Doctors prescribe benzodiazepines, also called benzos, to treat anxiety and sleep disturbances. These drugs can also be used in the treatment of muscle spasms, seizures, drug and alcohol withdrawal and tremors.
What Are Benzodiazepines?
Benzodiazepines are a class of drugs that relax the body by making the neurotransmitter gamma-aminobutyric acid (GABA) more active. When GABA activity increases, activity in the brain and the nervous system slows, which relaxes the body. It is in this way that benzos promote sleep and alleviate anxiety.
What Are Benzodiazepines Used For?
Aside from their most common uses (treating anxiety and insomnia), benzodiazepines can be prescribed to treat a range of health conditions. Some people may use benzos to treat panic disorder because they can quickly relieve anxiety. Benzos also have anticonvulsant properties, making them effective for treating seizures.
Benzos are also known for reducing the severity of alcohol withdrawal, so doctors may prescribe them during the detoxification process. Additionally, benzos have a history of use for the treatment of muscular conditions, such as pain and spasticity, and in some cases, they can be prescribed to treat multiple sclerosis, spinal injuries and cerebral palsy.
Dose and Administration
Benzodiazepine dose amounts depend upon the specific type of benzo prescribed and the purpose for which a person takes it. Low dose benzodiazepines include Ativan, Xanax and Klonopin, but Librium and Valium are typically prescribed in larger doses. The following dose and administration schedules are common for the various types of benzo medications:
- Ativan: .5 mg to 1 mg, three to four times per day
- Xanax: .25 mg to 1 mg, three times per day with a maximum daily dose of 4 mg
- Klonopin: .5 mg to 1 mg, three times per day with a maximum of 20 mg per day
- Librium: 5 mg to 25 mg, three to four times per day with a maximum daily dose of 100 mg
- Valium: 5 mg to 25 mg, three to four times per day up to a maximum dosage of 40 mg
While maximum doses are provided, the total daily dose that is safe will be different for each person. Only a licensed physician can determine the benzodiazepine maximum dose that will be effective and safe for a specific person.
There are numerous benzodiazepines that doctors can prescribe to treat anxiety and other conditions. Common benzos include the following:
- Alprazolam (Xanax)
- Clonazepam (Klonopin)
- Chlordiazepoxide (Librium)
- Diazepam (Valium)
- Lorazepam (Ativan)
- Flurazepam (Dalmane)
- Oxazepam (Serax)
- Temazepam (Restoril)
- Triazolam (Halcion)
What Do Benzodiazepines Look Like?
Benzodiazepines typically come in the form of a pill or tablet, but they can be different shapes or colors depending on their type. Some common benzo appearances are:
- Xanax: Xanax comes in a white, pink or light blue oval pill. It can also appear in the form of a white, oblong bar. Extended-release Xanax pills are white, yellow, blue or green and can be triangular, square, round or pentagon.
- Klonopin: Klonopin is typically a circular, blue pill with a “K” in the center.
- Librium: This benzo comes in capsule form and is often green and white, but colors can vary. It is also available as an injectable solution.
- Valium: This medication is seen as a circular, white pill with a “V” in the center.
- Ativan: Often appears as a white, pentagon tablet. Ativan is also available as a liquid solution for injection.
While common benzos typically appear as described, appearances can vary based upon the brand. For example, while Xanax is typically seen as an oval pill, or a “Xanax bar,” the generic version, alprazolam, is usually a round pill.
Benzodiazepines Street Names
Benzodiazepines have common street or slang names that describe them, and there are different terms for the various types of benzos:
- Xanax: Xanax street names include Xannies, Bars, Xanbars, Planks, Bricks, Upjohn and School Bus.
- Klonopin: Slang names for this drug include K, K-pin, Super Valium and Pin.
- Librium: Librium street names are typically the same as common slang terms for benzodiazepines in general: Benzos, Downers, Nerve Pills or Tranks.
- Valium: The following are common Valium street names: Benzos, V’s, Yellow V’s, Blue V’s, Benzos, Downers, Tranks, Sleep Aways, Howards and Old Joes.
- Ativan: Like Librium, the street names for Ativan can include Benzos, Tranqs, Downers, and Nerve Pills.
