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Benzodiazepine Addiction & Abuse

Benzodiazepines are powerful sedatives that are often prescribed for anxiety and sleep disorders. This class of drugs has a high risk of dependence and addiction.

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Quitting benzodiazepines isn’t easy. Stopping abruptly can lead to life-threatening symptoms, including seizures. Treatment programs can help.

What Are Benzodiazepines? 

Benzodiazepines, often referred to as benzos, are depressant drugs. They slow down the central nervous system and brain activity. People who take them feel sleepy and calm. 

Benzodiazepines are helpful therapies for anxiety disorders, seizures, and epilepsy. But they can trigger euphoria in large doses. People who use them for long periods can become dependent on them. Sometimes, people become addicted to them.

Key Facts About Benzos

Key Facts

  • In a study of 244 patients using benzodiazepines, 154 patients were identified as having benzodiazepine use disorder, which represented 63.1% of the sample group.[1]
  • Top benzodiazepine side effects include sedation, confusion, and dizziness.
  • Benzodiazepines are common. In the United States, more than 5% of adults use them.[2]
  • Benzos can remain in your system (and detectable via drug tests) for 5 to 90 days, depending on the testing method.

Medical Uses for Benzos: Why Are They Prescribed? 

Benzodiazepines slow brain activity and trigger central nervous system depression. Doctors use these medications to treat both physical and mental health issues. 

Benzodiazepines are most often prescribed in medical settings to treat the following conditions:

Common Types of Benzodiazepines 

Multiple forms of benzodiazepine medications exist. They all work in the same way, but important differences separate them. These are the most common forms: 

Xanax 

Xanax (generic name alprazolam) is commonly prescribed for insomnia or anxiety. Short-term prescriptions help people move through a difficult period. Long-term use is more controversial. The drug has been linked to abuse and severe withdrawal symptoms, including seizures. 

Klonopin 

Klonopin (generic name clonazepam) is commonly prescribed for panic disorder and insomnia. Some people experience dizziness and drowsiness when they start taking the medication. Others have serious side effects like suicidal thoughts. 

Valium

Valium (generic name diazepam) is one of the most recognizable benzodiazepines. It’s commonly used to treat anxiety, including symptoms in people trying to overcome alcohol use disorders. Long-term use can lead to addiction. 

Ativan 

Ativan (generic name lorazepam) is typically used to treat panic disorders, muscle spasms, and alcohol withdrawal. It can be habit-forming, so doctors are encouraged to shorten their prescription time frames. Some people keep taking Ativan and become addicted to it. 

Halcion 

Halcion (generic name triazolam) is often prescribed as a short-term solution to insomnia and other sleep issues. The medication helps people to fall asleep faster. But it shouldn’t be used for more than a few days, as withdrawal can lead to seizures. 

Several other types of benzodiazepines exist. This table can help you understand their differences and similarities:

Brand NameGeneric NameCommonly Prescribed For
XanaxAlprazolamAnxiety, insomnia
KlonopinClonazepamPanic disorders, insomnia 
ValiumDiazepamAnxiety, alcohol withdrawal
AtivanLorazepamPanic disorder, muscle spasms, alcohol withdrawal
LibriumChlordiazepoxideAnxiety, alcohol withdrawal
RestorilTemazepamInsomnia
SeraxOxazepamAnxiety, alcohol withdrawal
VersedMidazolamAnxiety, preparation for surgical procedures 
HalcionTriazolamInsomnia
RohypnolFlunitrazepamNot approved for medical use within the United States 

Addiction Potential: How Addictive Are Benzos?

Benzodiazepines are very addictive. Drugs in this class alter well-known brain pathways associated with addiction.

Each benzodiazepine dose you take enters your brain and modulates GABA receptors. That shift awakens dopamine receptors, triggering the release of dopamine.[3] This chemical can cause euphoria, and it’s responsible for addictions to other drugs, including heroin.

Most people know that drugs like heroin are addictive and dangerous. For years, researchers didn’t know that benzodiazepines worked on the same pathways. Now that we know, everyone should approach these drugs with caution. 

Experts say anyone who used benzodiazepines for longer than three to four weeks will likely have withdrawal symptoms when they quit cold turkey.[4] This can lead them to take more to avoid withdrawal. An addiction can quickly follow.

“Current benzodiazepine prescribing patterns are concerning. Despite many well-established risks and guideline recommendations, benzodiazepines are widely overprescribed around the world.”[2]

Side Effects: How Benzos Affect the Body Over Time 

Benzodiazepine side effects are serious. People who use these drugs for a short period may develop side effects of benzodiazepines. People who abuse them for long periods have even more difficulties. 

Short-Term Side Effects

Common side effects associated with the short-term use of benzos include the following:

  • Drowsiness
  • Dizziness
  • Lack of coordination 
  • Slurred speech
  • Confusion 
  • Memory loss

Anyone can develop these problems, but they are more common in older adults.[2]

Long-Term Side Effects

People who take benzodiazepines for weeks or months can develop the following issues:

  • Tolerance 
  • Dependence
  • Substance use disorders
  • Higher risk of overdose 

Side Effects of Benzodiazepine Use 

Short termLong term
DizzinessTolerance 
Lack of coordinationDependence 
Sedation Substance use disorder
Confusion Higher overdose risk 

Mixing Benzos With Other Substances

Using two or more drugs together, whether it is intentional or unintentional, is considered polydrug use. Mixing drugs amplify the effects and risks of each drug while also putting a tremendous amount of stress on the body. Overdose can result in coma or death. 

Overdose is much more common when benzodiazepines are being used in conjunction with other drugs. The most common substances used with benzos include opioids, alcohol, and other kinds of illicit or prescription drugs.

