications are most often referred to as “benzos” when speaking about using them recreationally. Other street names for benzos include:

  • Blue V
  • Downers
  • Sleeping pills
  • Tranks
Benzo Addiction

Most of the names are rather straightforward, especially knowing what you now know about benzodiazepines. Again, even with this list of street names, they are most commonly referred to as benzos.

What Do Benzos Look Like?

The look of benzodiazepine medications depends on the type of prescription and whether it’s brand name or generic. Most benzos have a recognizable shape to them, though, such as Xanax and Valium. Below is a short description of the look of the brand name of each benzodiazepine medication:

  • Restoril: Restoril looks like a capsule with the medication contained inside the casing. Restoril capsules are red and blue.
  • Valium: Valium looks like a small, circular tablet, often with a V-shaped cutout in the middle. The color of the tablet depends on the strength of the pill: 2 mg tablets are white, 5 mg tablets are yellow, and 10 mg tablets are blue.
  • Xanax: Xanax is one of the most recognizable pills and is often referred to as “bars” for their long, thin rectangular shape. Xanax looks like a long, white bar divided into smaller, breakable sections.
  • Klonopin: Klonopin looks similar to Valium but with a K-shaped cutout instead.
  • Ativan: Ativan looks like a small, white pill shaped like a pentagon (five sides). Its distinct shape also makes brand name Ativan incredibly recognizable.
  • Librium: Librium looks like another capsule medication. One side of a Librium capsule is always teal while the other side is either yellow, black, or white.

Having an idea of what benzos look like can help you identify any pills you may find from your loved one. Using a pill identifier online can also be helpful in figuring out what any pills you might find are.

Side Effects of Benzodiazepine Use

Side effects of benzodiazepine use vary depending on the number of pills consumed, the size of the individual, and a few other factors. General signs of benzodiazepine use include:

  • Slurred speech or difficulties talking
  • Shallow breathing
  • Sluggishness or fatigue
  • Disorientation
  • Lack of motor coordination
  • Dilated (small) pupils
  • Difficulties remembering things
  • Impaired judgment and coordination
  • Irritability, agitation, or frustration
  • Paranoia
  • Suicidal thoughts

This is by no means a full list, but it does outline some common side effects of benzodiazepine use.

Again, according to the National Survey on Drug Use and Health from SAMHSA, 1.8 million people reported misuse or abuse of benzodiazepines (or tranquilizers in general) in the past month. It is the sixth most misused drug among adults ages 18 and older in the United States behind alcohol, tobacco, marijuana, painkillers, and cocaine.

According to another study, 5.2 percent of the United States population use benzodiazepines. They also found that the number of adults ages 18 and older regularly using benzos increases with age.

  • 6% of adults ages 18-35 years old
  • 4% of adults ages 36-50 years old
  • 7% of adults ages 65-80 years old

Additionally, they discovered that benzodiazepine use is nearly twice as prevalent among women as it is in men. Older populations ages 65-80 years old) show higher rates of long-term use at 31.4 percent compared to 14.7 percent of adults ages 18-35 years old.

Clearly, benzos are commonly used among a significant portion of adults in the United States. Although 5.2 percent of the population may not sound like many people, it sounds more significant when you consider that 1 in every 20 adults misuse or abuse benzodiazepines.

According to the National Institute on Drug Abuse, benzodiazepine overdose deaths have quadrupled since 2002. There was a small dip in overdose deaths in 2012 but that was the only year rates lowered. The latest data collected revealed nearly 9,000 deaths due to a benzo overdose in 2015. This means that every hour someone dies of a benzodiazepine overdose.

Another incredibly alarming study showed that almost 30 percent of overdose deaths were caused by benzodiazepine use. Of those overdose deaths, 75 percent were unintentional. Additionally, although benzo misuse is more prevalent in women, greater numbers of men die due to overdose. If trends continue in the coming years, benzodiazepine overdose rates will continue rising steadily.

Overdosing on benzos alone is not as common as overdosing on benzos when they are used in combination with alcohol or other drugs. Because they react on the same receptors in the brain as alcohol does, drinking while on heavy doses of benzos can lead to an accidental overdose. For this reason it is important not to combine benzodiazepines with alcohol or any other drugs.

Why do people abuse benzos? In short, they provide a relaxing, euphoric feeling at the beginning. Benzodiazepines release the tranquilizing chemical in the brain which helps users feel comfortable and at ease.

