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Benzodiazepines

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Benzodiazepine Addiction

Benzodiazepine Addiction - The mental health community uses the term sedative, anxiolytic or sedative use disorder to describe benzodiazepine abuse or drug addiction. This term comes from a main mental health book for clinicians, the Diagnostic and Statistical Manual of Mental Disorders5th edition.

To be diagnosed with a sedative use disorder, at least two of a possible 11 symptoms must appear within the same 12- month period. 

For most patients, the use of a benzodiazepine for a period of several months does not seem to cause problems with addiction, tolerance, or difficulties in stopping the drug when it is no longer necessary. Several months of use significantly increases the risk for tolerance or addiction.

There is a substance abuse risk when Benzodiazepines are used for reasons other than prescribed.

Treatment at Turning Point of Tampa

Drug addiction like benzodiazepine addiction is a disease that affects the brain. Drug addiction also affects behavior. When drug addiction is present, a person loses their ability to control the ramifications from their use.

In 2020, 14.9% of people aged 12 or older (or 41.1 million people) were classified as needing substance use treatment in the past year. These findings were consistent with the SUD data.

Drug addiction can occur from the use of prescription medication that is prescribed, over the counter medication, or other drugs. Substances such as alcohol, opiates, and benzodiazepines are drugs that can become addictive.

Many treatment providers also specialize in co-occurring disorders or mental health challenges that an individual may struggle with alongside their addiction. 

What are Benzodiazepines?

Benzodiazepines are a class of drugs that can treat a range of conditions. A healthcare provider or doctor prescribes them to treat anxiety disorders, seizures, and insomnia.

They are commonly prescribed medications used to treat alcohol withdrawal and epilepsy. Medical professionals have become concerned about the risks of benzodiazepine drug use, specifically when they are used for a long time.

Some Benzodiazepines are used for other treatments. One type of benzodiazepine, Xanax, can temporarily lower blood pressure by slowing down essential functions such as breathing and heart rate.

Common Benzodiazepines

Common benzodiazepines include:

  • Xanax (alprazolam)
  • Ativan (lorazepam)
  • Librium
  • Valium (diazepam)
  • (chlordiazepoxide)

Formulations of benzodiazepines

All oral benzodiazepines are available in tablet forms.

  • Oxazepam, Chlordiazepoxide and temazepam are available as capsules
  • Alprazolam and clorazepate are available as extended-release tablets
  • Alprazolam, diazepam, clobazam and lorazepam are available in a liquid form
  • Diazepam also is available as a rectal gel
  • Clonazepam and alprazolam are available in orally dissolving tablets
  • Some benzodiazepines are available for injection

Use of Benzodiazepines

Treating Insomnia

Effects of drugs such as benzodiazepines or alprazolam Xanax, even when used as a sole drug for insomnia, can cause dependence and withdrawal will require medical help.

GABA is a neurotransmitter, or "chemical messenger" that travels between neurons in the brain. When these drugs attach to GABA receptors, it calms the nervous system. This results in muscle relaxation, sedation, and help in alleviating insomnia.

Benzodiazepines are used as sleeping pills to reduce anxiety and promote restful sleep by binding to the gamma-aminobutyric acid-A (GABA-A) receptors in the brain.

Treating Anxiety Disorders

Benzodiazepine use affects the gamma-aminobutyric acid (GABA) receptors of the brain as well. This action results in slowing of the central nervous system (CNS), causing a state of extreme relaxation. Benzodiazepines are short acting, which means they relieve symptoms in a short amount of time.

Alprazolam (Xanax), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), chlordiazepoxide (Librium), and midazolam are drugs used to relieve anxiety.

Simultaneously academic research institutions have shown these same drugs can be abused. When used in high doses, overdose can occur.

How do Benzodiazepines Work?

The benzodiazepine drug class is a Schedule IV controlled substance according to the Drug Enforcement Agency (DEA).

The exact mechanism for how benzodiazepines work is not known, but they appear to work by affecting neurotransmitters in the brain, chemicals that nerves release to communicate with other nearby nerves.

