Benzodiazepine drugs (bennies, benzos) are prescribed medications that are most often used for relief of anxiety, insomnia, stress, seizures, panic disorders, and as muscle relaxers. Discovered first in 1955, they were put on the market in 1960.
Controversy has followed the use of benzos since the mid-1960s when Valium, the most frequently prescribed benzodiazepine medication at the time, became popular with a new group of drug users: housewives in middle-class America. Prescribed by doctors to help “take the edge off” for patients who were stressed and anxious, Valium and other types of benzos began to show signs of being an addictive medication. Dependence was developed and side effects were beginning to be recognized by those who took the drug, as well as by the medical community.
Common Benzos and What They Treat
Three types of benzo medications are used to treat various disorders. Short-term medications, such as oxazepam or lorazepam, can be used for treating episodes of anxiety or symptoms that are not chronic. Some of the intermediate-term medications used to treat insomnia and some more severe symptoms of anxiety are temazepam, loprazolam and lormetazepam and other hypnotic medications. Some hypnotic medications are also used prior to surgical procedures to decrease memory of the patient. Long-term use of benzo medications is more frequently prescribed in treating ongoing anxiety muscle spasms and other chronic conditions. Some of the drugs used for these applications are diazepam and clorazepate.
Benzos are prescribed in pill form. When abused, they are taken in larger quantities than prescribed or are taken without prescription. Since their introduction and rapid rise to popularity in the 1960s, new forms of benzos have appeared on the scene. The popularity of the drugs is ongoing, both for those who require the medications by prescription and by those who abuse them. The following are a few of the most common benzos, including their common brand names, and what they are prescribed to treat:
- Alprazolam (Xanax, Paxal), treatment for anxiety
- Chlordiazepoxide (Librium), treatment for anxiety
- Clonazepam (Klonopin) treatment for anxiety, anticonvulsant
- Clorazepate (Tranxene), treatment for anxiety, anticonvulsant
- Diazepam (Valium), treatment for anxiety, anticonvulsant and muscle relaxer
- Flunitrazepam (Rohypnol), hypnotic
- Flurazepam (Dalmane), hypnotic
- Lorazepam (Ativan), treatment for anxiety, anticonvulsant
- Oxazepam (Seresta), treatment for anxiety
- Temazepam (Restoril), hypnotic
- Quazepam (Dora), hypnotic
- Triazolam (Halcion), hypnotic
Today, very few individuals are prescribed benzos for long-term use. Because of tolerance, which occurs when the drug dose needs to be increased to receive the same benefit, most patients will be placed on short-term prescriptions. Using benzos along with therapy can reduce symptoms of anxiety for many patients.
Physical and mental effects of benzos are similar to the effects of alcohol or opiates. The most common effects are drowsiness, lack of coordination, inability to concentrate, and dizziness. These make driving a vehicle or functioning in the workplace difficult and can lead to accidents or events of bad judgment. Loss of sexual interest and problems with erection can also occur, as well as mild depression that may become more severe over time. Blurred vision, loss of pleasure, disinterest and some nightmares may occur for some users. Memory is also impaired. With longer-term use, there may be some permanent memory loss.
Dangerous side effects are seen when benzos are abused. They have been known to increase episodes of seizure activity, aggression and violent behaviors, as well as impulsivity. This is especially recognized in persons who have taken high doses of benzodiazepine medications for long periods of time.
Other long-term use effects are seen in cognitive areas of the brain. Those persons have not fully recovered memory formation or decision-making abilities after use of benzos. Other effects can be behavioral or personality disturbances such as irritability and impulsivity that does not abate when the medications are stopped.
How Addictive Are Benzodiazepines?
Initially, it was believed that dependence on benzos was primarily psychological. Physical addiction has now been recognized as well.
Addiction begins with tolerance. The sedative and muscle relaxing benzodiazepine medications are the quickest for users to develop tolerance with. This means that patients will soon need more of the medication to receive the same benefit. As patients begin to take more and more of the drug, they will become more and more dependent on it to remain stable. This is the cycle of addiction.
Doctors who prescribe these medications consider the condition of the patient to be more important than their possible dependence on the medication. Some people suffering from chronic anxiety or panic disorders may need to take these medications for long-term relief and their dependence on the drugs is considered secondary to their chronic disorder. Others, who have less aggressive forms of disorders that are being treated with benzos, may need to stop taking these medications after some time to avoid dependence. These issues must be discussed with the physician responsible for treating the patient.
These drugs should not be used by those who are not being carefully monitored by a medical professional.
Overdosing on Benzos
Overdose on benzos is not as dangerous a risk as with some other medications. However, when combined with alcohol, narcotics or anti-depressant drugs, they can become deadly. The elderly are a population with a higher risk for benzo overdose. Some of the indicators for overdose are: slurred speech, slowed heart rate, and increased sleepiness. Overdose can result in coma, heart failure and death.
Withdrawal from Benzos
This addiction is one of the most dangerous, because suddenly stopping the medication is physically and mentally harmful to the user. Stopping benzos returns the user to full expression of the symptoms for which they took the drug initially. Added to this are symptoms of withdrawal, which can include:
- racing heart
- muscle spasms
The only safe way to withdraw from benzos is under the direct supervision of medical professionals. They will begin a tapering-off process until a safe level of medication remains in the body of the user and can then be stopped.
Addiction Treatment for Benzos
Addiction to benzodiazepine medications is treatable. Treatment begins with medically-supervised detox to manage withdrawal safely. Continued addiction treatment can commence before the medication is fully out of the system of the user. Most treatment programs can teach skills for coping with the symptoms that made the medications necessary to begin with. While new skills are learned, the user can begin to taper off the medication. At that point, they can begin to implement new coping strategies that will allow them to discontinue dependence on the medications permanently.
Because they may experience stronger symptoms during the tapering-off process, ongoing treatment and medical supervision are necessary to successfully wean the user off these medications. Without attaining the appropriate skills with which to cope with their symptoms, patients may continue to use drugs to offset their anxiety or other disorders.