What starts as innocent recreational use, though, can quickly spiral out of hand. Benzos are highly addictive and difficult to stop using. Many times, benzodiazepine misuse begins with a simple psychiatric or physical diagnosis. If someone has difficulties sleeping, their doctor may prescribe Ativan. Someone with a severe panic or anxiety disorder might come into a psychiatrist’s office and receive a prescription for Xanax.

As they take their medication regularly and the effects prove to be helpful, there are one of two routes to take:

  1. Continue taking the medication as prescribed and receiving relief.
  2. Take more than prescribed under the assumption that “if one makes me feel better, what will two do?

Those who follow the second path often find themselves quickly misusing their medication. Some even find themselves using compulsively without being able to stop. These individuals veer into the drug addiction category and should seek assistance before the drugs have a chance to further damage their body. What starts as self-medication can quickly spiral out of control.

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Long-Term Benzodiazepine Use and How It Affects the Body

As mentioned earlier, 31.4 percent of those using benzodiazepines who are between the ages of 65 and 80 have been on them long-term. Oftentimes elderly individuals are prescribed benzodiazepine medications like Ambien and Restoril for difficulties sleeping.

Benzos are proven to be beneficial for short-term use to treat difficulties sleeping, anxiety, or panic disorders. They are most effective when prescribed in combination with other methods to develop long-term practices to manage these issues. Long-term use of these medications is usually only approved for those with severe or chronic anxiety or sleeping problems.

Long-term benzodiazepine use tends to have detrimental effects on the body. In elderly patients who have taken benzos for years, researchers have seen poor perceived and actual physical health. Additionally, they have witnessed long-term use worsen underlying depression and anxiety rather than help.

Those who use benzodiazepines for an extended length of time also develop a serious physical and psychological dependence to them. If they suddenly stop taking their medication, especially at high doses, they will experience withdrawal symptoms. These symptoms range from mild to severe to life-threatening.

Combining Benzodiazepines and Alcohol or Other Drugs

As with all other prescription medications, benzodiazepines should not be combined with alcohol or other drugs. However, people often disregard these warnings and drink while on their medication. Others who use benzos recreationally prefer to combine them with other substances to increase the effects.

Especially at high dosages, benzodiazepines can cause dangerous interactions. Since benzos act as a central nervous system depressant, adding another depressant like alcohol, which acts on those same receptors, can quickly lead to an unintentional overdose.

In addition to the increased potential for overdose, because they react on the same receptors, combining alcohol with benzos increases other side effects. Loss of coordination worsens, and memory loss or blackouts are more frequent. Irritation, aggression, and hostility are often exacerbated by the combination.

Benzodiazepine Addiction: How Do You Know if Someone is Addicted to Benzos?

Benzodiazepine addiction may be easy for some to hide but as addiction progresses, it becomes difficult to keep everything a secret. When you first suspect someone you love may be addicted to benzos, keep an eye out for the signs of use. Again, look for:

  • Slurred speech or difficulties talking
  • Shallow breathing
  • Sluggishness or fatigue
  • Disorientation
  • Lack of motor coordination
  • Dilated (small) pupils
  • Difficulties remembering things
  • Impaired judgment and coordination
  • Irritability, agitation, or frustration
  • Paranoia
  • Suicidal thoughts

These are common signs of regular use and may help you catch addiction early on. However, as time passes, and the addiction becomes worse, there are other signs to look for that don’t necessarily have to do with physical symptoms.

  • Is their performance at work or in school suffering?
  • Has their physical appearance changed or have they started to neglect personal hygiene?
  • Did they suddenly switch friend groups or the places they spend time?
  • Do they disappear for extended periods of time, eventually coming back with excuses or no explanation at all?
  • Is your loved one spending less and less time doing things they used to love doing?
  • Are they avoiding family or friends in favor of staying home alone?
  • Are they struggling financially to make ends meet?

Most addicts continue to use despite any consequences they face. This is one of the tell-tale signs of addiction. No matter the amount of concern or worry you express, once your loved one is addicted to benzodiazepines, there is little you can do to intervene.

Withdrawals and Detox from Benzodiazepines

Despite there being few ways to intervene on an addict, it is still possible for them to realize what they are doing. As their social circle becomes smaller and smaller, as they lose jobs, and as they push family away, sometimes they realize the extent to which their addiction took them.