According to the Centers for Disease Control and Prevention, about 7,000 overdose deaths in 23 states involved benzodiazepines in 2020, which marked a sharp increase in overdose cases since 2019. This represented 17% of all drug overdose deaths in those states.[5]

The CDC also asserts that over 90% of illicit benzodiazepine-involved overdose deaths were in cases where individuals also used either prescription or illicitly manufactured opioids. This highlights the dangers of combining drugs, particularly benzodiazepines and opioids.

Causes of Benzodiazepine Addiction 

Anyone can develop an addiction to benzodiazepines, but people who share a few common factors have a higher risk of problematic drug use. These are a few of the issues that could make benzos even more dangerous for you:

Biological Factors 

How quickly your body processes benzodiazepines can impact your addiction risk. If you feel high quickly and it fades equally fast, you could develop an addiction faster than someone who isn’t programmed this way. 

Environmental Factors

It’s harder to develop an addiction when you can’t access drugs. If you live in an environment in which benzos are common, your risk of addiction is higher. Working in a place (like a hospital) where drugs are available also raises your risk. 

Social Factors

Spending time with people who abuse drugs can normalize the behavior. You can also access drugs easier when the people around you use them. 

Psychological Factors

People with insomnia, anxiety, and other mental health challenges can be introduced to benzos by their doctors. This introduction could develop into an addiction in time.

Signs & Symptoms of Addiction: What to Look Out For

Signs and symptoms of benzodiazepine addiction can be thought of in terms of physical symptoms as well as mental and behavioral symptoms.

Physical 

Physical symptoms of benzodiazepine addiction can include unexplained sedation or a lack of coordination. People who abuse these drugs may stumble and fall frequently, or they may be involved in automobile accidents. 

Cognitive Symptoms 

The sedating qualities of benzodiazepines can lead to memory problems. Some people lose entire days or weeks. They may also seem confused, slow, and indecisive. 

Behavioral Symptoms 

Perhaps the most recognizable symptoms are behavioral symptoms that occur in those who are addicted to benzodiazepines. Engaging in drug-seeking behaviors, stealing drugs, increasing isolation, and decreased interest in activities that don’t involve benzodiazepine use are all common.

Comparing Symptoms of Benzodiazepine Addiction 

Physical CognitiveBehavioral
Slurred speechMemory troubleEngaging in drug-seeking behaviors
Respiratory issuesSlowed reaction times Doctor shopping
Physical dependenceConfusionPrescription forgery
Blurred visionSlowed mental processingPoor performance at work or school
Weakness/lethargyInability to problem solveDecreased interest in activities that don’t involve drugs 

Benzodiazepine Overdose 

It’s possible to overdose on benzodiazepines. People who overdose often appear severely sedated with slurred speech and an altered mental status.[6] Most people who overdose are taking other medication at the same time. 

Common signs of benzodiazepine overdose include the following:

  • Sedation 
  • Slow respiration 
  • Lack of coordination 
  • Coma 
  • Stupor

In cases of benzodiazepine poisoning, flumazenil may be administered. The general treatment is supportive care, such as the administration of IV fluids. In some cases, intubation may be needed if the patient is unable to breathe on their own.[7]

Benzo Addiction Withdrawal Symptoms 

With repeated use, your brain cells become accustomed to the presence of benzodiazepines. If you try to quit them quickly or abruptly, you can develop withdrawal symptoms. 

Two types of benzo withdrawal exist: acute (or sudden symptoms) and protracted (or long-lasting symptoms). 

Common signs of acute withdrawal include the following:

  • Anxiety 
  • Dizziness
  • Light sensitivity 
  • Hallucinations 
  • Shaking hands and feet
  • Seizures 

Protracted withdrawal results in anxiety and insomnia that persist for weeks or even months. These issues can lead to drug relapse. 

Treatment Options for Benzodiazepine Addiction 

Benzodiazepine addiction can be treated with both outpatient and inpatient rehab, depending on an individual’s situation and the severity of the addiction. Inpatient treatment is generally recommended for severe and long-standing addictions or in cases of polysubstance abuse. It’s also the ideal solution for people with co-occurring disorders, such as when someone has both an addiction and another mental health disorder. 

Treatment typically includes the following steps:

Supervised Taper: Coming Off Benzodiazepines Safely 

Treatment may begin with a supervised taper, as you slowly wean off benzodiazepines. If you have been abusing a short-acting benzodiazepine, you may be transitioned to a long-acting one for the tapering process.

During a taper, your doctor offers a smaller amount of the drug until you’re not taking any at all. This method allows your brain to adjust to sobriety slowly. It’s much safer than quitting drugs abruptly and shocking your system. 

Medical Detox 

A medically supervised detox is another approach to benzodiazepine addiction. In this process, doctors monitor your response to sobriety and offer medications as needed. Your team can also provide therapy, nutrition, and counseling to help you transition. 

Since detoxing from benzos can cause life-threatening seizures, it’s critical to either use a supervised taper or enter medical detox. 

Rehabilitation 

Outpatient treatment works well for people who have a supportive home environment. They attend therapy sessions and other addiction treatments during the day but return home to sleep at night. 

Oftentimes, people begin in a more intensive level of treatment and transition to a less intensive form of care once they begin to find their footing in recovery. Outpatient rehab is a core part of what we offer. 

Aftercare

Once you’ve completed an addiction treatment program, new challenges may appear. Stressors could lead to cravings and higher relapse risks. Staying in touch with recovery may help. You might attend support group meetings, participate in scheduled therapy sessions, or both.

Profile image for Dr. Alison Tarlow
Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated December 6, 2023
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