Benzodiazepines are a class of psychoactive drugs that act as minor tranquilizers. They treat a handful of conditions and were first introduced in 1963. While they are only intended for short-term use, a number of patients end up taking them for longer periods.
When people misuse benzodiazepines or benzos in this manner, the specter of addiction becomes all the more real. Benzo addiction, in particular, can produce an array of harrowing physical, mental, and behavioral effects that can be life-threatening.
Over the past two decades, the fears surrounding these drugs’ use have come home to roost as the number of fatal benzodiazepine overdoses quadrupled during the past 20 years. Doctors have been prescribing benzodiazepines for decades even though they possess a high addiction potential.
What’s more, benzodiazepine addiction has been ensnaring an increasing number of older people, who make up the largest contingent of users.
Often, the only way to tackle a life-threatening benzodiazepine addiction is through a focused, specialized, and balanced professional treatment plan, offered at a program that treats a user’s underlying conditions.
Anything short of this significantly increases the risk for relapse and death as outcomes of addiction.
Doctors prescribe benzodiazepines to treat a handful of conditions, such as anxiety disorders, insomnia, seizures, panic disorders, and acute alcohol withdrawal. Benzos primarily act on GABA, a neurotransmitter in the brain. GABA or gamma-Aminobutyric acid is responsible for sending messages between the brain and the rest of the central nervous system (CNS). Its primary function is to reduce or inhibit the excitability of the nervous system.
Consequently, benzos produce a relaxing, sedative effect on the user, endowing them with a sense of euphoria in the process. This effect impacts the brain’s reward center, which plays into a user developing an addiction.
The most widely prescribed benzodiazepines include:
Xanax (alprazolam): This benzo is one of the most widely prescribed and abused benzodiazepines on the market. It’s a fast-acting sedative that inhibits users within 15 minutes to 60 minutes, leaving them feeling drowsy, if not incapacitated, for a few hours.
Valium (diazepam): This long-acting sedative is also one of the most frequently prescribed drugs on the market. It treats anxiety, insomnia, panic attacks, muscle spasms, and seizure disorders. A sign of valium addiction is that a person can experience lowered inhibitions which can cause him or her to become aggressive or engage in risky behavior.
Librium (chlordiazepoxide): This benzo is primarily used to treat people with alcohol withdrawal symptoms. Because Librium possesses high addiction potential, it should be taken as prescribed. It is not unusual for patients in alcohol recovery to develop an addiction to Librium.
Klonopin (clonazepam): This is another popular benzodiazepine prescribed to people with seizures, anxiety, and muscle disorders. It is also prescribed for children with epilepsy. Like other benzos in its class, it is only intended for short-term use due to its high addiction potential.
Ativan (lorazepam): Ativan is typically prescribed to people with seizures. It is also administered to patients who are about to undergo surgery. Users are advised not to take Ativan with alcohol because it can lead to seizure, coma, or death
During the past 20 years, the number of benzodiazepine prescriptions has greatly increased, particularly among older patients who have trouble with anxiety or insomnia. Despite the risks, doctors continue to prescribe it, and a certain set of users tend to misuse it.
The reason people flock to benzos despite their inherent dangers is because of their initial effectiveness, especially in the area of sleep.
Take a benzodiazepine and “the first night, you’ll get a better night’s sleep,” one doctor told The New York Times in a February 2015 article.
That same article quoted medical experts who say older users prefer medication over therapy to treat the underlying symptoms associated with benzodiazepine use. People who misuse benzodiazepines to manage their anxiety, seizures, panic, or muscle disorders, run the risk of developing an addiction.
The road toward addiction begins when users develop a tolerance, meaning they take more medication than what is prescribed in the hopes of experiencing the same effect from a previous dose. That tolerance grows into dependence when a user can only feel normal on the medication. They experience effects that include the following:
That quickly morphs into an addiction when users begin to exhibit compulsive behaviors around obtaining and taking benzos. They can exhibit the following behaviors when they are addicted:
What’s more, excessive benzodiazepine use can cause daytime drowsiness which can make users prone to falls and accidents.
The dangers that benzodiazepines present make it necessary for users to find a balance between taking medication and participating in evidence-based therapy (EBT) to treat their underlying conditions.
Evidence-based therapy, as defined by the American Psychiatric Association and the American Psychological Association, is the “‘best practice’ and ‘preferred’ approaches for psychological symptom treatment.”
The two goals of EBT are “increased quality of treatment, as well as increased accountability,” in order that patients only invest in and participate in treatments that have been proven effective, states the Positive Psychology Program.
Instead of taking benzodiazepines to treat anxiety or insomnia, for example, patients can participate in exercise, muscle relaxation training, yoga, and hypnosis to treat those conditions. However, according to Harvard Health Publishing (HHP), the best alternative to taking benzodiazepines is cognitive behavioral therapy (CBT).
For sleep disorders like insomnia, states HHP, “the cognitive behavioral approach involves recording and changing both sleep habits and ways of thinking about sleep.”
“Patients learn to go to bed only when sleepy, to exercise regularly but not near bedtime, to avoid eating, reading, or watching television in bed, and to rise at the same time no matter how little they have slept.”
HHP goes on further to state that with CBT for anxiety, “patients record, examine, and analyze their thoughts and feelings, with special attention to those that provoke or relieve anxiety. While the therapist helps them to become aware of unrealistic thinking, they also learn new ways to respond to anxiety-provoking situations, and practice the techniques of exposure and systematic desensitization.”
The study concludes by noting: “cognitive behavioral therapy is found to be as effective as benzodiazepines and other medications, and its impact often lasts longer.”
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If you want to cease using benzodiazepines, it is best to consult your doctor before you decide to stop taking your medication. When you stop taking a benzodiazepine on your own, you will experience painful and sometimes life-threatening withdrawal symptoms that will invariably lead you to relapse, if not death.
Your best course of action is to enter into a professional addiction treatment program where you will be supervised by medical staff and a team of clinicians that will ensure a safe and comfortable recovery process.
In professional treatment, you will first undergo medical detoxification, where you will be safely weaned off of benzodiazepines to prevent potential complications that come during withdrawal.
After detox, it is recommended that you receive ongoing care at a residential treatment facility, where you will receive therapy and counseling designed to help you get to the bottom of your addiction.
During this process, you can access strategies to help you treat the underlying conditions associated with a benzodiazepine addiction. At this level of care, you will also be able to access time-tested and innovative therapies including CBT.
Reuters. (2016, February 26) Benzodiazepine prescriptions, overdose deaths on the rise in U.S. Kennedy, M. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816010/
Benzodiazepines: Uses, Side Effects, Interactions & Warnings. (n.d.). from https://www.drugs.com/article/benzodiazepines.html
Harvard Health Publishing. (n.d.). Benzodiazepines (and the alternatives). from https://www.health.harvard.edu/newsletter_article/Benzodiazepines_and_the_alternatives
National Institute on Drug Abuse. (2018, August 09). Overdose Death Rates. from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
Span, P. (2015, February 13). Continued Questions on Benzodiazepine Use in Older Patients. from https://www.nytimes.com/2015/02/13/health/continued-questions-on-benzodiazepine-use-in-older-patients.html
American Psychological Association. (2008) Evidence-Based Practice in Psychology. Retrieved from https://www.apa.org/practice/resources/evidence/
Positive Psychology. What is Evidence-Based Therapy: 3 EBT Interventions. Selva, J. BcS. Retrieved from https://positivepsychology.com/evidence-based-therapy/#what-evidence-based-therapy
American Journal of Public Health. (2016, April) Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996–2013. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816010/