Benzodiazepine Abuse: Effects, Addiction & Treatment

Benzodiazepines are depressants that produce sedation in users. They have also proven effective in relieving anxiety and muscle spasms and reducing seizures.2 They work by slowing down the central nervous system, causing sleepiness and a relaxed mood.1  

Benzodiazepines have been in widespread use since the 1960s, making them well-researched and understood by the medical community.1 The most well-known benzodiazepines are the prescription drugs Valium®, Xanax®, Halcion®, and Ativan®. Common street names for benzodiazepines are “benzos” and “downers.”2 

Benzodiazepines are a Schedule IV drug under the Controlled Substances Act.2 This is because they can be habit-forming and can have dangerous effects, especially when misused. Benzodiazepines also carry a significant risk of overdose, especially when used with alcohol or other substances.1 For example, some people take benzodiazepines to help them “come down” from the effects of stimulants like cocaine and amphetamines. They are also associated with dependence and withdrawal symptoms, even after just a brief period of using them. Because of such factors, healthcare providers prescribe benzodiazepines cautiously.1

Types of Benzodiazepines

Potency and duration of action are the two main ways in which experts classify benzodiazepines. Some benzodiazepines are fast-acting but last only a few hours while others are longer-acting and last several days.  

These two measures of benzos—strength and duration of action—are the main factors in deciding which conditions they treat. Short-term or emergency conditions like insomnia and seizures typically merit the use of stronger, short-acting benzodiazepines. Chronic, non-emergency conditions are usually treatable with lower-strength, longer-acting benzodiazepines.1  

Shorter-acting benzodiazepines, commonly used to manage insomnia, include:2  

• Estazolam (ProSom®) 
• Flurazepam (Dalmane®) 
• Temazepam (Restoril®) 
• Triazolam (Halcion®) 

Midazolam (Versed®) is a short-acting benzodiazepine used for sedation, anxiety, and amnesia in critical care settings as well as prior to anesthesia.2  

Longer-acting benzodiazepines are utilized to treat insomnia in patients living with daytime anxiety. These benzodiazepines include:2  

• Alprazolam (Xanax®) 
• Chlordiazepoxide (Librium®) 
• Clorazepate (Tranxene®) 
• Diazepam (Valium®) 
• Halazepam (Paxipam®) 
• Lorazepam (Ativan®) 
• Oxazepam (Serax®) 
• Prazepam (Centrax®) 
• Quazepam (Doral®)  

Clonazepam (Klonopin®), diazepam, and clorazepate are also commonly used as anticonvulsants, though usually not in emergency cases.2

Because of the relaxation they produce, benzodiazepines can reinforce repeated use, which can lead to dependence or addiction. Benzodiazepine dependence is characterized by a physical tolerance for taking benzos, meaning that the user needs increasing doses of the drug to attain the desired feeling, as well as the development of withdrawal symptoms after one has stopped using. 

It should be noted that dependence differs from addiction, which is characterized by the compulsive seeking and taking of a substance despite negative life consequences. However, benzodiazepine dependence can lead to benzodiazepine addiction.

Signs of Benzodiazepine Addiction

The signs of benzodiazepine addiction include:3

• Taking benzodiazepines in larger amounts or for a longer period than you are meant to 
• Wanting to cut down or stop using the substance but not managing to 
• Spending a lot of time getting, using, or recovering from use of the substance 
• Cravings and urges to use benzodiazepines 
• Not managing to do what you should at work, home, or school because of substance use 
• Continuing to use benzodiazepines even when it causes problems in relationships 
• Giving up important social, occupational, or recreational activities because of benzodiazepine use 
• Using substances repeatedly despite their dangers 
• Continuing to use benzodiazepines even when you know you have a physical or psychological problem that could have been caused or made worse by the substance 
• Needing more of the substance to reach the effect you want 
• Development of withdrawal symptoms, which are only relieved by taking more of the substance

When a person takes a benzodiazepine, their brain releases a neurotransmitter, gamma-aminobutyric acid (GABA). This neurotransmitter slows the activity of the user’s nervous system, causing sleepiness and a relaxed mood. Slowed activity in the nervous system can also have the following side effects:4 

• Fatigue 
• Confusion 
• Weakness or unsteadiness 
• Dizziness 
• Changes in appetite  
• Nausea and diarrhea 
• Restlessness or excitement 
• Constipation 
• Blurred vision 
• Fluctuations in sex drive 

Benzodiazepines have also been associated with amnesia, hostility, irritability, and vivid or disturbing dreams.2 Their side effects can be felt more severely when the drug is misused, like in combination with alcohol and other drugs.

Risk of Benzodiazepine Overdose 

Benzodiazepines carry the risk of overdose. This risk is heightened when the drug is misused, such as taking a larger-than-prescribed dose or combining benzodiazepines with alcohol or other drugs like opioids or cocaine.1 Benzos can cause both respiratory and central nervous system depression, which can lead to impaired coordination, confusion, and extreme drowsiness. Benzodiazepine overdose signs include:2,4 

• Extreme drowsiness 
• Confusion 
• Impaired coordination or ataxia 
• Decreased reflexes 
• Respiratory depression or slowed breathing 
• Coma 

If you believe someone is experiencing benzodiazepine overdose, seek medical care immediately. Call 911 or your local emergency number and stay with that person until medical help arrives. Be prepared to give information about the kind and amount of substances the person took.

