Mood Disorders Caused by Benzodiazepines
Benzodiazepines are a class of drugs that are very widely prescribed for their effectiveness in treating anxiety, insomnia, and other conditions. They are well known for their sedative and relaxant effects. When used as prescribed, they cause few or no serious side effects. However, benzodiazepine misuse can lead to tolerance, dependence, and addiction.
A Brief Overview of Benzodiazepines
Mental and medical health professional prescribe benzodiazepines to treat a number of different conditions. Benzodiazepines can help manage generalized anxiety disorder, alcohol withdrawal, insomnia, seizures and panic attacks. They reduce stress and anxiety by making certain neurotransmitters more effective. Benzodiazepines are among the most commonly prescribed prescription medications. CNN.com reports: “The percentage of adults in the United States who filled a benzodiazepine prescription per year increased by about 30%, from 4.1% in 1996, to 5.6% in 2013. In addition, the amount of benzodiazepine medicine — whether Xanax, Valium, Ativan, Klonopin or other drugs in this class — in a prescription doubled over this time period.”1 While benzodiazepines can help some people manage their health, the rapid increase in prescriptions and dosage is troubling. It has contributed to overdose deaths, accidents, addiction and mood disorder development.
Benzodiazepines and Mood Disorders
Mood disorders include various forms of depression and bipolar disorder. They are common among Americans but aren’t always diagnosed or treated as they should be. According to Mental Health America shares, “About 20% of the U.S. population reports at least one depressive symptom in a given month, and 12% report two or more in a year… Bipolar disorder is less common, occurring at a rate of 1% in the general population, but some believe the diagnosis is often overlooked because manic elation is too rarely reported as an illness.”2 When a mood disorder is diagnosed, it is often treated with benzodiazepines. However this is a short-term option, and medication alone is not comprehensive treatment for any mental health issue. Use needs to be closely monitored and combined with traditional and alternative therapy options. Benzodiazepines should only be used for a few weeks to stabilize mood and health. When used for longer, they may worsen mood disorders rather than help treat them.
Benzodiazepines’ Impact on Mental Health
Benzodiazepines can cause nearly immediate health problems.“Current guidelines for doctors say [benzodiazepines] should be prescribed for a maximum of four weeks,” the Independent reports. “But some people become ‘involuntarily addicted’ within days, unable to stop without withdrawal symptoms such as burning sensations, distorted vision, headaches, and even fatal seizures.”3 When someone misuses a benzodiazepine, side effects can be even more rapid and serious. If use continues, individuals may experience significant changes to mood, health, and behavior. They may experience brain damage that impacts attention, memory, and feelings of wellbeing. They may experience more or more severe depression, bipolar disorder or other mental health concerns.
Treating Mood Disorders and Addiction
When addiction and mental health issues occur at the same time, professional treatment becomes essential. Integrated treatment addresses all aspects of mental, physical and emotional health. This treatment begins with detox but certainly doesn’t end there. Once benzodiazepines have left the body and withdrawal symptoms have faded, patients begin psychotherapy, group therapy, and supportive practices.
With treatment comes hope. Real, lasting recovery is possible for anyone no matter the challenges they face. You or your loved one can manage mental health symptoms and find freedom from addiction. Black Bear Lodge can help. We know how frustrating the combination of addiction and mental health issues can be. We offer in-depth assessments, world-class treatment and experienced, compassionate professionals. Call 706-909-9811 today to learn how we can help.
An Overview of Benzodiazepine Abuse
Knowledge is power, the adage says. And it certainly rings true when it comes to what you know about benzodiazepine abuse. The more you know, the more empowered you’ll be —to help yourself or a loved one in an emergency situation, to respond in the safest, quickest way.
After all, especially with substance abuse issues, timing is everything. Taking immediate, informed action improves your loved one’s chances of long-term recovery success. In other words, when you learn more about benzodiazepine abuse, you’re learning how to save a life.
What Are Benzodiazepines?
The word benzodiazepine might be unfamiliar. The drugs included in this class are anything but. Common, recognizable benzodiazepines include the following:
These drugs may be an important part of your or a loved one’s mental health treatment. They may also be the cause of serious substance use or addiction concerns.
How Do Benzodiazepines Work?
