Benzodiazepines are a type of sedative medication frequently used to treat anxiety, panic disorder and insomnia. Benzodiazepines can also be used to treat seizures, muscle conditions or be used as part of a treatment protocol for addiction recovery. Benzodiazepines target the central nervous system to initiate sedation, to relax muscles and to decrease anxiety.

Benzodiazepines are often effective in decreasing anxiety, alleviating symptoms of panic disorder and promoting sleep. Benzodiazepines can generate immediate effects and be prescribed for short-term use, as needed, or long-term use. Benzodiazepines are commonly safe and effective when taken as prescribed, but can become physically and psychologically addictive if not taken as directed.

Benzodiazepine addiction can result from its sedative effects, chemical properties and immediate effects. In the beginning, individuals commonly have a valid reason for using them, but benzodiazepine abuse tends to develop over time if the medication is misused. Benzo addiction is linked with a variety of physical and psychological symptoms, which serves to strengthen addictive properties. Benzodiazepine addiction can have serious consequences if not effectively treated.

How Are Benzodiazepines Abused?

Benzodiazepine abuse occurs when the medication is misused or not taken as prescribed. People can develop a tolerance and become used to the high and other calming effects, leading them to take the medication more frequently and in larger amounts. Benzo abuse is attributed to the drug’s general availability along with the physical and psychological effects.

Crushing and snorting benzos have become a route of administration for individuals seeking a quicker high. Snorting benzodiazepines is associated with elevated risks of decreased heart rate, respiratory depression, elevated behavioral and psychological symptoms and potentially overdose or death.

Benzo Addiction Symptoms

The fact that benzodiazepines are prescribed from a physician may cause loved ones to be less vigilant to the potential warning signs of benzo abuse. Signs of benzodiazepine abuse tend to vary depending on the volume of the drug taken and the length of time it has been abused.

Benzo addiction symptoms commonly include a variety of physical, psychological and behavioral symptoms. Identifying the signs and symptoms of benzodiazepine abuse is critical to getting a loved one the help and treatment that they need.

Physical Abuse Symptoms

There are several physical benzodiazepine abuse symptoms including:

  • Excessive tiredness and fatigue
  • Slurred speech and impaired coordination
  • Decreased heart rate and shallow breathing
  • Fainting, lightheadedness and impaired reflexes
  • Increased perspiration, pale and cold skin
  • Dizziness, nausea and vomiting
  • Seizures and trembling

Psychological Abuse Symptoms

When taken for an extended period of time, psychological benzodiazepine addiction signs can result, including:

  • Mood fluctuations
  • Depression and suicidal thoughts
  • Elevated levels of anxiety
  • Increased irritability and aggression

Behavioral Abuse Symptoms

Individuals with a benzodiazepine addiction may be impaired in their daily functioning. Personal relationships, work and school responsibilities and finances may suffer. Other behavioral signs of abuse can include:

  • Elevated drug seeking behaviors
  • Attempts to acquire more prescriptions
  • Increased secretive and isolative behaviors
  • Hiding bottles of pills
  • Taking medication in higher amounts or for longer durations
  • Trouble functioning in occupational, academic, or social settings

Side Effects of Benzodiazepine Abuse

In high-stress situations, heart rate, breathing and blood pressure can increase, causing increased levels of anxiety. Benzodiazepines work to reduce anxiety by repressing actions of the central nervous system to inhibit the physical and emotional impact of stress. Both mental and physical benzodiazepine side effects can result from the body slowing down.

Benzo side effects can be immediate and can even result when benzodiazepines have been used for a short duration of time. Benzodiazepines side effects are related to dosing, the particular benzodiazepine being used and a person’s length of use. There are short-term and long-term side effects resulting from benzodiazepine abuse and addiction.

Short Term Side Effects

Short term side effects of benzodiazepine abuse can include:

  • Headaches and vision difficulties
  • Dizziness and flawed motor coordination
  • Confusion and impacted memory functions
  • Tiredness and fatigue
  • Slurred speech, physical weakness and impaired reaction time
  • Irritability, forgetfulness and restlessness
  • Anxiety, paranoia and mood difficulties
  • Loss of libido and impotence

Long Term Side Effects

Long-term effects of benzodiazepine abuse can include:

  • Tolerance — requiring increased amounts of benzodiazepines to achieve euphoria.
  • Impaired relationships resulting from changes in personality and lower impulse control.
  • Impaired mental faculties and brain damage, resulting in occupational and academic consequences such as unemployment, dropping out of school or reduced finances
  • Potential death from overdose, polysubstance abuse or increased feelings of depression and suicidal attempts.
  • Legal issues resulting from benzodiazepine abuse.
  • Increased risk of Alzheimer’s Disease in the geriatric population.