Benzodiazepine Side Effects
Benzodiazepine side effects include long-term and short-term effects. Short-term effects can occur soon after taking benzodiazepines, whereas long-term effects occur with prolonged use of these drugs.
Common side effects that occur soon after taking benzodiazepines are dizziness, lightheadedness, confusion, memory issues, lack of balance and coordination, sedation, appetite changes, nausea and vomiting, dry mouth, fatigue, weight gain and sexual dysfunction.
Long-term effects of benzodiazepines can be more serious. With ongoing use, a person may develop an addiction to benzos and experience withdrawal symptoms when drug use stops. People may also experience significant side effects, such as dangerously low blood pressure, seizures, movement disorders and suicidal thoughts.
When a person develops a dependence upon benzos from long-term use, withdrawal symptoms can include tremors, anxiety, panic attacks, vomiting, muscle pains, headache, heart palpitations, sleep disturbances and difficulties concentrating.
How Long Do Benzos Stay in Your System?
The length of time that benzos are detectable in a person’s system depends on the testing method and the frequency of benzo use. The following are estimates of how long benzos stay in a person’s system:
- Urine: When benzos are taken as prescribed at typical doses, they can stay in a person’s system for three to seven days; with chronic use, they can be detected for up to 30 days
- Blood: Blood tests can reveal benzodiazepine use within the past 12 to 24 hours before the test
- Hair: Hair tests can detect benzodiazepine use that has occurred within the past three months
- Breastmilk: Using benzodiazepines while pregnant is not recommended because newborns can experience withdrawal symptoms. Benzodiazepines can also be transferred to infants via breast milk. One study found that Xanax levels in breast milk peaked one hour after administration.
Are Benzodiazepines Addictive?
Benzodiazepines are addictive, even for people who take them as prescribed.
Benzodiazepine addiction could be suspected if a person is spending a significant amount of time and money attempting to obtain benzos or if they find it difficult to stop or reduce their benzodiazepine use. Other signs of addiction include experiencing regular difficulties at work or in personal life because of drug use.
If you or a loved one struggle with benzodiazepine addiction, contact The Recovery Village Palm Beach to speak with a representative about how professional addiction treatment can help. The Recovery Village Palm Beach uses personalized treatment programs to ensure that each client receives the treatment that caters to their unique needs. Take the first step toward a healthier future by calling today.
Harvard Health Publishing. “Benzodiazepines (and the alternatives).” March 15, 2019. Accessed July 10, 2019.
Nordqvist, J. “The benefits and risks of benzodiazepines.” Medical News Today, March 7, 2019. Accessed July 10, 2019.
Botvin-Madorsky, J. “The Role of Benzodiazepines in the Management of Neurological and Muscular Disorders.” Journal of Psychoactive Drugs, 1983. Accessed July 10, 2019.
Kim, P; Weinstein, S. “Benzodiazepines.” John Hopkins Medicine, December 19, 2016. Accessed July 10, 2019.
WebMD. “Drugs & Medications A-Z.” Accessed July 12, 2019.
Drugs.com. “Librium 25 Roche (Librium 25 mg).” Accessed July 12, 2019.
EMPR. “Klonopin® (Clonazepam) Drug Slang/Code Words.” August 1, 2017. Accessed July 14, 2019.
Prescription Drug Abuse. “Valium street names 101.” Accessed July 14, 2019.
Connecticut State Department of Consumer Protection. “Lorazepam.” Accessed July 14, 2019.
Drug Enforcement Administration. “Benzodiazepines.” July 2019. Accessed July 14, 2019.
Substance Abuse and Mental Health Services Administration. “Appendix B. Urine Collection and Testing Procedures and Alternative Methods for Monitoring Drug Use.” 2006. Accessed July 14, 2019.
United States Drug Testing Laboratories, Inc. “Hair drug testing.” Accessed July 14, 2019.
Women’s Mental Health. “Benzodiazepines and pregnancy.” May 6, 2001. Accessed July 14, 2019.
National Library of Medicine. “Drugs and lactation database.” April 1, 2019. Accessed July 14, 2019.