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Old 08-02-2018, 11:07 PM   #1 (permalink)
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Benzodiazepine Abuse Overview


Benzodiazepine Abuse Overview

Benzodiazepines are a type of medication known as tranquilizers. Familiar names include Valium and Xanax. They are some of the most commonly prescribed medications in the United States. When people without prescriptions obtain and take these drugs for their sedating effects, use turns into abuse.
Doctors may prescribe a benzodiazepine for the following legitimate medical conditions:
Anxiety
Insomnia
Alcohol withdrawal
Seizure control
Muscle relaxation
Inducing amnesia for uncomfortable procedures
Given before an anesthetic (such as before surgery)

Benzodiazepines act on the central nervous system, produce sedation and muscle relaxation, and lower anxiety levels.

Although more than 2,000 different benzodiazepines have been produced, only about 15 are currently FDA-approved in the United States. They are usually classified by how long their effects last.

Ultra-short acting - Midazolam (Versed), triazolam (Halcion)
Short-acting - Alprazolam (Xanax), lorazepam (Ativan)
Long-acting - Chlordiazepoxide (Librium), diazepam (Valium)

Benzodiazepines are commonly abused. This abuse is partially related to the toxic effects that they produce and also to their widespread availability. They can be chronically abused or, as seen more commonly in hospital emergency departments, intentionally or accidentally taken in overdose. Death and serious illness rarely result from benzodiazepine abuse alone; however, they are frequently taken with either alcohol or other medications. The combination of benzodiazepines and alcohol can be dangerous -- and even lethal.

Benzodiazepines have also been used as a "date rape" drug because they can markedly impair and even abolish functions that normally allow a person to resist or even want to resist sexual aggression or assault. In recent years, the detection and conviction of people involved in this has increased dramatically. The drug is usually added to alcohol-containing drinks or even soft drinks in powder or liquid forms and can be hard to taste.

Benzodiazepine Abuse Causes

Although some people may have a genetic tendency to become addicted to drugs, there is little doubt that environmental factors also play a significant role. Some of the more common environmental influences are low socioeconomic status, unemployment, and peer pressure.

Benzodiazepine Abuse Symptoms

At normal or regular doses, benzodiazepines relieve anxiety and insomnia. They are usually well tolerated. Sometimes, people taking benzodiazepines may feel drowsy or dizzy. This side effect can be more pronounced with increased doses.

High doses of benzodiazepines can produce more serious side effects. Signs and symptoms of acute toxicity or overdose may include the following:
Drowsiness
Confusion
Dizziness
Blurred vision
Weakness
Slurred speech
Lack of coordination
Difficulty breathing
Coma

Signs of chronic drug abuse can be very nonspecific and include changes in appearance and behavior that affect relationships and work performance. Warning signs in children include abrupt changes in mood or deterioration of school performance. Chronic abuse of benzodiazepines can lead to the following symptoms that mimic many of the indications for using them in the first place:

Anxiety
Insomnia
Anorexia
Headaches
Weakness

Despite their many helpful uses, benzodiazepines can lead to physical and psychological dependence. Dependence can result in withdrawal symptoms and even seizures when they are stopped abruptly.

Dependence and withdrawal occur in only a very small percentage of people taking normal doses for short periods. The symptoms of withdrawal can be difficult to distinguish from anxiety. Symptoms usually develop at 3-4 days from last use, although they can appear earlier with shorter-acting varieties.

When to Seek Medical Care

If you have any questions, you could call your doctor, but if you are in doubt whether someone needs immediate medical attention, you should go directly to a hospital emergency department.

If you are concerned that you or someone else has taken an overdose, it is very important that you seek medical help immediately. You should go to the nearest emergency department or call 911 for help. After someone takes an overdose, the effects may not become immediately obvious.

It will assist the doctors if you bring the pill containers with you because it helps them determine the number and type of pills taken.
Exams and Tests

The diagnosis is based on findings from your medical history, examination, and any lab tests performed.

