Benzodiazepines

Signs of benzodiazepine misuse

When taken as prescribed, benzodiazepines are effective, targeted therapies to help you address certain situations in the short term. For example, you may feel anxiety when you fly. Before you board a plane, you take your benzodiazepine dose as prescribed. The medication relieves the anxiety.

Benzodiazepines can cause euphoria, or a high. It can therefore be tempting to misuse them by taking more than the minimum necessary amount to treat anxiety or insomnia.

If you continue to use the drug for months and years — even when not using it for those times you fly — you can develop a tolerance. You start to need more doses and can become dependent on the drug. With dependence comes withdrawal symptoms, which can occur shortly after the drug’s effects wear off. And dependence can occur even if you’re using the drug as originally prescribed.

Needing and taking more of the drug can be harmful because benzodiazepines work by pumping the brakes on the central nervous system. When misused, they can cause serious risk by slowing your breathing, putting you in a coma, or even causing death. They are especially hazardous when taken in combination with other sedatives, such as opioids.

Use only medication that you are prescribed. If you or someone you know is prescribed a benzodiazepine, take only the required amount and read the label explaining how the drug interacts with other substances. And given the high potential for dependence, explore alternative therapies for anxiety and sleep disorders before opting for a prescription for benzodiazepines.

Benzodiazepine withdrawal 

Withdrawal from benzodiazepines depends on several factors, including the type you are taking, how long you’ve been taking it, the dosage, and whether you are taking it in combination with other depressants, such as opioids or alcohol. The shorter the duration of usage and the lower the dosage, the less severe the withdrawal. Larger doses taken over longer periods tend to extend the withdrawal period.

Symptoms of withdrawal include:

• Anxiety and anxiety-related symptoms (e.g., dysphoria, hyperventilation, muscle spasms, panic attacks, sweating).
• Perceptual disorders (e.g., abnormal bodily sensations, depersonalization/derealization, hypersensitivity to stimuli).
• Hallucinations, seizures, and unstable vital signs.

If you find that you are experiencing benzodiazepine withdrawal (for example, because you have run out of your benzodiazepine prescription), seek immediate medical attention. Untreated benzodiazepine withdrawal can lead to seizures and other potentially life-threatening consequences.

Treatment for benzodiazepine dependence

If you recognize the signs of benzodiazepine misuse or dependence in yourself, take a first step toward recovery by seeking help from a licensed medical professional. With medical help, you can reduce your dependence on the drug.

Usually, a clinician will help you taper the dosage slowly and carefully in an outpatient setting. In some cases, where it is not safe for you to continue the medication at all, you will be admitted to a facility for a faster medically-supervised taper.

Anxiety or sleeplessness may return during the tapering process. Lessen these side effects through physical exercise, which studies show can increase your brain’s serotonin levels and stimulate feelings of peace and relaxation.

In an overdose, the medication Flumazenil is sometimes used to reverse the effects of benzodiazepines. This intravenous solution is typically administered to patients in health care settings. The drug can cause serious side effects, particularly among those in withdrawal from addiction to sedatives. Unlike naloxone (i.e., Narcan), it is not available in the United States over the counter without a prescription.

Make your recovery plan 

Recovery from benzodiazepine dependency is possible, and treatment works. A licensed medical professional can help you lower your dosage over time, and a mental health professional can provide therapy and other ways to relieve symptoms. 

Cognitive behavioral therapy and other behavioral therapies obtained from a licensed mental health professional can help you understand and reduce the symptoms of anxiety or sleeplessness. Behavioral therapies, meditation and mindfulness, and physical exercise such as walking, yoga, or tai chi all help lower blood pressure, relieve stress, and improve sleep.

Once you are established in a treatment program, you can often manage your progress independently with the ongoing support of family, friends, others in recovery, and the guidance of medical and mental health professionals. Learn more about making a plan for your recovery. 

Sources

Benzodiazepines and Opioids, National Institute on Drug Abuse, February 3, 2021

FDA Requiring Labeling Changes for Benzodiazepines, Food and Drug Administration, September 23, 2020

Flumazenil, StatPearls, September 3, 2020

Mind and Body Approaches for Stress and Anxiety, National Center for Complementary and Integrative Health, National Institutes of Health, April 2020

National Health Statistics Reports, Centers for Disease Control and Prevention, January 17, 2020

Benzodiazepine Use and Misuse Among Adults in the United States, Psychiatric Services, December 17, 2018

Benzodiazepines I: Upping the Care on Downers: The Evidence of Risks, Benefits and Alternatives, Journal of Clinical Medicine, January 30, 2018

Benzodiazepine Dependence and Its Treatment With Low Dose Flumazenil, British Pharmacological Society Journals, November 5, 2012

Benzodiazepine Dependence Among Multidrug Users in the Club Scene, Drug and Alcohol Dependence, December 1, 2011