Benzodiazepines are prescribed to manage anxiety and insomnia symptoms. They work by slowing electrical activity in the brain. They make GABA, a neurotransmitter responsible for calming the brain, more effective. Prescription use or recreational abuse can lead to tolerance, dependence, and addiction. The brain gets used to benzodiazepines, and it adjusts in an attempt to create balance. As it adjusts, you or a loved one will need more of the drug.
Taking the drug more often or in greater doses than prescribed is abuse. Taking the drug without a prescription is abuse. Once you are tolerant to the effects of a drug, you will find you have to take the drug to even feel normal. You may no longer feel good when you take the drug, but you know you feel bad when you do not.
American Family Physician explains: “Long-term use of benzodiazepines may lead to an overreliance on the need for the agent, loss of self-confidence, and varying degrees of drug-seeking behavior. Patients may be reluctant to discontinue the drug because of misplaced fears or anticipatory anxiety. Some patients combine alcohol with benzodiazepines when they are not able to acquire the desired or ‘needed’ effects.”4 The longer you use benzodiazepines, the more likely you are to rely on them to feel good. You may come up with reasons and excuses for continuing use despite experiencing other, unwanted side effects. You may start to combine these drugs with other drugs or alcohol. All of these are signs of addiction. They are signs to take action and get help for yourself or a loved one.
Who Abuses Benzodiazepines?
Anyone can abuse, and become addicted to, benzodiazepines. There is no one type of person or personality that becomes addicted. If you have a personal or family history of addiction, you are at greater risk for developing a benzodiazepine, or any, addiction. “Some of the more common environmental influences,” according to WebMD, “are low socioeconomic status, unemployment, and peer pressure.”5 Addiction is a chronic disease. Like other chronic diseases, factors such as genetics, lifestyle, and environment can contribute to its development. Like other chronic diseases, addiction can be treated.
Treating Benzodiazepine Abuse
Benzodiazepine abuse treatment begins with detox. When medically supervised, detox is safe and straightforward. If someone attempts the process at home, it can be dangerous and often leads to relapse and setbacks. Some people experience seizures during withdrawal. Most people experience uncomfortable physical side effects and unpleasant psychological ones. Treatment helps you manage withdrawal symptoms and stay motivated to continue on to the real heart of recovery.
Therapy helps you or your loved one better understand benzodiazepine abuse and how to move past it. You may explore your past, delve into present thoughts and develop skills and strategies for staying clean in the future. An integrated treatment program will diagnose any co-occurring mental health concerns and provide appropriate care. Programs can work with families so that everyone can begin to find wellness. Your treatment team works with you to determine the best forms the therapy and the best treatment plan for you as an individual. Benzodiazepine abuse recovery is real, and it is within reach.
At Black Bear Lodge, we create customized treatment plans. We specialize in treating co-occurring substance abuse and mental health issues. If you or someone you love needs help, we are here for you. We can help you understand your options and take the first steps toward recovery. Call us now at 706-909-9811, and begin the healing process today.
Benzodiazepine Addiction Rates
There are more than 15 approved prescription benzodiazepine medications in the United States. These drugs are used to treat a variety of physical and psychiatric symptoms. They have sedative, hypnotic, anticonvulsant, amnesiac, muscle-relaxing and anxiety-relieving properties. Benzodiazepines can do so much because they are central nervous system depressants. They affect the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) and its receptor sites in the brain. GABA is a natural tranquilizer with sedative and calming effects. Benzodiazepines make GABA more effective, its receptors more sensitive or both. Benzodiazepines have useful medical properties. They also have harmful side effects. The sedative properties that make them important medical tools make them highly addictive as well.
Who Uses Benzodiazepines?
Benzodiazepines like Xanax, Valium, and Ambien are household names. They are widely popular and widely prescribed. Psych Central reports that in 2013 Xanax, a benzodiazepine, was the most commonly prescribed drug. Other benzodiazepines, Ativan and Valium, came in fifth and ninth in popularity.
The Drug Enforcement Agency6 reports the number of prescriptions written in 2011 for popularly benzodiazepines:
- Alprazolam (Xanax): 49 million prescriptions
- Lorazepam (Ativan): 27.6 million prescriptions
- Clonazepam (Klonopin): 26.9 million prescriptions
- Diazepam (Valium): 15 million prescriptions
- Temazepam (Restoril): 8.5 million prescriptions7
When a drug is widely available, it is easier to misuse and abuse. The drug is seen as less harmful. It is easier to get pills from doctors, family members, and friends. Availability affects addiction rates.
