Benzodiazepine Addiction Treatment
Benzodiazepines, also known as Benzos, are drugs particularly prescribed by doctors to treat anxiety, panic attacks, epilepsy, seizures, and sleeping problems/insomnia. Their short-term use is generally considered safe and effective; however, the long-term use may lead to addiction and other side-effects. In today’s article, we’ll be looking at how Benzos work, their effects on the body, potential risks of taking these drugs, and addiction and withdrawal.
How Benzodiazepines Work
Benzodiazepines act as sedatives by slowing down the body’s overall functioning. They do this by increasing the effect of a chemical known as GABA (gamma amino butyric acid) which is involved in decelerating brain activity in the areas responsible for controlling breathing, rational thought, emotions, and memory.
As a result, benzodiazepines induce feelings of sedation and muscular relaxation, in turn reducing feelings of panic and anxiety.
Statistics on Benzodiazepine Use
The 2015–2016 National Surveys on Drug Use and Health of 102,000 adults found that 12.5 percent of US adults used benzodiazepines. Only 2.1 percent misused these drugs (at least once), and 0.2 percent were characterized as having a benzodiazepine use disorder.
Considering benzodiazepine users, 17.1 percent misused them, and less than 2 percent had benzodiazepine use disorders.
Types of Benzodiazepines
Benzodiazepines are generally classified into three types based on their effects: long-acting, intermediate, and short-acting. Short-acting benzodiazepines, also known as hypnotics, have a stronger withdrawal or ‘coming down’ effect, and maybe more addictive as compared to the other types. They are mostly used to treat insomnia. Long-acting benzodiazepines, also known as anxiolytics, are mostly used to treat anxiety and panic disorders. Some common benzodiazepines and their uses are tabulated below.
Generic Name: Alprazolam
Brand Name: Xanax®, Kalma®, Alprax®
Type: Short-acting
Use: Panic and anxiety disorders
Generic Name: Diazepam
Brand Name: Ducene®, Valium®
Type: Long-acting
Use: Panic attacks, restless leg syndrome, insomnia, seizures, and alcohol withdrawal
Generic Name: Oxazepam
Brand Name: Alepam®, Murelax®, Serepax®
Type: Short-acting
Use: Anxiety
Generic Name: Nitrazepam
Brand Name: Alodorm®, Mogadon®
Type: Intermediate-acting
Use: Severe, disabling anxiety and insomnia
Generic Name: Temazepam
Brand Name: Euhypnos®, Normison®
Type: Short-acting
Use: Insomnia
Generic Name: Lorazepam
Brand Name: Ativan®
Type: Short-acting
Use: Anxiety, seizures, and anesthesia
Generic Name: Clonazepam
Brand Name: Klonopin®
Type: Short-acting
Use: Panic disorder and seizure disorders
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Side-Effects of Benzodiazepines
Depending on every individual’s distinctive brain chemistry, benzodiazepines can have varying side-effects. Some of the common ones include:
- feelings of isolation or euphoria
- depression
- confusion and impaired thinking
- memory loss
- headache, drowsiness, dizziness, and fatigue
- dry mouth, slurred speech, or stammering
- blurred or double vision
- impaired coordination and tremors
- nausea and loss of appetite
- constipation or diarrhea
Benzodiazepines Along With Other Medication
Benzodiazepines are frequently prescribed, and should preferably be used, in combination with other psychiatric drugs, such as:
- Antidepressants– since benzodiazepines work quickly as compared to antidepressants, they can help control some of the symptoms and establish a base-line. Once the antidepressants begin to take effect, the benzodiazepine can be discontinued.
- Antipsychotics– sometimes these drugs are used in combination with benzodiazepines to treat disorders such as schizophrenia or similar conditions. For instance, short-term benzodiazepines might be prescribed to calm the individual down quickly if they seem highly agitated or over-excited, or maybe having a severe mental meltdown.
Potential Risks
While benzodiazepines are extremely effective, their use must be kept short-term. Taking benzos continuously for over a few months causes the brain to regulate itself to their effects, resulting in dependence to the drugs as well as hypersensitivity to regular brain chemicals when one stops taking them.
Benzodiazepines are also generally not recommended for pregnant or lactating women, since they have been associated with pre-term delivery, low birth weight, and possible birth defects.
Moreover, people suffering from acute asthma, sleep apnea, emphysema (shortness of breath), advanced liver or kidney disease, and those with a history of substance use disorders (SUD) should also avoid using these drugs, since they can lead to worsening their symptoms and drug dependence.
Benzodiazepines and Addiction
Health practitioners should ideally prescribe benzodiazepines for the shortest period possible, since taking benzodiazepines continuously for more than a few weeks may lead to drug dependence and ultimately addiction. Hence, doctors generally recommend taking benzodiazepines for a minimum of 2 to 4 weeks. In some cases, for instance, where longer drug therapy may be essential in managing symptoms, intermittent use can prevent addiction to the drug. This means that the medication is not taken regularly, for example, not every day. Moreover, the risk of addiction is greater for those with a history of drug or alcohol abuse, and also for those with a personality disorder.
Withdrawal
Withdrawal from benzodiazepines can cause certain uncomfortable symptoms and often happens when the medication is not taken regularly for at least 4 to 6 weeks. This happens because the body gets used to the medication and its effects. Some common withdrawal symptoms are:
- anxiety and restlessness
- tremors and cramps
- dizziness and fatigue
- sleep disturbances
- shortness of breath
- sweating and flushing
- hallucinations
- gastrointestinal problems
Conclusion
Benzodiazepines are referred to as minor tranquilizers. These are commonly prescribed to relieve stress, anxiety and manage sleep problems and insomnia. They are also used in the treatment of alcohol withdrawal and epilepsy.
Benzodiazepines, usually after being taken for extended periods, may result in dependence and addiction, and uncomfortable withdrawal symptoms on discontinuation. Because of this, these drugs are not preferred as the first option for the pharmacological treatment of anxiety, insomnia, or other health conditions.
Hence, the general advice is that benzodiazepines must not be prescribed for more than four weeks, and should be used intermittently, i.e. not be taken daily. These drugs more are likely to be most effective when taken as a one-off dose occasionally as opposed to a continuous treatment regime.
However, in certain special circumstances, doctors might prescribe benzodiazepines for longer periods at low doses, and a carefully planned regime might not cause a problem and maybe the most suitable treatment for certain people.
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