Benzodiazepines: Addiction and Side Effects

Benzodiazepines are controlled in schedule IV under the Controlled Substances Act which means they are not likely to be abused as other substances. However, they are still a highly addictive substance and about one-third of individuals who take benzos for six months or more will experience health problems, including seizures, when they try to stop. Benzodiazepines have a very difficult withdrawal process and long-term abusers can experience what is called protracted withdrawal symptoms which can last for 6 months to a year after they stop taking the substance. It’s important for individuals who have been taking more than prescribed by a doctor or have been taking benzos for an extended period of time to seek medical detox instead of trying to quit cold turkey.

After detox and stabilization, individuals continue their recovery through inpatient or outpatient programs that offer cognitive therapies and counseling sessions as well as tools for relapse prevention.

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What Are The Effects Of Benzodiazepine Addiction?

Benzodiazepines bind with special neurons called GABA receptors in a process that slows overactive brain function and relieves severe mental stress. Those abusing benzodiazepines can experience a euphoric “high” or alcohol-like “buzz” depending on the brand abused. This is followed by prolonged sedation.

Any use of benzodiazepines outside of a doctor’s recommendation constitutes abuse. Some benzodiazepine users crush and snort their tablets or pills to amplify the potency. This increases the likelihood of overdose. Seizures and coma are common symptoms of a benzo overdose. ​​Benzodiazepine overdose can slow breathing and heart rate until they stop completely, resulting in death.

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Addiction To Benzodiazepines

Due to their high potency, benzodiazepines can change the brain’s neurochemistry. Over time, the drugs build up in the user’s body. Users can develop mental and physical dependencies on the drugs as a result. The prevalence of benzodiazepines as popular, often-prescribed anti-anxiety medications means that people from every demographic and lifestyle can be exposed to them. Addiction can form even under a physician’s care and prescribed doses.

Because benzodiazepines are available by prescription, users and their loved ones are often unaware of the high potential for addiction and abuse. Signs of addiction that might be overlooked include developing a tolerance to the drugs’ sedative effects or dismissing important people and activities to focus solely on getting and abusing the drugs.

Benzodiazepine Addiction Diagnosis

Today, the mental health community uses the term hypnotic, sedative, or anxiolytic use disorder to describe benzodiazepine abuse or addiction. This term comes from a main mental health book for clinicians, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. In order to be diagnosed with a sedative use disorder, at least two of a possible 11 symptoms must manifest within the same 12- month period. The National Association of Addiction Professionals explains each symptom, five of which are paraphrased here:

  • The sedative is taken in a higher volume or over a longer time period than first intended.
  • Considerable time is spent getting the drug, using it, and recovering from its effects.
  • When the drug is not in a person’s system, the person experiences withdrawal, which can include cravings for the drug.
  • Over time, more of the drug is needed to achieve the familiar desired effects (i.e., tolerance).
  • The person experiences impaired performance at home, work, or school due to the drug’s effects.

The sedative effect of these drugs, as well as their addiction-forming chemical properties, makes them ripe for abuse. Since these are prescription drugs, it is critical to note that some individuals may initially have a legitimate medical reason to use them, but over time, they develop a use disorder. If a patient who has a prescription for a benzodiazepine follows their doctor’s orders, a use disorder will not likely set in. But if a use disorder does arise, there are different ways people go about getting the volume they need (discussed below). Legitimate doctors will not overprescribe these medications.

Frequently Asked Questions: Benzo Addiction

  • How Do Addicts Get Benzos?

    Many users maintain their drug supply by getting prescriptions from several different doctors, forging prescriptions, or buying them illicitly on the street. Xanax, Alprazolam, and Clonazepam are the three most frequently encountered benzodiazepines that are abused and sold for recreational use.

  • How Long Does It Take To Become Addicted To Benzodiazepines?

    The most commonly prescribed and also most commonly abused benzos are lorazepam, clonazepam, diazepam, Valium, Xanax, and alprazolam.  It is estimated that it takes about two months for someone to become addicted to benzodiazepines after taking them consistently. Addiction results and the time it takes to become addicted may vary depending on the individual’s physiology and how often they are taking the drug.
  • How Is Benzodiazepine Addiction Defined And Diagnosed?

    The DSM-5 Diagnostic manual has criteria for diagnosing ‘Sedative, Hypnotic and Anxiolytic Use Disorder’ which is a class of diagnosis that barbituates and benzodiazepines fall into. The diagnosis requires at least 2 of the following criteria. The disorder is mild if 2-3 criteria are met, moderate if 4-5 are present and severe with 6-7 or more.

    • Continuing to use a substance, in this case a barbiturate, benzodiazepine or other sedative-hypnotic, despite negative personal consequences.
    • Repeated inability to carry out major functions at work, school or home on account of use.
    • Recurrent use in physically hazardous situations
    • Continued use despite recurrent or persistent social or interpersonal problems caused or made worse by use.
    • Tolerance, as manifested by needing a markedly increased dose to achieve intoxication or desired effect, or by markedly diminished effect with continued use of the same amount.
    • Withdrawal with the characteristic syndrome, or use of the drug to avoid withdrawal.
    • Using more of the drug or using for a longer period than intended.
    • Persistent desire to cut down use, or unsuccessful attempts to control use.
    • Spending a lot of time obtaining or using the substance or recovering from use.
    • Stopping or reducing important occupational, social or recreational activities due to use.
    • Craving or strong desire to use.