How Does Benzodiazepine Addiction Start?
Most benzodiazepine medications usually start working quickly. They provide almost immediate relief from panic or anxiety symptoms. Some benzodiazepines are better sleep aids, or muscle relaxants, while still others are used prior to surgery or medical procedures for their sedative effects and the short-term memory loss they can induce. Different benzodiazepine medications may work on different receptors in the brain. They have many medical uses. They also have many recreational uses. Benzodiazepines are considered Schedule IV drugs under the Controlled Substances Act by the Drug Enforcement Agency, or DEA, due to their medicinal value and estimated potential for abuse and addiction.8
Most benzodiazepines are only meant to be taken for a few weeks. They are not long-term solutions for mental or physical health issues. The U.S. Food and Drug Administration9 warns that using Xanax in doses over 4 mg/day for longer than 12 weeks increases the likelihood of dependence. Even when taken as directed, the body develops a tolerance to the effects of benzodiazepines. This means users must take increasing doses of the drug to get the desired effects. Brain and body come to expect and rely on the drug in order to function normally. Users will experience withdrawal symptoms if they take less of the drug, miss a dose or stop taking it. Psychiatric Times found that “43% of patients taking diazepam for 8 months or more experienced withdrawal…2 to 10 mg per day of alprazolam for 8 weeks produced withdrawal symptoms in 35% of patients.”10 Withdrawal symptoms provide motivation to keep using a drug. Patients may not recognize withdrawal symptoms, but they will notice they feel bad when they don’t take the drug and better when they do.
Who Gets Addicted to Benzodiazepines?
Dependence differs from addiction. A person can be dependent but not addicted. However, dependence is often a precursor to substance abuse and addiction. When a person takes a benzodiazepine without a prescription or in a way other than prescribed, he or she is abusing the drug. The Addiction Technology Transfer Center shares that an estimated 14% of those who use a prescription drug for a non-medical reason meet the criteria for abuse or dependence.11 The Substance Abuse and Mental Health Services Administration found that in 2012 8.5 percent of Americans over 12 had a substance abuse disorder. A substance use disorder or addiction is a disease.12 It affects the reward and motivation centers in the brain. Someone who is addicted to a substance will spend an excessive amount of time seeking the drug, using it and recovering from its effects. He or she will continue to use the drug despite experiencing negative consequences of use.
The Consequences of Benzodiazepine Abuse and Addiction
Many people believe prescription drugs are safer than street drugs. They don’t realize prescription drug abuse comes with almost as many dangers. The Centers for Disease Control explains, “Drug overdose deaths and opioid-involved deaths continue to increase in the United States…From 2000 to 2015 more than half a million people died from drug overdoses. 91 Americans die every day from an opioid overdose.”13 Prescription drug addiction is an epidemic. It is a real disease, and it is deadly. While the majority of overdose deaths involve opioids, a large percentage involve benzodiazepines as well.
Benzodiazepines reduce heart rate, blood pressure, body temperature, and respiratory rate. These are all essential body functions. Reduced rates and levels can lead to respiratory failure, cardiac complications and more. They can lead to serious health issues and even death. The Journal of Pharmacy Practice reports “A 5-fold increase in deaths attributed to benzodiazepines occurred from 1999 to 2009.” Emergency room visits related to benzodiazepine use rose 89%. Alprazolam death rates rose 233.8%.” Benzodiazepines can cause overdose and death when used alone. They are even more dangerous when used in combination with other drugs and particularly when used with opioids or alcohol.
Signs of a benzodiazepine overdose include the following:
- Extreme drowsiness
- Severe confusion
- Weakness
- Shallow or troubled breathing
- Irregular heart rate
- Loss of consciousness
- Hallucinations
- Lack of coordination
- Anxiety
- Agitation
If you think you or a loved one may have overdosed, take action. A benzodiazepine overdose is a medical emergency, and you should seek immediate medical attention if you suspect one.
What Should I Do About Benzodiazepine Addiction?
Benzodiazepine addiction recovery begins with detox. This addresses immediate medical concerns. It begins the process of ending a drug’s influence over a person’s body, thoughts, and actions. Call Black Bear Lodge at 706-909-9811 to learn more about beginning recovery with medically supervised detox services. This allows for a safe withdrawal experience that can flow seamlessly into in-depth addiction treatment. We offer a private, serene and supportive recovery environment. Our staff is highly trained and experienced in benzodiazepine addiction treatment. We offer evidence-based treatment and personalized recovery programs. We address co-occurring mental and physical health concerns. Reach out today, and begin your recovery journey.
