Benzodiazepines is a term that describes a category of psychoactive substances that act as central nervous system depressants and which are often prescribed to treat symptoms of generalized anxiety disorder, panic disorder, and insomnia. Benzodiazepines, which are often referred to as benzos, are also used to alleviate muscle pain and prevent seizures. The World Health Organization recommends benzodiazepines as a front-line medication to combat withdrawal symptoms, such as discomfort, seizures, and delirium, in patients who are undergoing medically supervised alcohol detox. Commonly prescribed medications that contain benzodiazepines include Valium, Klonopin, Ativan, and Xanax.
Benzos create a sense of sedation and relaxation by enhancing the effectiveness of the neurotransmitter gamma-aminobutyric acid, or GABA, which controls the excitability of neurons within the central nervous system. While these effects can be of significant value in medical settings, they also make benzos an enticing choice for individuals who intend to abuse them for purposes of self-medication or to achieve a recreational high. Among recreational substance abusers, benzos are often used to counterbalance the negative side effects of stimulants, such as amphetamines and cocaine.
Regardless of the reasons that a person begins to misuse benzodiazepines, the results can be dangerous and even deadly. Dependence upon benzos is a risk even for people who are using these substances under the supervision of a qualified medical professional, and severe withdrawal symptoms can make it difficult for a person to stop abusing benzos without professional help. Thankfully, benzo dependence can be effectively treated, and individuals who were once trapped in a downward spiral of benzo abuse and addiction can live drug-free lives.
More than 50 million prescriptions for benzodiazepine medications are written every year in the United States, and about one of every 20 adults in the U.S. has used a benzodiazepine in the past month.
According to the National Survey on Drug Use and Health (NS-DUH), 2.3 percent of high school students between the ages of 14 and 17 have abused a benzo at least once in their lives, and just below 1.5 percent have done so in the past 12 months. Past-year benzo abuse decreased from 1.9 percent to 1.4 percent between 2011 and 2013, while lifetime use remained at a consistent 2.3 percent over the same period of time.
The Drug Abuse Warning Network (DAWN) reports that more than one-third of all drug-related visits to emergency rooms and urgent care facilities are related to benzo abuse. In many cases, benzo abuse increases the damage that is caused by another abused substance. For example, between 1996 and 2006, more than 50 percent of people who died from opioid overdose also had traces of benzos in their system at their time of death. From 1994 to 2004, annual benzo-related admissions to addiction treatment more than doubled, increasing from 3,257 to 7,827.
Causes and Risk Factors for Benzodiazepine Abuse
As is the case with other forms of substance abuse and addiction, the likelihood that a person will abuse and become dependent upon benzodiazepines can be influenced by a number of genetic and environmental factors.
Genetic: Having a parent or sibling who developed a substance use disorder increases the likelihood that a person will also have a drug problem. Also, people whose parents and/or siblings suffer from mental illness have a similarly increased risk for addiction. Because benzos are used to treat mental health issues, such as anxiety disorders, people who are genetically predisposed to these conditions will also be at increased risk for abusing these medications.
Environmental: Substance abuse and mental illness within a family can also be environmental influences on the development of a substance use disorder. Children who grow up in households where the misuse of benzo-based medications is common are more likely to engage in similar behaviors than are people who were raised in drug-free environments. Also, individuals who live in communities where substance abuse occurs frequently, or who work in high-stress jobs, may be more likely to seek relief via substance abuse.
- Being female
- Aging (benzo abuse risk factors increase with age)
- Family history of substance use disorders and/or mental illness
- Personal history of prior substance abuse and/or mental illness
- Poor coping skills
- Associating with individuals who abuse drugs
Signs and Symptoms of Benzodiazepine Abuse
People who have been abusing benzodiazepines or other prescription medications may show a range of symptoms depending upon the specific benzo they are abusing, the amount of time they have been engaging in this behavior, and their personal history. The following are among the signs that may indicate that a person has been abusing a benzodiazepine:
- Visiting a variety doctors in an attempt to get multiple prescriptions
- Asking to borrow medications that have been prescribed to someone else
- Stealing medication that has been prescribed to someone else
- Using larger-than-directed amounts of a prescribed medications
- Using medications to deal with stress
- Withdrawing from family and friends
- Lying or being otherwise deceptive about medication use
- Coordination problems
- Impaired motor skills
- Blurry vision
- Slurred speech
- Shallow or irregular breathing
- Respiratory infections
- Twitches and tremors
- Poor judgment
- Retrograde amnesia
- Delayed reaction time
- Lowered inhibitions
- Mood swings
- Irritability and hostility
Effects of Benzodiazepine Abuse
Benzodiazepine abuse is associated with several unpleasant health effects, including the following:
- Confusion and disorientation
- Memory problems
- Family conflict
- Strained interpersonal relationships
- Declining performance at work or in school
- Social withdrawal and isolation
- Suicidal ideation and self-harm
- Muscle weakness and/or spasms
The following disorders may also be present in people who have developed a substance use disorder related to benzodiazepine abuse:
- Anxiety disorders
- Depressive disorders
- Bipolar disorder
- Obsessive-compulsive disorder (OCD)
- Posttraumatic stress disorder (PTSD)
- Schizoaffective disorder
- Other substance use disorders
Effects of Withdrawal and Overdose
Effects of benzodiazepine withdrawal: When a person attempts to stop using benzos after a period of prolonged abuse, he or she will likely experience a number of painful withdrawal symptoms. The following are among the common symptoms that are associated with benzo withdrawal:
- Strong cravings for benzos
- Increased heart rate
- Increased sensitivity to touch, sound, and/or light
- Hot and cold flashes
- Ringing in the ears
- Double vision
- Suicidal ideation
Effects of benzodiazepine overdose: People who abuse benzos, especially those who do so in combination with other drugs, are at increased risk for overdosing. Benzo overdose, which may be indicated by the following symptoms, can be fatal:
- Memory failure
- Difficulty breathing
- Irregular or dangerously slow heart rate
- Cardiac arrest
- Low body temperature
- Hallucinations and delirium
- Loss of consciousness