In the short term, benzodiazepines typically donâ€™t have serious enough side effects to be a major concern if only used as prescribed.
If used for longer than about two to four weeks, their impact on a personâ€™s health can become more serious even as they become less effective in terms of treatment, so theyâ€™re not typically prescribed this way if other alternatives are available.
If benzodiazepines are misused, side effects are more likely.
Commonly prescribed long-acting benzodiazepines include the following:
- Alprazolam (Xanax)
- Chlordiazepoxide (Librium)
- Clorazepate (Tranxene)
- Diazepam (Valium)
- Halazepam (Paxipam)
- Lorazepam (Ativan)
- Oxazepam (Serax)
- Prazepam (Centrax)
- Quazepam (Doral)
Some short-acting benzodiazepines include the following:
- Estazolam (ProSom)
- Flurazepam (Dalmane)
- Temazepam (Restoril)
- Triazolam (Halcion)
- Midazolam (Versed)
When people discuss benzodiazepine misuse, theyâ€™re generally (but not exclusively) referring to long-acting benzodiazepine abuse.
Common Side Effects
Benzodiazepines have a number of common side effects associated with them, including these:
- Tremors or uncontrollable shakiness
- Reduced sex drive
- Difficulty concentrating
In many cases, benzodiazepine use can temporarily make the driving or operation of heavy machinery (including cars) unsafe. This is primarily due to a person becoming too drowsy and having difficulty focusing on the road.
Long-Term Health Impact of Benzos
Benzodiazepines are considered to have at least moderate abuse potential. Even a person engaging in normal, prescribed use can become physically dependent on them if they are taken for too long.
Because of addiction risk, benzodiazepines arenâ€™t typically prescribed for longer than four weeks if it can be avoided. They can also become less effective if used for longer than a month, further making doctors hesitate to prescribe them for too long.
In addition to abuse and dependence risks, benzodiazepines are associated with a number of other serious health and safety risks that have to be weighed against their use. Benzodiazepine use can cause cognitive impairment, affecting a personâ€™s memory, reaction time, coordination, and more. At least one meta-analysis found that diazepam, one commonly prescribed benzodiazepine, can cause cognitive decline that did not resolve three months after discontinuation.
Benzodiazepine use increases a personâ€™s risk of a motor vehicle accident to a degree similar to that of having a blood alcohol content of about 0.05% to 0.079%, depending on the dose and individual.
In older adults, benzodiazepine use is associated with a significant risk of hip fracture. Benzodiazepines seem to increase an older personâ€™s risk by at least 1.5 times, with one study showing zolpidem increasing the risk of hip fracture in adults over 65 by about 2.55 times.
Benzodiazepine withdrawal can be serious, even life-threatening. A person should not just suddenly stop taking benzodiazepines. Instead, they should work with their doctor to safely taper off the medication.
Abruptly stopping high-dose use is associated with several withdrawal symptoms, including anxiety, insomnia, autonomic hyperactivity, and, in severe cases, seizures.
People who are pregnant should not generally take benzodiazepines, as the fetus can develop a dependence in the womb, and the baby may experience withdrawal symptoms after birth.
Can Benzodiazepines Cause Permanent Harm?
The majority of the health risks associated with benzodiazepines should go away if a person listens to their doctorâ€™s recommendations and tapers their dosing appropriately. Even if your benzodiazepine use has been unprescribed or otherwise illegal, you should still talk to a medical professional, likely an addiction professional, about the best way to stop taking benzodiazepines.
Most of the most serious risks associated with benzodiazepines are those that might result in a serious injury that wouldnâ€™t have occurred if you werenâ€™t taking the medication. Incidents like motor vehicle and heavy machinery accidents, as well as hip fractures, have the potential to cause long-lasting, potentially life-threatening, damage if they do occur.
Benzodiazepine addiction also has the potential to significantly impact a personâ€™s quality of life and overall health, especially if it results in damaging their relationships and causing financial difficulties. Benzodiazepines are also frequently misused with other drugs, such as opioids, which can significantly increase a personâ€™s risk of a life-threatening overdose.
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- Risks Associated with Long-Term Benzodiazepine Use. (2013). American Family Physician.
- Addiction: Part I. Benzodiazepinesâ€”Side Effects, Abuse Risk and Alternatives. (2000). American Family Physician.
- Is Long-Term Benzodiazepine Use a Risk Factor for Cognitive Decline? Results of a Systematic Review. (January 2020). Journal of Addiction.