Benzodiazepines Facts
In the current conversation about prescription drug abuse, benzodiazepines get second billing. It’s unfair for benzodiazepines to be out of the limelight – these drugs, which include Xanax and Valium, have a strong risk for abuse and bring on long-term psychological symptoms.
While coverage of the prescription painkiller epidemic rightly tops conversations, there also are problems with benzodiazepine abuse. Important medical uses exist for this class of drugs, but they are intended for limited use. Unfortunately, many people prescribed these drugs don’t know about the dangers of taking them for too long or at higher doses. In addition, many people misuse benzodiazepines because they believe they are safe, and the drugs are tied to the painkiller epidemic as well, because they intensify the feeling of opiates.
Medical Uses for Benzodiazepines
Benzodiazepinesare a class of drugs that relieve anxiety, control muscle spasms, prevent seizures, and promote sleep. They are used in the treatment of a variety of anxiety-based disorders as well as insomnia and seizures.14 The drugs also may treat panic attacks and alcohol withdrawal. When patients take them for longer than recommended they may experience lingering psychological symptoms, such as depression, when they stop taking the drug. The also must step down gradually to avoid dangerous withdrawal symptoms.
The most commonly prescribed benzodiazepines are Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), and Ativan (lorazepam). When possible, physicians should prescribe drugs that are less addictive than benzodiazepines. Aside from being highly addictive, the majority of medications in this category must not exceed maximum recommended doses. Therefore, someone with a lifelong disorder like generalized anxiety disorder— would develop a tolerance to a benzodiazepine like Xanax, and the drug would no longer be effective. Thus, benzodiazepine drugs are generally not the first in line for treatments if something else is available.15
Tolerance to benzodiazepines occurs after regular use, and in some patients, it only takes around a month. A 2008 review of benzodiazepine prescribing habits revealed 112.8 million prescriptions were filled in the prior year: primary care doctors prescribed 55% of them, psychiatrists prescribed 16%, and other specialists prescribed the remaining 29%.16 With so many types of physicians prescribing benzodiazepines, it’s likely many of them miss the signs of a patient’s growing dependence or are unaware of doctor shopping habits that allow patients to sell pills on the black market. Even when benzodiazepines are taken at therapeutic doses, patients still develop a physical dependence. That’s why it’s important to only take them for a short time. People who are dependent and want to stop taking benzodiazepines must wean off them gradually under the supervision of a medical professional. Stopping the drug abruptly puts a person at risk of life-threatening seizures, tremors, and muscle cramps.17
Known on the street as “nerve pills,” “mother’s little helpers,” “downers,” “benzos” and “valley girls,” many people use benzodiazepines to get high, and they develop tolerance and dependency as their addiction grows. For this reason, benzodiazepines are a gateway drug because many people move on to harder substances when exceedingly high doses of the drugs no longer produce a good high for them.
Of course, not all benzodiazepines are available by prescription; some drugs are illegal in the United States. Rohypnol — often known as the date rape drug — is linked to many sexual assaults.18 Other popular benzodiazepines, Xanax and Halcion, contribute to violent behavior in some people.19
The History of Benzodiazepines
Benzodiazepines entered the medical field in the 1950s. By the mid-1970s, benzos were popular for treating depression and anxiety, with 103 million benzo prescriptions filled in 1975 in America alone. As reports of brain damage and addiction surfaced physicians began scaling back on benzo prescribing. Since the 1970s, however, benzo use has cycled through many variations, bursting onto the medical scene with great success, slowly waning for a couple decades, and then popping back up again in recent years.20 The type of benzodiazepine prescribed is largely dependent on a patient’s medical condition. Most start taking effect soon after ingestion, but some, like Klonopin, have longer-lasting effects than others.21
Side Effects
The short-term side effects of benzodiazepine use include the following:
- Drowsiness
- Relaxed feeling
- Lethargy
- Confusion
- Dizziness
- Mood instability
- Stuttering or slurring of speech
- Poor coordination
- Blurred and/or double vision
- Lapses or loss of short-term memory22
The long-term effects of benzodiazepines include:
- Impaired cognition
- Poor judgment
- Memory lapses
- Poor coordination
- Slurred speech
- Muscle fatigue23
