There are more than 15 approved prescription benzodiazepine medications in the United States. These drugs are used to treat a variety of physical and psychiatric symptoms. They have sedative, hypnotic, anticonvulsant, amnesiac, muscle-relaxing and anxiety-relieving properties. Benzodiazepines can do so much because they are central nervous system depressants. They affect the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) and its receptor sites in the brain. GABA is a natural tranquilizer with sedative and calming effects. Benzodiazepines make GABA more effective, its receptors more sensitive or both. Benzodiazepines have useful medical properties. They also have harmful side effects. The sedative properties that make them important medical tools make them highly addictive as well.
Who Uses Benzodiazepines?
Benzodiazepines like Xanax, Valium and Ambien are household names. They are widely popular and widely prescribed. Psych Central reports that in 2013 Xanax, a benzodiazepine, was the most commonly prescribed drug. Other benzodiazepines, Ativan and Valium, came in fifth and ninth in popularity.3 The Drug Enforcement Agency reports the number of prescriptions written in 2011 for popularly benzodiazepines:
- Alprazolam (Xanax): 49 million prescriptions
- Lorazepam (Ativan): 27.6 million prescriptions
- Clonazepam (Klonopin): 26.9 million prescriptions
- Diazepam (Valium): 15 million prescriptions
- Temazepam (Restoril): 8.5 million prescriptions4
When a drug is widely available, it is easier to misuse and abuse. The drug is seen as less harmful. It is easier to get pills from doctors, family members and friends. Availability affects addiction rates.
How Does Benzodiazepine Addiction Start?
Most benzodiazepine medications usually start working quickly. They provide almost immediate relief from panic or anxiety symptoms. Some benzodiazepines are better sleep aids, or muscle relaxants, while still others are used prior to surgery or medical procedures for their sedative effects and the short-term memory loss they can induce. Different benzodiazepine medications may work on different receptors in the brain. They have many medical uses. They also have many recreational uses. Benzodiazepines are considered Schedule IV drugs under the Controlled Substances Act by the Drug Enforcement Agency, or DEA, due to their medicinal value and estimated potential for abuse and addiction.4
Most benzodiazepines are only meant to be taken for a few weeks. They are not long-term solutions for mental or physical health issues. The U.S. Food and Drug Administration4 warns that using Xanax in doses over 4 mg/day for longer than 12 weeks increases the likelihood of dependence. Even when taken as directed, the body develops a tolerance to the effects of benzodiazepines. This means users must take increasing doses of the drug to get the desired effects. Brain and body come to expect and rely on the drug in order to function normally. Users will experience withdrawal symptoms if they take less of the drug, miss a dose or stop taking it. Psychiatric Times found that “43% of patients taking diazepam for 8 months or more experienced withdrawal…2 to 10 mg per day of alprazolam for 8 weeks produced withdrawal symptoms in 35% of patients.”5 Withdrawal symptoms provide motivation to keep using a drug. Patients may not recognize withdrawal symptoms, but they will notice they feel bad when they don’t take the drug and better when they do.
Who Gets Addicted to Benzodiazepines?
Dependence differs from addiction. A person can be dependent but not addicted. However dependence is often a precursor to substance abuse and addiction. When a person takes a benzodiazepine without a prescription or in a way other than prescribed, he or she is abusing the drug. The Addiction Technology Transfer Center shares that an estimated 14% of those who use a prescription drug for a non-medical reason meet the criteria for abuse or dependence.3 The Substance Abuse and Mental Health Services Administration found that in 2012 8.5 percent of Americans over 12 had a substance abuse disorder. A substance use disorder or addiction is a disease.6 It affects the reward and motivation centers in the brain. Someone who is addicted to a substance will spend an excessive amount of time seeking the drug, using it and recovering from its effects. He or she will continue to use the drug despite experiencing negative consequences of use.
The Consequences of Benzodiazepine Abuse and Addiction
Many people believe prescription drugs are safer than street drugs. They don’t realize prescription drug abuse comes with almost as many dangers. The Centers for Disease Control explains, “Drug overdose deaths and opioid-involved deaths continue to increase in the United States…From 2000 to 2015 more than half a million people died from drug overdoses. 91 Americans die every day from an opioid overdose.”7 Prescription drug addiction is an epidemic. It is a real disease, and it is deadly. While the majority of overdose deaths involve opioids, a large percentage involve benzodiazepines as well.
Benzodiazepines reduce heart rate, blood pressure, body temperature and respiratory rate. These are all essential body functions. Reduced rates and levels can lead to respiratory failure, cardiac complications and more. They can lead to serious health issues and even death. The Journal of Pharmacy Practice reports “A 5-fold increase in deaths attributed to benzodiazepines occurred from 1999 to 2009.”8 Emergency room visits related to benzodiazepine use rose 89%. Alprazolam death rates rose 233.8%.” Benzodiazepines can cause overdose and death when used alone. They are even more dangerous when used in combination with other drugs and particularly when used with opioids or alcohol. Signs of a benzodiazepine overdose include the following:
- Extreme drowsiness
- Severe confusion
- Shallow or troubled breathing
- Irregular heart rate
- Loss of consciousness
- Lack of coordination
If you think you or a loved one may have overdosed, take action. A benzodiazepine overdose is a medical emergency, and you should seek immediate medical attention if you suspect one.
What Should I Do About Benzodiazepine Addiction?
Benzodiazepine addiction recovery begins with detox. This addresses immediate medical concerns. It begins the process of ending a drug’s influence over a person’s body, thoughts and actions. Call Black Bear Lodge to learn more about beginning recovery with medically supervised detox services. This allows for a safe withdrawal experience that can flow seamlessly into in-depth addiction treatment. We offer a private, serene and supportive recovery environment. Our staff is highly trained and experienced in benzodiazepine addiction treatment. We offer evidence-based treatment and personalized recovery programs. We address co-occurring mental and physical health concerns. Reach out today, and begin your recovery journey.
1 Grohol, John. “Top 25 Psychiatric Medication Prescriptions for 2013.” Psych Central. 17 Jul. 2016. Accessed 30 Mar. 2015.
2 Drug Enforcement Agency. “Benzodiazepines.” Jan. 2013. Accessed 13 Sep. 2017.
3 Maxwell, Jane Carlisle. “Trends in the Abuse of Prescription Drugs.” The Gulf Coast Addiction Technology Transfer Center. Nov. 2006. Accessed 13 Sep. 2017.
4 Food and Drug Administration. “Xanax.” Jun. 2011. Accessed 13 Sep. 2017.
5 Pomerantz, Jay. “Risk Versus Benefit of Benzodiazepines.” Psychiatric Times. 1 Aug. 2007. Accessed 13 Sep. 2017.
6 Substance Abuse and Mental health Services Administration. “Mental and Substance Abuse Disorders.” 27 Oct. 2015. Accessed 13 Sep. 2017.
7 Centers for Disease Control. “Understanding the Epidemic.” 30 Aug. 2017. Accessed 14 Sep. 2017.
8 Jann, M; Kennedy, WK; Lopez, G. “Benzodiazepines: A Major Component in Unintentional Prescription Drug Overdoses with Opioid Analgesics.” Journal of Pharmacy Practice. Feb. 2014. Accessed 14 Sep. 2017.