Benzodiazepine Addiction

Understanding benzodiazepines

Benzodiazepines, often referred to as benzos, are prescription drugs used to treat a broad spectrum of physical ailments and mental health disorders. They are often used to treat moderate to severe anxiety disorders, epileptic seizures, muscle spasms, panic attacks, and in some cases, to manage withdrawal symptoms from other central nervous system depressants, such as alcohol withdrawal. They are usually prescribed for short-term use, owing to their high potential for addiction.

Most forms of benzodiazepines come in pill form for oral consumption, but some brands, such as Valium, can also be taken intravenously in the form of a clear, odorless liquid. While legal when prescribed, there is a black market for benzodiazepines, often used when people can no longer get them as prescription medication. Some street terms for benzodiazepines include tranks, downers, bars, sticks, French fries, ladders, or simply benzo(s).

Types of benzodiazepines

Some common brands of prescription and nonprescription (in the US) benzodiazepines include:

• Valium (diazepam)
• Ativan (lorazepam)
• Klonopin (clonazepam)
• Xanax (alprazolam)
• Halcion (triazolam)
• Librium (Chlordiazepoxide)
• Rohypnol

Effects of benzodiazepine abuse

Benzodiazepines interact with the brain by binding with neurons called GABA receptors. This process slows overactive brain functions and relieves severe mental stress. Those who abuse benzodiazepines often experience similar effects to other central nervous system (CNS) depressants such as alcohol, namely a euphoric high or buzz, which can vary depending on the type being abused. Following the initial high, there is a period of prolonged sedation.

Many people who abuse benzodiazepines will crush and snort them to amplify their potency and the speed to take effect. Unfortunately, this also increases the likelihood of overdose, which can mean seizures or coma. Occasionally, a benzodiazepine overdose can cause breathing to slow until it stops completely.

Related blog: Benzodiazepines Have Highest Overdose Risk of Sleep Drugs Among Adolescents

Warning signs of benzodiazepine abuse

The following symptoms of benzodiazepine abuse are listed from mild to severe. The mild symptoms can act as a warning sign that someone is abusing benzos, the severe will often be seen at the point of overdose or when benzodiazepines are abused with other substances like alcohol or opioids.

Addiction to benzodiazepines

Benzodiazepines have high potency, meaning prolonged abuse can change the brain’s neurochemistry. Abusing benzodiazepine can lead to a tolerance forming in the user’s body, leading to psychological or physical dependence on the drug to create the same high. 

As Benzodiazepines are often obtained on prescription as anti-anxiety medication, the ability to abuse them is heightened for those who fall under specific diagnoses. Some users may not realize they have formed a dependence as it is possible to do so even on a prescribed amount.

An addiction occurs when the negative effects of drug abuse become moderate to severe. The mental health community often uses the term hypnotic, anxiolytic, or sedative use disorder to describe benzodiazepine abuse or addiction. ^[2]

This term comes from a main mental health book for clinicians, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), which is used to measure the criteria for addiction. If you or someone you care about is at risk of having a benzodiazepine addiction, then see if they meet the following criteria:

1. Hazardous use: You have used the substance in ways that are dangerous to yourself and others, i.e., overdosed, driven while under the influence, or blacked out.
2. Social or interpersonal problems related to use: Substance use has caused relationship problems or conflicts with others.
3. Neglected major roles to use: You have failed to meet your responsibilities at work, school, or home because of substance use.
4. Withdrawal: When you stop using the substance, you experience withdrawal symptoms.
5. Tolerance: You have built up a tolerance to the substance so that you have to use more to get the same effect.
6. Used larger amounts/longer: You have started to use larger amounts or use the substance for longer amounts of time.
7. Repeated attempts to control, use, or quit: You’ve tried to cut back or quit entirely but haven’t been successful.
8. Much time spent using: You spend a lot of your time using the substance.
9. Physical or psychological problems related to use: Your substance use has led to physical health problems, such as liver damage or lung cancer, or psychological issues, such as depression or anxiety.
10. Activities are given up to use: You have skipped activities or stopped doing activities you once enjoyed to use the substance.
11. Craving: You have experienced an intense craving for the substance 

These criteria are measured by the negative impact the substance has on a person’s life, including physical, psychological, and behavioral measures, and are classified as mild, moderate, and severe. The criteria are measured against the previous 12 months of substance use, and a score of 2-3 is considered mild, 3-5 moderate, and six or more severe. ^[4] Even severe benzodiazepine addictions can be treated and overcome.

Benzodiazepines and other drugs

To boost the effects of benzodiazepines, some users will mix them with other central nervous system (CNS) depressants, such as alcohol. Alcohol is often the chosen substance abused in conjunction with benzos, though some will use opiates as they believe the combination heightens the high felt by both.

People with alcohol abuse problems often sight benzos as creating a psychoactive effect when combined with alcohol, most likely due to altered neurobiological mechanisms associated with alcohol use disorder. Regardless of the CNS depressant used, polysubstance use while on benzodiazepines dramatically increases the chance of overdose, seizures, coma, or death.

Treating a benzodiazepine addiction

Due to the potentially life-threatening nature of benzodiazepine withdrawal symptoms, a medical detox overseen by a trained professional is advised. There are inpatient treatment centers across the country that can help benzodiazepine addicts, providing safe spaces for detoxification and help with long-term recovery.

If you or someone you care about is suffering from addiction, contact a treatment center today.