The following are signs of a benzodiazepine overdose:
- Shallow breathing
- Damp skin
- Dilated pupils
- Weak and/or accelerated pulse
- Coma
The number of benzodiazepine prescriptions filled each year continues to rise. In 2008, 85 million prescriptions for the 20 most popular benzos were filled.24 Between 2005 and 2011 nearly 1 million emergency room visits involved benzo use or benzo use in combination with opiates or alcohol. Patients who use benzos have a 20% chance of a more serious outcome in the E.R. and patients who combine the drugs with opiates or alcohol have a 25% to 55% chance of a more serious outcome. Older patients, particularly patients 65 or older, have the highest risk of being hospitalized or dying as a result of using the drugs.25 Benzodiazepine use has other risks for seniors. One study found a 50% increased risk for the development of dementia in patients over age 65.26
Addiction
Four of every 10 people taking benzodiazepines daily for six weeks or longer face the possibility of addiction.27 People with mental health problems like mood or personality disorders are more likely to develop an addiction, as are males, 18- to 44-year-olds, single people, Native Americans, and those in lower socioeconomic classes.28 One study shows 80 percent of benzodiazepines are prescribed for periods no longer than six months but the remaining prescriptions may promote recreational abuse as these patients are more likely to be using many substances.29
Benzos and Painkillers
Many prescription painkiller abusers also use benzodiazepines because the drugs boost the effects of opiates. The Substance Abuse and Mental Health Services Administration reports a massive increase of treatment center admissions for patients abusing both benzos and painkillers,going from 5,032 in 2000 to 33,701 in 2010 — a 569.7% escalation.30 SAMHSA also reports the number of people admitted from 1998 to 2008 for benzo use was nearly a threefold difference despite the fact that overall admission numbers only increased 11% in the 10-year period.31 Nearly 50% of the patients treated for a combined addiction to both opiate-based painkillers and benzodiazepines meet the criteria for a psychiatric disorder.32
Risks of Immediate, Short-term and Long-term Use of Benzodiazepines
According to Fox News, benzodiazepine medications, including alprazolam derivatives like Xanax, are some of the most prescribed psychiatric medications in America.
Anxiety, stress, panic disorders, insomnia, seizures, and alcohol or opioid withdrawal can be successfully managed with benzodiazepine tranquilizers. Valium, Klonopin, Ativan, and Librium are some of the brand name benzodiazepine medications commonly prescribed for short-term relief.
Benzodiazepines are central nervous system depressants that activate the inhibitory neurotransmitter gamma-aminobutyric acid, or GABA, which has natural hypnotic, calming, and relaxing effects. In short, benzodiazepines, or benzos, can make you feel good and therefore are commonly abused.
The National Survey on Drug Use and Health (NSDUH) reported that 1.7 million Americans over the age of 12 abused tranquilizers in the month prior to the 2013 survey.
Any time a medication is used beyond its medical scope or intended purpose, it is considered abuse. Abusing benzodiazepine medications can create a plethora of short-term and long-term side effects. Even when used as directed, benzodiazepines are not without risk factors.
Benzodiazepine Overdose
One of the most serious potential immediate risks when using or abusing benzodiazepines is the chance of an overdose, which occurs when the drug reaches toxic levels in the bloodstream that the body cannot break down. Benzos suppress the central nervous system and by doing so slow down respiration, heart rate, body temperature, and blood pressure.
Thus a benzo overdose may cause:
- Shallow breathing
- Irregular heart rate
- Blood pressure
- Dizziness
- Muscle weakness
- Drowsiness
- Slurred speech
- Irregular eye movement
- Blurred vision
- Potential loss of consciousness
Emotional symptoms are also present during an overdose, such as anxiety, agitation, hostility, confusion, impaired cognition, short-term memory loss, or hallucinations. A drug overdose is a medical emergency, and if you recognize any of the symptoms of a benzodiazepine overdose, you should seek immediate medical attention.
According to the Centers for Disease Control and Prevention (CDC), drug overdose was the leading cause of injury death in 2012, and approximately 120 people die every day from a drug overdose in America. The CDC further reports that 51.8 percent of the drug overdose fatalities in the United States are related to pharmaceuticals, with 30.6 percent of the pharmaceutical overdoses being linked to benzodiazepines. Injecting benzodiazepines increases the risk for an overdose as it sends the drugs directly across the blood-brain barrier and rapidly into the bloodstream.
