woman talking with counselor about her benzo addiction

What Do You Know About Benzos? How Addictive Are They?

Benzos or benzodiazepines are a class of pharmaceutical medications commonly prescribed for anxiety, seizures, and insomnia. They are the most widely prescribed depressants in the US. However, these drugs are extremely addictive and difficult to wean away from. If you are concerned that you or a loved one may be addicted to benzos, please contact us at North Jersey Recovery Center and get help today.

Benzodiazepines were intended to replace barbiturates, another class of drugs used to treat anxiety and seizures. Abuse of barbiturates had become a societal problem; doctors thought that benzos would offer similar relief with lower potential for abuse. However, they found that dependence on and addiction to benzos can develop even among people following their physician’s instructions.

Intended for Low, Short Dosages

Research suggests that benzos can be effective at low doses for a few weeks. To date, no evidence confirms that these medications work for anxiety over a long period. Still, doctors prescribe these medications for months, years, and even decades. In spite of growing concerns over benzo abuse and complications, prescriptions spiked 67%, from 8.1 million to 13.5 million between 1996 and 2013. 

The US Drug Enforcement Administration has classified all benzos as controlled substances, and all of these kinds of drugs have the potential for abuse. According to SAMHSA, benzos are most often misused in conjunction with other substances including other benzos, alcohol, opioids, cannabis, and stimulants to enhance the effect of those substances. About one in eight US adults – over 30 million – used benzodiazepines in 2018; five million of these individuals reported misuse.

How Do Benzos Affect the Body?

Scientists do not yet understand all of the mechanisms by which benzos work. They generally agree that these medications interact with gamma-aminobutyric acid (GABA), a neurotransmitter. Neurotransmitters are chemicals that interact with neurons in the brain and spinal cord.  As an inhibitory neurotransmitter, GABA impedes brain activity and makes people feel relaxed and sleepy.

Short-Term Effects

Many of the conditions that benzos treat, such as anxiety and seizures, are thought to be triggered by the rapid activity of neurons. Consequently, these drugs provide a sedative effect to ease symptoms. Short-term use of low to moderate doses may induce these effects:

  • Drowsiness
  • Depression
  • Impaired motor function
  • Vision problems
  • Tremors
  • Vertigo
  • Respiratory depression
  • Nausea

Long-Terms Effects

Higher doses of benzos can lead to erratic thinking and behavior, slowing of reflexes, and a euphoric state. These are the effects that whet the appetite for abuse. Misuse of benzos can also produce troubling side effects such as:

  • Jaundice
  • Severe itching
  • Changes in libido
  • Physical weakness
  • Disorientation or confusion
  • Menstrual problems in women
  • Greater risk of Alzheimer’s disease
  • Memory and judgment impairment
  • Heightened risk of falls, especially among the elderly

Other phenomena arising from benzo use might include anterograde amnesia, the inability to recall events that transpired after consuming the drug. Paradoxical disinhibition also occurs, marked by antisocial or violent tendencies.

Signs of Benzo Addiction

You or someone you know may have developed an addiction to benzodiazepines if these issues regularly occur:

  • Thinking about obtaining and using benzos often
  • Taking benzos at work, while driving, or in other hazardous scenarios
  • Intentionally using benzos with other drugs or alcohol
  • Taking more than prescribed
  • Ignoring responsibilities due to drug use
  • Repeated, unsuccessful attempts to eliminate or cut back on drug consumption
  • Forgoing previously enjoyed activities in favor of using drugs
  • Doctor shopping to get more benzos
  • Denial in spite of other signs of addiction

Benzo abuse often leads to dire consequences for users and their families. Family problems including child neglect or divorce could result. Financial difficulties can mount up due to mismanagement of money and job absenteeism or loss. All too often, many individuals resort to criminal behavior to support their benzo addiction.

Types of Benzodiazepines

The benzodiazepine class of drugs includes many different formulations. All benzos affect the same neurochemical pathways, but they work differently depending on the formulation. Some are more suited for treating panic attacks or short-term anxiety; others can treat insomnia. Other types can help alleviate depression symptoms or halt seizures.

Benzos also differ in how quickly they take effect, how potent they are, how long the effects last, and their tendency to build up and remain in the body.