What Are The Signs Of Benzodiazepine Abuse?

Due to the natural process of building a tolerance, over time, a person will require a higher volume of benzodiazepines to reach the familiar high. When the abuse stops or the familiar dose is significantly cut down, withdrawal symptoms will emerge. Benzodiazepine withdrawal can be particularly dangerous and even life-threatening. Undergoing medical detox under the direct care of a doctor is generally advised.

Although benzodiazepines have a calming effect, they are highly addictive, and a person who abuses them faces a host of symptoms. Some of the physical, psychological, and behavioral symptoms of benzodiazepine abuse include:

  • Physical weakness
  • Slurred speech
  • Confusion
  • Poor decision-making abilities and poor judgment
  • Blurred vision
  • Lack of motor coordination
  • Dizziness
  • Inability to defend oneself in the case of an attack or threat
  • Drowsiness
  • Coma
  • Difficulty breathing
  • Death (Rare when abused on its own, fatal overdose may occur when a benzodiazepine is mixed with alcohol.)

If a person chronically abused benzodiazepines, the following symptoms may emerge:

  • Anorexia
  • Insomnia
  • Anxiety
  • Tremors
  • Headaches
  • Insomnia
  • Memory problems

As discussed, the development of tolerance is one of the phases of addiction to benzodiazepines is a medical condition, known as physical dependence. Tolerance is the process by which the brain becomes increasingly accustomed to the drug and, for this reason, requires more of it in order for the person to get the familiar high. When the brain does not get its familiar dose, because the person is abstaining or reducing the familiar amount, withdrawal is triggered. Withdrawal from benzodiazepines is considered to be particularly dangerous, and in some instances, it can be fatal. For instance, seizures are a symptom of withdrawal.

A person who is concerned with a loved one’s benzodiazepine abuse may not be able to pinpoint whether the signs they are seeing are symptoms that are emerging as a result of drug use or because of withdrawal. People who want to help may feel unsure and not know whether what they are seeing is a dangerous symptom or a common one. Ideally, the person who used the benzodiazepine would disclose important facts, such as the amount recently taken. If any serious symptoms emerge such as signs of benzodiazepine overdose the best practice is to seek immediate help, which can include going to a local emergency room or contacting a doctor.


Behavioral Signs of Benzodiazepine Abuse

The development of a sedative use disorder may creep up on a person, but when it exists, it is likely going to be observable. Substance abuse has a way of shifting a person into exhibiting uncharacteristic traits. In short, the person stops being in service of the life they used to lead, and now spends an increasing amount of time in service to the drug abuse. People who develop a sedative use disorder may exhibit some or all of the following (partial) list of behavioral symptoms of substance abuse, per Mayo Clinic:

  • The person withdraws from friends, family, and obligations in order to use the drug.
  • From a place of fear of being without the drug, the person ensures that an adequate supply is maintained at home.
  • The person does uncharacteristic things to be able to pay for the drug, such as borrowing money, stealing, draining bank accounts, or maxing out credit cards.
  • The person engages in risky activities, such as driving, after using the drug.
  • The person spends an increasing amount of time and energy on different facets of drug abuse.
  • The person exhibits a reduction in effort to maintain hygiene or grooming (i.e., the person may begin to look disheveled).
  • The person is uncharacteristically secretive about daily schedules and/or tells lies to protect the substance abuse.
  • Shifts in mood or personality are experienced.

Behaviors around drug abuse relate to different facets of drug use, including how the person administers the drug. Typically, benzodiazepines are swallowed. According to feedback from individuals who tried to crush, cook, and inject benzodiazepines, they do not appear to be injectable drugs. There may be very little paraphernalia associated with benzodiazepine abuse.

Since benzodiazepines are prescription drugs, some individuals who have a sedative use disorder will get a high volume of this drug by “doctor shopping.” Getting a few prescriptions from different doctors can occur, and individuals will have to fill these prescriptions at different pharmacies. Prescription bottles and their labels will reveal if an individual has different prescriptions from different doctors, filled by different pharmacies within the same timeframe.

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Ben Fisher

Ben is a content creator with multiple years in recovery. Ben has been writing content and managing instagram and facebook pages that provide hope and healing information to individuals seeking help for substance use disorder. In addition to his work in behavioral health, Ben loves to play guitar and hangout with his kids.

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Now is your chance to seek help for yourself or a loved one, as treatment options are available across the country for benzodiazepine abuse and addiction. You deserve to live a life where you feel emotionally safe and we can help you heal the mental, emotional, and spiritual wounds of addiction and create a life that feels fulfilling. Contact our recovery centers today for a free, confidential consultation.