The Drug Abuse Warning Network (DAWN) reported that in 2011 approximately 89,310 Americans over the age of 12 sought emergency department (ED) treatment for an adverse reaction to benzodiazepines. Benzos are also commonly mixed with other drugs or alcohol, which increases the potential for a hazardous consequence or overdose. The DAWN report indicated that an additional 50,561 people sought ED treatment for the mixture of opioids and benzodiazepines, another 27,452 for mixing alcohol and benzodiazepines, and 8,229 for combining all three substances.
Alcohol and benzodiazepines are both central nervous system depressants, and the combination of the two can depress vital life functions to dangerously low levels.
Mixing benzodiazepines with opioids can also have disastrous results, as Medpage Today published that 30 percent of the narcotic painkiller overdoses in 2010 also involved benzodiazepine drugs. The mixing of benzodiazepine medications and opioids or alcohol resulted in serious medical health issues 50 percent of the time in hospital emergency visits, as published by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Short-term Side Effects of Benzodiazepine Use and Abuse
The medical use of benzodiazepine medications for the treatment of acute anxiety, panic, stress, or insomnia is considered relatively safe if used for a short period of time and if taken as directed. Most benzodiazepines are short-acting, meaning that they can provide relief rather quickly, within a few minutes even, and last for a few hours. You may experience a sort of hangover effect the next day, resulting in drowsiness and sluggishness if you take these medications to help you sleep.
Taking benzodiazepines recreationally, or in larger than intended doses, can result in various potential side effects, including:
- Fatigue
- Drowsiness
- Lethargy
- Mental confusion
- Headaches
- Motor coordination impairment
- Vertigo
- Depression
- Blurred vision
- Memory issues
- Nausea and/or vomiting
- Slurred speech
- Tremors
- Constipation or diarrhea
- Dry mouth
- Loss of appetite
- Shallow breathing
- Mood swings
- Slowed reflexes
Most of these side effects are the result of over-sedation and will depend on the type of benzodiazepine medication taken, the dosage and method of ingestion, as well as personal physiology. Benzos with shorter half-lives, such as lorazepam or alprazolam, will leave the bloodstream faster, for example, while longer-acting ones, such as diazepam, will have more lasting effects.
Even when used as directed, benzodiazepines can lead to physical dependence. The U.S. Food and Drug Administration, or FDA, publishes warnings that even short-term use of Xanax can lead to the development of a tolerance, for example, stating that dosages greater than 4 mg/day or using Xanax for more than 12 weeks may increase the severity or potential for dependence and withdrawal symptoms when the drug is stopped.
Physical Tolerance, Dependency and Addiction
When the body requires more or higher doses of a drug in order to produce its effects, the user is considered tolerant. The regular use or abuse of a benzodiazepine medication can quickly lead to tolerance, which may then continue on to dependence. A physical dependence occurs when the brain depends on the chemical’s interaction with it. The natural balance and reward pathways are disrupted, and in order to feel what it now perceives as normal, the brain will expect and rely on the drug’s effects.
When the drug is removed, or even between doses, the brain will struggle to restore balance, creating uncomfortable and even dangerous withdrawal symptoms. The severity and duration of these symptoms will depend on the level of dependency and duration of use or abuse as well as the dosage amount and method of ingestion. Injecting benzodiazepines may increase the potential for developing a dependency or addiction, for example.
Addiction is defined as compulsive drug-seeking behavior wherein the addict spends most of his or her time obtaining the drug, using the drug, and recovering from its effects. Both tolerance and the presence of withdrawal are symptoms of physical dependence but may not always signify addiction.
In order to be classified with addiction at least two of the following criteria must additionally be present in a 12-month period, according to the most current Diagnostic and Statistical Manual of Mental Disorders (DSM-V), as published by the National Institute on Drug Abuse (NIDA):
- Use of the substance for longer than intended or in greater amounts than intended
- Drug cravings
- Numerous unsuccessful attempts to stop using substance
- Using the substance regardless of negative physical or interpersonal consequences or in physically hazardous conditions
- Withdrawal from previously enjoyed activities
- Loss of production at work or school and failure to fulfill familial obligations
Physical dependency may be best treated by a gradual decrease, or controlled tapering, of benzodiazepine medications, closely monitored by medical professionals and consulting physicians through a detox protocol. Adjunct medications may also be used to combat drug cravings and withdrawal symptoms, resulting in a rebound effect as the brain tries to regain its natural balance.