In order to get clean, addicts must go through a bezno withdrawal period. As mentioned earlier, when someone suddenly removes the substances their body is dependent upon, they will experience withdrawal symptoms. Benzo withdrawal during the detox period is no different.

General benzodiazepine withdrawal symptoms include:

  • Difficulties falling asleep or staying asleep
  • Increased irritation, tension, frustration, or anxiety
  • Panic attacks
  • Hand tremors
  • Sweating
  • Difficulties concentrating
  • Nausea and dry heaving
  • Weight loss
  • Heart palpitations
  • Muscle aches, soreness, and stiffness

Those who stay within regular dosages of benzodiazepines will experience at least a few of these symptoms during the detox period. The severity of the symptoms depends on the amount of benzos used and how often they were used.

If someone was heavily addicted to benzos, they may experience more significant and dangerous withdrawal symptoms including potential seizures or psychotic reactions. Individuals in a psychosis are likely to pose a danger to themselves or others. In cases like these, attendance at a benzodiazepine detox facility or a trip to the emergency room may be necessary.

Maintain a close eye on your loved one as they go through the benzo detox and withdrawal process to ensure they are safe. Though it is possible to detox alone, you may prefer to enroll them in a benzo detox to manage withdrawal symptoms and keep discomfort to a minimum.

How long does the benzodiazepine detox process last? The actual length of benzo detox depends on the half-life of the particular drug they were taking. Some medications have a longer half-life, resulting in a longer detox process.

An outline of the typical benzodiazepine detox and withdrawal process usually looks like:

  • First 1 to 4 days: Mounting anxiety due to the lack of depression of the central nervous system. Insomnia or other difficulties with sleeping set in, often resulting in sleepless nights.
  • Following 10 to 14 days: Full withdrawal symptoms take effect, including many of those listed above. Anxiety, irritation, insomnia, and sleeping difficulties continue to be a consistent issue.
  • Following month or more: Although there is no definite length of time, psychological symptoms of benzodiazepine withdrawals tend to last at least a month. The anxiety may require psychiatric or psychological intervention to manage day-to-day life.

Again, the benzo detox timeline differs depending on the type of drug or drugs used and whether they were used in combination with other drugs. When someone combines benzos with alcohol or other drugs, they not only have to manage the benzo withdrawals but withdrawals from the other substances they used as well.

Attending Benzodiazepine Rehab: Do You Need Treatment to Get Clean?

Your loved one does not necessarily need to attend a benzodiazepine rehab to get clean. However, detox, inpatient rehab, or an Intensive Outpatient Program (IOP) can significantly benefit them during their early recovery.

Attending benzodiazepine detox will help manage the withdrawal symptoms during those first few days and weeks. Medication assisted treatment will use other drugs to limit the impact of benzo withdrawal symptoms such as anxiety and insomnia. The detox period is one of the most triggering times in recovery because the addict knows exactly how to fix the symptoms they are experiencing.

During inpatient benzodiazepine rehab or an IOP, addicts learn more about benzo addiction and why they use drugs to cope with life. Treatment for benzodiazepine includes educational presentations, individual therapy, and group therapy. Addressing past traumas through individual and group therapy can help them discover underlying causes of addiction. After healing these traumas, they have fewer reasons to use.

Benzo treatment also teaches relapse prevention methods and how to manage triggers. Both are incredibly important for achieving long-term clean time once outside of the treatment environment. It’s easier to stay clean in treatment but once out in the “real world,” there are a lot of triggers to avoid.

Treatment for benzodiazepines helps establish a solid recovery foundation before heading back into the real world. For those who don’t feel comfortable living where they were living before, sober living is another option. This provides a sober environment to focus on staying clean and building their lives back up during the first year or so or recovery.

Finding the Right Benzodiazepine Treatment Facility

Your loved one must make a few decisions regarding how they want to approach treatment before selecting a facility. Do they want to attend a detox program to get clean? How intensive do they want treatment to be? Do they want to attend inpatient and stay at the facility or do they want to return home at the end of the evening with an IOP? 

After making a few decisions, you can start to reach out to the admissions offices at a few different treatment centers that are within the parameters you set. Find out about insurance options and other ways to pay for treatment. Once you select the right facility, all that’s needed is to show up. 

Benzodiazepine addiction doesn’t have to mean the end. There is a full life ahead of those presently addicted to benzos if they take the action to get clean. Through the help of treatment and loved ones, achieving long-term sobriety doesn’t have to be a far-off goal; it can be one that begins today.

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