Side Effects of Polysubstance Abuse

Benzodiazepine abuse very rarely results in death, but it can have dangerous or lethal effects when taken with alcohol or other substances. Combining benzodiazepines and alcohol to increase euphoria is very dangerous as it can put a person at risk for coma or overdose. This increased risk is due to the fact that both benzos and alcohol suppress the central nervous system. The combination of depressant effects can suppress the central nervous system to critical levels of unconsciousness. Benzodiazepine and opiate interactions are also dangerous, as both types of drugs suppress breathing and causes sedation and impairment to cognitive functioning. More than 30% of overdoses involve opioids and benzodiazepines.

Causes of Benzodiazepine Addiction

There are various causes of benzodiazepine addiction. Some people may have a hereditary or genetic predisposition for addiction. Environmental influences, such as socioeconomic status, living conditions, accessibility and peer pressure can also have a significant impact on addiction.

Benzodiazepines are easily accessible and habit forming, increasing the risk of addiction when not taken as prescribed. When benzodiazepines are consumed excessively in elevated amounts, people experience euphoria and increased levels of relaxation, often resulting in increased tolerance.

Addiction Risk Factors

While anyone can become addicted to benzos, there are some important risk factors that increase the likelihood, including:

  • Long-Term Use. A person is at increased risk for addiction when they begin taking drugs at an early age and use it on a long-term basis. Early drug use can prompt changes in the developing brain, elevating the potential of drug use progressing to addiction
  • Polysubstance Abuse. Drug experimentation and the use of multiple substances can increase a person’s risk for addiction.
  • Co-occurring Disorders. Co-occurring disorders can increase a person’s addiction risk as both conditions can contribute to low impulse control, poor decision-making or risk-taking behaviors.
  • Use of High Doses. Using high doses of substances to achieve euphoric effects can lead to increased levels of tolerance.
  • Other Risk Factors. Other risk factors can include poor parental supervision and attachment, peer pressure and impaired social skills, and the ease and accessibility in obtaining drugs.

Benzo Withdrawal Symptoms

Benzodiazepine withdrawal can be hazardous, especially for people with significant levels of dependence or other co-occurring health conditions. Severe symptoms of benzo withdrawal can include psychosis or seizures. When benzo withdrawal symptoms are not addressed, withdrawal seizures may be continuous, hard to control or potentially deadly.

Benzodiazepine withdrawal symptoms can include:

  • Agitation, irritability and impaired concentration
  • Anxiety, panic and insomnia
  • Increased perspiration, racing heart and elevated blood pressure
  • Headaches, sensory impairments  and nausea
  • Muscle pain and trembling

Benzodiazepines Abuse Facts & Statistics

Some general facts about benzodiazepines include:

  • Benzodiazepines are classified as depressants that induce sleep and sedation, alleviate anxiety and muscle-related issues and prevent seizures.
  • The term benzodiazepine is derived from the chemical structure of the compound, which includes a “benzene” ring and a “diazepine” ring.
  • The street names for benzodiazepines include “benzos” and “downers.”
  • Benzodiazepine abuse is commonly linked with adolescents and young adults who either take it orally or crush and snort it.
  • Benzodiazepine abuse is common for people who use heroin or cocaine.
  • Benzodiazepines target and suppress the central nervous system.
  • Benzodiazepines are controlled as schedule IV drugs in the United States.

Benzodiazepine addiction statistics are as follows:

  • The prevalence of benzodiazepines in the general population is between 4% and 5%.
  • About 2.3% to 18% of people in the United States have misused sedatives or tranquilizers for recreational use in their lifetime.
  • In 2010, there were approximately 186,000 people who misused benzodiazepine for the first time.
  • Emergency departments have seen a 139% increase in hospital visits related to benzodiazepines.
  • Benzodiazepine abuse close to tripled from 1998 to 2008.
  • About 1 in 5 people who abuse alcohol also abuse benzodiazepines.
  • Deaths related to benzodiazepines increased from 18% in 2004 to 31% in 2011.
  • Hospital admissions for benzodiazepines for people over age 12 rose from 22,400 in 1998 to about 60,200 in 2008.

Benzo Abuse and Treatment Trends in South Florida

The abuse of benzodiazepines, specifically Xanax, continues to be a significant issue in South Florida. It is especially problematic when used recreationally in combination with alcohol and other illegal drugs. In the first half of 2012, there were 2,622 reports of benzodiazepines found in the blood of deceased individuals in southern Florida. Of these reports, benzodiazepines were considered to be “the cause of death” for 25% of cases.