This can cause the individual to experience symptoms that he may have been taking benzodiazepines to suppress, such as in insomnia, anxiety, tremors, or panic. Additional withdrawal symptoms may include dizziness, nightmares, sweating, irregular heart rate, muscle fatigue, altered perceptions and sensory functions, confusion and cognitive impairment, agitation, difficulties concentrating, hallucinations, or even seizures.
Successful Treatment
Addiction and withdrawal can, however, be successfully treated in a specialty facility that attends to both the physical and emotional symptoms through detox and psychotherapy.
Lasting Effects of Benzodiazepine Use or Abuse
In addition to the risks for developing a physical and psychological dependency or addiction, using benzodiazepine medications long-term can have lasting effects on the brain and body. Most benzodiazepines are not meant to be taken for a long period of time due to these increased risks.
While the exact science or persistence of cognitive impairment down the line is unclear, medical professionals do indicate that long-term benzodiazepine use may potentially negatively affect memory, sensory perceptions, processing speed, and learning abilities.
The journal BMJ published a study showing a link between benzodiazepine use and an increased risk for the dementia form of Alzheimer’s. The risks increase with the length of time taking a benzodiazepine medication. Those taking benzos for fewer than three months showed no increase in risks for developing dementia while those taking them for three to six months showed a 32 percent increased risk. Those using benzodiazepines for longer than six months showed an 84 percent increased risk for developing the incurable disease, as published by Harvard Health.
Specific Risks for the Elderly
Approximately 30 percent of all medications are prescribed to the elderly, and one of the most prescribed classes of drugs is benzodiazepines, as reported by Psychiatry Online. The elderly population may be at an increased risk for adverse side effects of benzodiazepines, not only for the heightened potential of developing Alzheimer’s disease.
In the elderly, these drugs may also increase the odds for impaired motor coordination, causing motor vehicle accidents or other injuries related to a loss of balance, as published by the Psychiatric Times. Elderly patients may have increased sensitivities to central nervous system depressant medications, including benzodiazepines. As you age, your metabolism also slows down, which can lead to a dangerous buildup of medications in your system, leading to hazardous long-term consequences.
Benzodiazepine medications are generally prescribed for the treatment of mental illness symptoms and sleep issues, as muscle relaxers, or to manage acute short-term stress. When used as directed, these medications can be very effective; however, when they are used in higher-than-intended doses, or for an extended period of time, the risk factors increase. Co-occurring disorders, such as substance abuse and mental illness, need to be treated with simultaneous and integrated care by teams of highly trained professionals.
Residential Treatment
Black Bear Lodge offers a peaceful respite where you can recover from a benzodiazepine dependency or addiction in privacy. Highly trained professionals use evidence-based methods to address the entire individual.
Withdrawal symptoms can be managed with adjunct medications and behavioral therapies during detox and recovery. Addiction is a treatable brain disease, and with the proper care, recovery can help you or your loved one start a new healthy life. Call us at 706-909-9811 to learn more.
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What Are Benzos Prescribed for and How Do They Work?
There are more than 15 different types of FDA-approved benzodiazepine medications. These drugs are referred to as benzos and are widely prescribed for a variety of medical and mental health concerns. PsychCentral reports that the benzodiazepine drug Xanax was the mostly widely prescribed psychiatric medication from 2005 to 2013.33 Benzos have hypnotic, muscle-relaxant, or anticonvulsant properties. They can provide anxiety relief.
They are therefore prescribed to treat the following:
- Generalized anxiety disorder (GAD)
- Insomnia
- Social anxiety
- Panic disorder
- Catatonia
- Tremors
- Alcohol withdrawal
- Sedation prior to surgery
- Acute agitation
- Seizures
Benzos are not a long-term solution for most of these issues. They are intended to be used short-term for acute symptoms. Extended use can lead to tolerance and dependence.
Types of Benzodiazepine Medications
Benzodiazepines are short-, intermediate-, or long-acting. Drugs with shorter half-lives work rapidly and leave the system faster. Longer-acting medications take longer to begin working and stay longer in a person’s system.
All benzodiazepines are generally dispensed in tablet or capsule form, as liquid syrup, or intravenously. The Drug Enforcement Agency considers all benzodiazepines Schedule IV drugs.