Benzodiazepines affect the neurotransmitters is gamma-aminobutyric acid (GABA), a neurotransmitter that suppresses the activity of nerves resulting in the desired effects.

Side Effects of Benzodiazepines

Mild Side Effects

Some physical symptoms after use of benzodiazepines include:

  • Drowsiness
  • Impaired coordination, increasing the risk of accidents and falls
  • Confusion
  • Increased anxiety
  • Depression
  • Dizziness

Serious Side Effects

  • Memory problems
  • Behavioral changes — for example, increased risk taking
  • Delirium, especially in older people
  • Risk of dependence, especially with long-term use
  • An increased risk of dementia, although scientists are unsure of this

People taking benzodiazepine drugs should seek immediate medical attention if they experience any of the above, potentially life-threatening side effects.

Withdrawal Symptoms

People experience withdrawal symptoms when stopping benzodiazepines. They include:

  • Anxiety and panic
  • Shortness of breath
  • Headaches and muscle pain
  • Agitation and restlessness
  • Feelings of unreality
  • Dizziness
  • Gastrointestinal problems
  • Fatigue
  • Sleep problems
  • Tremors
  • Muscle cramps
  • Sweating
  • Flushing
  • Tremors
  • Seizures
  • Hallucinations

Taking Benzodiazepines with Other Drugs

Taking benzodiazepines with other medications can be dangerous. Some drug interactions result in a higher risk for adverse effects such as severe sleepiness, coma, respiratory depression, and death. Benzodiazepines should not be taken with sedative drugs or alcohol.

Alprazolam should not be taken with an opioid unless there are no other available treatment options. Taking benzodiazepines in combination with other substances including opioid drugs increases the risk for severe side effects.

Overdose

Benzodiazepine overdose contributes to a significant number of trips to the hospital emergency department and increased hospital admissions. The treatment for Benzodiazepine overdose is flumazenil (Romazicon). To treat benzodiazepine overdose, flumazenil medication is injected into the vein rapidly.

Flumazenil reverses the sedative effect of benzodiazepines. Because it can cause seizures and withdrawal in people who are chronic benzodiazepine abusers, it is typically reserved for severe poisoning. It also may require careful monitoring and repeated administrations due to its short duration of action.

Benzodiazepine Drug Abuse

All benzodiazepines can cause withdrawals and physical dependence. If people stop taking the drug suddenly there could be withdrawal symptoms which include agitation, a feeling of loss of self-worth, and insomnia.

If benzodiazepines are taken continuously for longer than a few months, stopping therapy suddenly may produce serious or life-threatening withdrawal symptoms and side effects.

Who Should Not Take Benzodiazepines?

Benzodiazepines are not recommended for use during pregnancy or while breastfeeding. They can be associated with pre-term delivery, potential birth defects and low birth weight.

They may also be dangerous for people with emphysema, sleep apnea, or acute asthma; kidney disease or advanced liver disease; or people with a history of substance use disorders, as their use can lead to dependence. Elderly people taking Benzodiazepines may have an increased risk for falls and other injuries. 

Seek medical advice by a doctor or healthcare provider before taking Benzodiazepines. They can provide medical advice to determine if they are safe to take.

Getting Help

Turning Point of Tampa has helped individuals find recovery from addiction and substance use since 1987. If you need help or know someone who does, please contact us at 813-543-8701 or admissions@tpoftampa.com.

Benzodiazepine Therapy | Turning Point of Tampa

Ativan Uses

Ativan (Lorazepam) is used to treat insomnia (trouble sleeping), anxiety symptoms, and status epilepticus (a type of severe seizure).

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Lorazepam for Sleep

Lorazepam is a benzodiazepine that is approved for the treatment of insomnia, anxiety, or sleep difficulty due to stress or anxiety, status epilepticus (continuous seizures), and as a medication given right before anesthesia.

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Is Lorazepam an Opioid

No, Lorazepam is in a class of medications called benzodiazepines. It works by slowing activity in the brain to allow for relaxation.