When someone has developed a dependence on or addiction to benzodiazepines, stopping or drastically decreasing their substance use can result in withdrawal symptoms. Often, these withdrawal symptoms can be so uncomfortable that the user will relapse, or return to using benzodiazepines. Some might even find that their benzodiazepine withdrawal symptoms resemble those of the anxiety- and insomnia-related conditions for which they first took the drug. Common symptoms of benzodiazepine withdrawal include:5,6  

• Headache 
• Sweating and palpitations 
• Dizziness 
• Confusion, disorientation 
• Nausea 
• Insomnia, nightmares 
• Anxiety 
• Irritability and restlessness 
• Poor memory and concentration 

A medically supervised detox and treatment program can help those with a benzodiazepine dependence or addiction safely manage their withdrawal symptoms and quit benzos for good. Some addiction programs provide Medication Assisted Treatment (MAT), which combines prescription medications to manage withdrawal symptoms with drug counseling and therapy.

Benzodiazepine addiction treatment can take place in many settings, though it always starts with detox. Detox is the process of ridding the substance from the body while managing any withdrawal symptoms that might occur. This typically takes between three and seven days.  

Once detox is completed, the patient may move through one or more drug addiction treatments designed to help them remain sober for the long term. These treatments include inpatient, partial hospitalization (PHP), intensive outpatient (IOP), outpatient (OP), and even aftercare. 

During treatment, patients typically receive therapy and learn various coping mechanisms to help them recover from their addiction and live a more productive life. Many addiction treatment programs offer one or more research-based behavioral therapies in combination with MAT to ease the process of withdrawal and reduce cravings. Many addiction treatment plans also offer dual diagnosis treatment, a therapeutic approach that simultaneously addresses both the addiction as well as any co-occurring mental health disorders. Finding an appropriate treatment plan depends on the person’s health history, the length of their addiction, and their individual needs.

When looking for a rehab facility, especially for treating benzodiazepine addiction in Atlanta, GA, it’s crucial to make informed decisions. Our approach at Empowered Recovery focuses on providing a comprehensive and holistic path to recovery, ensuring every individual receives the care best suited to their needs. Here, we outline key factors to consider when selecting the right rehab facility for Benzo addiction treatment.

Accreditation and What It Means for Quality of Care

Accreditations are pivotal when evaluating the quality of care offered by a rehab facility. These certifications are awarded by governing bodies and ensure that a center meets high standards of care and safety. Our accreditation signifies our commitment to excellence in benzo addiction treatment in Atlanta, GA. 

Accreditation guarantees that our programs, from benzo detox to long-term recovery strategies, adhere to the latest in clinical safety standards and therapeutic methodologies. This means our clients can trust they are receiving the highest quality of care, facilitated by trained professionals who are experts in their field.

Inpatient vs. Outpatient Treatment Programs

Understanding the difference between inpatient and outpatient treatment programs is essential when navigating the road to recovery from benzodiazepine addiction. An inpatient program provides a structured environment where individuals can receive 24/7 care and support. This is often recommended for those with severe addiction or those who have tried other forms of treatment without success.

On the other hand, outpatient programs allow individuals to receive treatment during the day and return home at night. Our Intensive Outpatient Program (IOP) offers a flexible approach to benzodiazepine addiction treatment. It’s designed for those who may need to maintain their daily responsibilities, such as work or school while undergoing treatment.

Whether opting for an inpatient or outpatient program, or a combination of the two, the decision plays a critical role in the journey towards recovery. Our team at Empowered Recovery in Atlanta is dedicated to guiding each individual through their options, helping them to choose the program that best fits their unique situation. With a focus on compassion, evidence-based treatment, and ongoing support, we aim to empower our clients towards a life free from benzo addiction.

At Empowered Recovery Center in Atlanta, we empower our patients with the education and skills they need to effect a lasting, positive change in their lives. Our benzodiazepine addiction treatment can and will guide you through the challenges of long-term recovery. 

Empowered Recovery Center offers a wide range of rehab programs to suit your unique needs. All our addiction treatment programs include one full year of recovery coaching at no extra cost to provide continued support once you’ve completed your program.  

Concerned about the cost of treatment? We accept most major insurance plans, and can work with many out-of-network insurance plans to guarantee you get the help you need. From verifying your benefits to going over the details with you to ensure you know exactly what to expect when it comes to paying for rehab, including using insurance to pay for rehab, our admissions team can help. If you’d like to learn more about our comprehensive, individualized benzodiazepine rehab program, contact us today.

References

1. Cleveland Clinic. (n.d.) Benzodiazepines (Benzos). Cleveland Clinic’s Health Library. Retrieved October 8, 2024, from https://my.clevelandclinic.org/health/treatments/24570-benzodiazepines-benzos 
2. Drug Enforcement Administration (2020). Drug Fact Sheet: Benzodiazepines. Department of Justice/Drug Enforcement Administration. Retrieved October 8, 2024, from https://www.dea.gov/sites/default/files/2020-06/Benzodiazepenes-2020_1.pdf 
3. Cleveland Clinic. (n.d.) Substance Use Disorder (SUD): Symptoms and Treatment. Cleveland Clinic’s Health Library. Retrieved October 10, 2024, from https://my.clevelandclinic.org/health/diseases/16652-drug-addiction-substance-use-disorder-sud 
4. MedLine Plus. (n.d.) Lorazepam. National Library of Medicine. Retrieved October 12, 2024, from https://medlineplus.gov/druginfo/meds/a682053.html 
5. U.S. National Library of Medicine (2015). Management of benzodiazepine misuse and dependence. National Institutes of Health. Retrieved October 31, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308/
6. U.S. National Library of Medicine (1995). The benzodiazepine withdrawal syndrome. National Institutes of Health. Retrieved November 21, 2024, from https://pubmed.ncbi.nlm.nih.gov/7841856/