Benzodiazepines, commonly called nerve pills or “mother’s little helpers,” are some of the most frequently prescribed medications in the United States. Benzodiazepines have a calming effect. They can also lower your inhibitions, making them very addictive, especially if you are in a high-stress environment or struggle with anxious thoughts.
Benzodiazepine Use Disorder
Familiar names include Valium®, Klonopin®, Ativan®, Librium®, and Xanax®. Benzodiazepines are often prescribed to help treat anxiety, seizure disorders, alcohol withdrawal and insomnia, and are generally only prescribed for very short-term use. Benzodiazepine use disorders commonly occur when individuals use benzodiazepines longer than prescribed. These prescription medications have similar effects on the body and brain as alcohol. Benzodiazepines act on the central nervous system to produce sedation, muscle relaxation and decrease anxiety levels. Both overdose and withdrawal from benzodiazepines can be life-threatening. According to studies, benzodiazepine abuse resulted in 8,000 deaths in 2015 in the United States.
Benzodiazepine Abuse Statistics
According to American Family Physician’s study:
- In the U.S., 11-15% of the adult population has taken a benzodiazepine one or more times during the previous year.
- Approximately 80% of individuals who abuse benzodiazepines use another substance (most commonly opioids).
- The number of benzodiazepine prescriptions doubled from 2003 to 2015.
- Most users obtained benzodiazepines from friends or relatives, with only about 20% receiving them from their doctor.
- The most common reasons for benzodiazepine misuse include the need to relax or relieve tension.
Number of Individuals Who Abuse Benzodiazepines
- Percent That Abuse Benzodiazepines & Another Substance
- Percent That Abuse Only Benzodiazepines
Risk Factors for Benzodiazepine Abuse
- Access to unnecessary or too many prescriptions
- Female gender
- Over 65 years of age
- Low socioeconomic status
- Peer pressure
Signs and Symptoms of Benzodiazepine Abuse
If you or someone you know demonstrates two or more of the following behaviors over 12 months, we recommend you get screened for benzodiazepine abuse:
- Tolerance (the need to increase the dosage over time to obtain the same desired effect)
- Withdrawals (physical withdrawal symptoms in the absence of benzodiazepines)
- Doctor shopping (visiting multiple doctors to get prescriptions)
- Impaired performance at work, home or school
- Spending a considerable amount of time and effort obtaining and using benzodiazepines
- Taking benzodiazepines in larger doses than intended or for a longer time than intended
- Social withdrawal
- Forging prescriptions
- Mood swings
- Interpersonal conflicts
- Inability to stop taking benzodiazepines
- Engaging in risky activities, such as driving, after using benzodiazepines
Signs and Symptoms of Acute Benzodiazepine Toxicity
- Lack of coordination
- Blurred vision
- Slurred speech
- Slowed breathing
- Decreased blood pressure
Withdrawal symptoms can occur after one month of use, even in small, therapeutic doses. According to studies, approximately 40% of individuals who are taking benzodiazepines for at least six months will experience moderate to severe withdrawal effects when they quit suddenly. The other 60% can experience mild withdrawal symptoms.
Short-acting benzodiazepines, such as Xanax and Ativan, leave the body faster. These withdrawal symptoms can appear 8 to 12 hours after the last use and can last up to seven days. Longer-acting benzodiazepines, such as Klonopin, can stay in the body longer. Withdrawal symptoms usually begin one to two days after the last dose and last up to weeks or even months.
Between 10-25% of individuals who abuse benzodiazepines over a long period may experience protracted withdrawal. Protracted withdrawal is a long-term withdrawal that can last for several months. Symptoms are usually milder and can disappear for weeks at a time before returning. If you are withdrawing from benzodiazepines, you will experience a spectrum of uncomfortable physical symptoms.
Signs and Symptoms of Benzodiazepine Withdrawal
- Changes in perception (hypersensitivity to light, goosebumps, skin-crawling, hallucinations or delusions).
- Difficulty with concentration and memory
- Shaky hands
- Muscle spasms
- Increased heart rate
Similar to alcohol, the immediate cessation from benzodiazepines can result in seizures and death, thus, a slow taper must be initiated. Tapering means taking progressively smaller doses over a few weeks or months. It is important to consult a medical professional if you are trying to wean yourself from benzodiazepines. Treatment centers will monitor for signs and symptoms of benzodiazepine withdrawal and will administer medication that can help prevent withdrawal as well as help curb cravings.
When to Seek Help for Benzodiazepine Use Disorder
Seek treatment if you display these signs of benzodiazepine abuse :
- Violent/irritable behavior
- Poor work/school performance
- Legal trouble
- Withdrawal from benzodiazepines
- Strained/broken relationships
- Mixing benzodiazepines with alcohol or other drugs
- Stealing/forging prescriptions
- Purchasing benzodiazepines on the street
- Taking benzodiazepines to relieve stress
- Hiding benzodiazepine abuse from friends, coworkers or family
- Driving under the influence
- Craving benzodiazepines
- Others express concern about your behavior
Treatment Options for Benzodiazepine Abuse
Some drugs are safe to quit on your own, but benzodiazepines are not. Depending on the severity and the duration of benzodiazepine use disorder, treatment options range from inpatient treatment to outpatient treatment. Psychotherapy, combined with medications, is the mainstay treatment for benzodiazepine abuse. A slow taper of benzodiazepines will be given to ease the withdrawal symptoms. It is quite common to switch from short-acting benzodiazepines to long-acting benzodiazepines such as Klonopin. This taper regimen prevents further complications associated with withdrawal effects. Tapering can last from two weeks to several months, depending on the severity of the benzodiazepine use disorder. Once you are out of the acute withdrawal phase and your tapering regimen seems to be working, it is possible to finish your taper at home. You should still undergo outpatient treatment for psychotherapy and breakthrough symptoms. If you are in treatment for benzodiazepine use disorder, it is important to not drink alcohol during this time as alcohol can worsen the withdrawal symptoms.