Benzodiazepines and the Brain
Benzodiazepine medications are central nervous system depressants. The central nervous system is responsible for regulating heart rate, respiration, blood pressure, and body temperature. Benzos slow these functions. They do so by interrupting how brain and body communicate. The brain influences body systems through chemical messengers called neurotransmitters. Stress and anxiety have a stimulating effect on the brain. Benzodiazepines inhibit the production or interpretation of neurotransmitters. This slows brain activity and produces calming, sedative, and relaxing effects.
Since benzodiazepines can work quickly, they are often used to help manage immediate or severe effects of overstimulation. They are first-course but not long-term medications. The brain and body quickly adjust to their presence when used frequently. Users develop a tolerance to their effects. If individuals keep using the drug, they will need increases quantities or frequencies to continue to experience the same effects. Benzodiazepines work best in conjunction with other, longer-term medications. For example general anxiety disorder may be treated with antidepressants long-term after the initial symptoms of anxiety are managed with a short course of benzodiazepines.
Benzodiazepines are effective when used as indicated. They can help create balance so that longer-term solutions can take root. Longer-acting benzodiazepines can benefit individuals with social anxiety, alcohol withdrawal, and seizure disorders. Benzodiazepines have amnesiac results. This means they can cause short-term memory lapses that may be desired during a medical procedure or surgery. Many benzos are also used as short-term muscle relaxers, to relieve acute tension, or as temporary sleep aids.
Side Effects of Benzodiazepine Use
Benzodiazepines have side effects and associated risks. Side effects vary from person to person. They are determined by factors such as genes, metabolism, tolerance levels, and more. The type of medication taken, dosage amount, duration of use, and method of ingestion also influence what and if unwanted effects occur.
Short-term side effects may include the following:
- Headaches
- Drowsiness
- Dry mouth
- Depression
- Blurred vision
- Slurred speech
- Weak muscles
- Short-term memory loss
- Impaired cognition
- Dizziness
- Tremors
- Impaired motor skills and coordination
- Loss of appetite
- Nausea
- Confusion
- Fatigue
- Diarrhea
- Constipation
Over-sedation can occur if you take too much of a benzodiazepine. You can overdose and experience extreme sleepiness, mood swings, shallow breathing, irregular heart rate, psychosis, loss of consciousness, and even death. CNN reports benzodiazepines, “were involved in about 30% of prescription drug overdose deaths in 2013.”35 Mixing benzodiazepines with other medications, particularly narcotic pain relievers or alcohol increases overdose risk.
Benzodiazepines may have lasting effects on memory, processing speed, sensory perceptions, and learning when used regularly in high doses for an extended amount of time. BMJ links benzodiazepine use to an increased risk for the dementia form of Alzheimer’s disease especially when used for a prolonged period of time.36 Elderly patients are at an increased risk for injury due to a loss of motor control as well as heightened risks of dangerous central nervous system suppression and cognitive impairment.
Benzodiazepine Abuse and Dependency
Any non-prescribed use of a prescription medication is considered abuse. If you have a prescription but take too much of the drug or crush or otherwise tamper with it, you are abusing it. If you take the drug without a prescription, even if you have a medical or mental health need, you are abusing it. People get extra benzos from friends or family members. They doctor shop to gain multiple prescriptions and may fake or exaggerate symptoms.
Users quickly become dependent if they take large doses or use the drug for longer than recommended. Abuse makes dependence even more likely. Dependence occurs when the brain changes its circuitry to adjust for the drug’s presence. This alters the reward pathway. Individuals will experience cravings. They will experience withdrawal symptoms when the drug leaves the bloodstream. A person’s withdrawal experience depends on the level of dependency, type of drug abused, method of abuse, dosage, and duration of abuse.
Symptoms may include the following:
- Insomnia
- Restlessness
- Anxiety
- Irritability
- Muscle weakness
- Dizziness
- Difficulties concentrating
- Increased heart rate
- Sweats
- Depression
- Drug cravings
Individuals may also experience rebound symptoms of the original health condition they were attempting to treat or mask. You should never attempt to stop taking benzodiazepines suddenly without medical supervision.
Talk with Black Bear Lodge or another professional, comprehensive treatment program. Find medically supervised detox services that flow seamlessly into integrated treatment. Treatment offers real options for a mentally and physically healthy life. We offer real hope for a happy, drug-free future. Please reach out today at 706-909-9811. Learn more about your options.
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Sources
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