In acute ingestions, diagnosis is often obvious because you or your family can tell the doctor exactly what was taken.
The diagnosis of chronic drug abuse can be much more difficult, because an abuser and his or her family often try to cover up or hide what is going on.

The emergency department work-up of any possible toxic drug overdose consists of an initial evaluation. Doctors will assess how well you are breathing. The rest of the work-up depends on you and your symptoms. The physician will ask about many of the signs and symptoms. Unless you are willing to admit that you are abusing benzodiazepines or family members are present to help with the history, it is easy for you to cover up drug abuse.

Monitoring and testing

In the emergency department, you will usually be placed on a monitor evaluating heart rate, blood pressure, and pulse oximetry (a measure of how much oxygen is in your bloodstream). An IV line will be started. Oxygen is given if you are short of breath or have a reduced level of consciousness.

Urine drug screens are sometimes performed. These lab tests can detect many of the commonly abused drugs, including benzodiazepines (but may not be able to discover them all). The urine drug screens do not, however, reveal a specific level or amount of the drug taken. Urine is also usually tested for pregnancy in all females of childbearing age.

Blood samples, ECGs, and chest x-rays may be obtained if there is concern that you may have taken other dangerous drugs.

Benzodiazepine Abuse Treatment Self-Care at Home

Drug abusers often deny their problem by playing down the extent of their drug use or blaming job or family stress. The most important thing that can be done at home is to recognize that there may be a problem and to seek help.

Awareness of the signs and symptoms of abuse help with recognition.

The next step is to try to obtain help for the person. This can be done either through your doctor or by contacting many of the drug abuse help lines in your community.

Medical Treatment

Acute toxicity: The treatment required usually depends on what drugs were taken and how much. Often, you need only a period of evaluation in a hospital emergency department.

If the drugs were taken within the previous 1-2 hours, the doctor may consider gastric lavage. With this procedure, a large tube is placed directly into your stomach through the mouth or nose. Large volumes of water can then be pushed into the stomach in an attempt to wash out the pill fragments. This is not used often and only if you are known to have swallowed other potentially more lethal medications.

A single dose of activated charcoal is recommended for people who come to the emergency department within 4 hours of taking drugs. This acts to prevent absorption of the medication. It is a black powder that is mixed with water and given to you to drink. Side effects can include nausea, vomiting, and abdominal cramps.

There is an antidote to counteract the toxic effects of benzodiazepines called flumazenil (or Romazicon). This reverses the sedative effect of benzodiazepines. It is, however, usually reserved for severe poisoning, because it can cause withdrawal and seizures in people who are chronic benzodiazepine abusers, and also may require repeated administrations, with careful monitoring, due to its fairly short duration of action.

Chronic abuse: The treatment of chronic abuse can usually be done at home with the help of your doctor or in specific drug rehabilitation centers.

The first step consists of gradual reduction of benzodiazepines to prevent withdrawal and seizures. This is often much easier than the prolonged recovery phase in which the person attempts to stay drug-free. In addition to the medical care, someone abusing these drugs often requires social support and help in finding housing and employment. The involvement of family and friends can be very helpful in this difficult stage.

Next Steps Outlook


Although benzodiazepines are commonly abused, they rarely cause serious illness or death unless combined with other drugs. Consultation with poison specialists is usually unnecessary. A psychiatrist, however, is often asked to interview anyone seen in the emergency department before sending the person home. This is done if there is any concern that the overdose was swallowed intentionally and that the person may be at risk of harming himself or herself or others. Inpatient treatment may be required.

WebMD
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Old 08-02-2018, 11:57 PM   #2 (permalink)
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Benzodiazepine Info, Effects, Addiction, Treatment

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

Benzo Effects

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:

nausea
insomnia
tremors
irritability
panic
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.

https://www.soberrecovery.com/addict...ion-treatment/
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Old 08-05-2018, 05:48 AM   #3 (permalink)
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Thank you, MG! This is great information!
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