Benzodiazepine misuse is prevalent in young adults and is common in the majority of individuals who frequent club scenes in Miami, Florida. In structured interviews amongst young adults who regularly attended electronic dance music venues in Miami, the prevalence of benzodiazepine dependence was found to be 12.6%, benzodiazepine abuse was 21.1% and benzodiazepine abuse and/or dependence was 24.2%.

Benzodiazepine Overdose

Benzodiazepine overdoses do not occur frequently by themselves but can occur when high doses of benzodiazepines are combined with other substances. Benzo overdose is more common when high amounts of benzodiazepines are consumed with alcohol, opioids, barbiturates or tricyclic antidepressants. These combinations can lead to significant complications, coma or fatality. If it is suspected that a person has overdosed on benzodiazepines, 911 should be contacted immediately for emergency services.

Benzodiazepine Overdose Symptoms

Benzodiazepine overdose symptoms generally appear quickly and within several hours of benzodiazepine overdose. People usually present with mild to moderate impairments to the central nervous system unless the overdose occurs in combination with other recreational drugs or medications. In most cases, benzo overdose symptoms are alleviated within 12 to 36 hours.

Benzo overdose symptoms can include:

  • Abnormal breathing and slowed respiration
  • Extreme fatigue and tiredness
  • Inability to control fine motor skills, slurred words and clumsiness
  • Lightheadedness or fainting
  • Vision impairments and uncontrolled eye movements

How to Help Someone Addicted to Benzodiazepines

The first step to helping a loved one with benzodiazepine addiction is to identify the problem. It may be difficult to differentiate between legitimate use and benzodiazepine abuse and addiction. Once it is determined that a loved one has a benzo addiction, it is important to seek and find the appropriate type of treatment for them. Benzodiazepine addiction can be very dangerous and withdrawal can become fatal if a person stops using the drug suddenly.

Benzodiazepine Addiction Treatment Options

There are several benzodiazepine addiction treatment options that help a person detox and minimize withdrawal symptoms. An addiction assessment can help identify the type of benzo addiction treatment that is right for a particular individual. Generally, benzodiazepines treatment options include detox, residential treatment, outpatient treatment and dual diagnosis treatment.

  • Detox. Benzodiazepine withdrawal can be extremely dangerous and can cause a condition called benzodiazepine withdrawal syndrome. A medically assisted detox facility can monitor and treat the most dangerous symptoms of withdrawal, including seizures, elevated blood pressure and cardiac ailments.
  • Residential. Residential treatment facilities are recommended when withdrawal symptoms are severe or if a person has abused benzodiazepines over a long period of time. Residential facilities allow for close monitoring of the detoxification process.
  • Outpatient. Outpatient treatment allows individuals to remain at home while they are receiving treatment. Outpatient treatment can be sought if withdrawal symptoms are not severe and if a person is able to adhere to a detox regiment.
  • Dual Diagnosis. Benzodiazepines are generally used to treat an underlying condition such as anxiety, depression or another mental health condition. The majority of individuals with a benzodiazepine addiction have a co-occurring disorder that must be treated simultaneously to the benzo addiction.

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Key Points: Understanding Benzodiazepine Abuse

  • Benzodiazepine addiction occurs when an individual does not take benzodiazepines as prescribed by their physician.
  • Benzodiazepine abuse is often more dangerous than the anxiety and insomnia conditions that they are prescribed to treat.
  • Benzo addiction results when a person purchases benzodiazepines illegally, exceeds recommended dosages or takes them for extended lengths of time.
  • People who misuse benzodiazepines develop a tolerance to the drug, causing them to use it more often in higher dosages to achieve the same high.
  • Benzodiazepine addiction can result in physical, behavioral and psychological symptoms.
  • Causes for benzo addiction can be genetic or environmental factors.
  • Short- and long-term side effects are related to the type of benzodiazepine being used along with the amount and length of time taken.
  • Benzodiazepine overdose is not common, but can be extremely dangerous and 911 must be contacted immediately if an overdose is suspected.
  • Withdrawal symptoms related to stopping the use of benzodiazepines can be serious and can be treated in outpatient or inpatient settings, depending on the level of severity.
  • There are various treatment options to treat benzo addiction including detox, dual diagnosis treatment, residential and outpatient centers.

If you or a loved one is struggling with benzodiazepine addiction, help is available. The Recovery Village Palm Beach at Baptist Health is a treatment center staffed with knowledgeable and compassionate addiction professionals. Contacting The Recovery Village Palm Beach at Baptist Health is free and confidential and can provide you with the guidance you need to select the treatment option that is best for you.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.