Xanax

Xanax (alprazolam), the most commonly prescribed benzodiazepine, is prescribed for treating anxiety and panic disorders. It comes in various strengths. This drug is considered especially dangerous because it works immediately, inducing drastic changes all at once.

Valium

Valium (diazepam), one of the oldest benzos on the market, treats muscle spasms, anxiety disorders, and alcohol withdrawal symptoms. It comes in different strengths; some release their effects over an extended period. This drug doesn’t produce an immediate high.

Ativan

Ativan (lorazepam) treats panic disorders. It comes in pill and liquid forms that can be taken intravenously. This drug has a short-to-intermediate effect, producing a big, “rewarding” rush in some individuals.

Klonopin

Klonopin (clonazepam) is used to treat severe anxiety disorders, PTSD, panic disorders, seizure disorders, mania, and social phobias. It is more sedating than Xanax and comes in two levels of strength. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) considers this drug an intermediate-acting benzo. 

Ambien

Ambien (zolpidem) is a hypnotic drug used to treat insomnia. Its sedative effect induces sleep, while added ingredients help people forget what happens while they’re sleeping. This drug is not abused as much as other benzos because although this drug acts quickly, many people can’t stay awake long enough to take more than one dose.

Halcion

Halcion (triazolam) is widely prescribed to treat insomnia, aggression, anxiety, schizophrenia, suicidal behavior, and Tourette’s. It comes in tablets, and some doctors prescribe it to ease anxiety before medical procedures. Halcion induces feelings similar to alcohol intoxication and typically takes effect more quickly than most other benzos.

Restoril

Restoril (temazepam) is another hypnotic medication that slows down electrical activity in the brain. Taking this drug makes people sleepy in just moments. However, these people tend to do things like driving, cooking, or having sex in this extremely sedated state without being able to recall their actions upon awakening. 

Librium

Librium (chlordiazepoxide) is a psychotropic medication used to treat anxiety, insomnia, seizures, and irritable bowel syndrome. It comes in capsules of varying strengths. However, the contents of the capsule are often snorted or mixed with water and taken intravenously. 

Why Are Benzos So Highly Addictive?

Benzos can alter the brain’s GABA and dopamine systems rapidly. According to Marc Fishman, MD, an addiction psychiatrist, users often build up a tolerance to the medication. Tolerance occurs when the brain becomes accustomed to the presence of a drug, rendering the drug less effective.

Researchers have found that benzos, opioids, cannabinoids, and the club drug GHB affect the same neural mechanisms underlying addictions. 4 out of 10 individuals who take benzos for longer than six weeks will develop an addiction to these drugs. Fishman stated: “…the new normal becomes the intoxicated, benzo-addled state” in which users crave for more.

Recreational Use of Benzos

Although benzos are controlled drugs, they have a long history of recreational use. Their calming, relaxing properties make them popular as they elicit a dreamy state of mind, temporarily relieving stress. The chemicals circulate on the black market, obtained by theft or from legitimate patients selling some or all of their prescriptions. 

Benzos and Polysubstance Abuse

The abuse of more than one chemical puts a person at an even greater risk for health problems and other adverse conditions than the misuse of one substance. These results can be short- and long-term. Polysubstance abuse often adds another obstacle to recovery, and relapse is more likely.

Benzos and Opioids

Medical experts often warn against polydrug use, yet doctors regularly prescribe benzodiazepines and opioids concurrently. The growing segmentation of healthcare practices is a leading factor in this dilemma. For instance, many people receive one opioid prescription from one specialist to treat chronic pain while also getting a benzodiazepine prescription from another clinician to treat anxiety or muscle spasms

Mounting research indicates that this is a risky combination. Oversedation, the inability to respond to stimuli, is a major issue here. Both drugs can also depress breathing, cutting off oxygen from the brain and vital organs.

Studies show that people who have used both drugs experience a higher risk of death by drug overdose. In 2016, the US Food and Drug Administration mandated that benzos carry a prominent warning against their potential for harmful interactions with opioid pain relievers.

The National Institute of Drug Abuse (NIDA) reported a 10-fold spike in overdose fatalities involving benzos in the US from 1999 to 2017, an increase from 1,135 to 11,537. Most of these deaths involved the use of benzos and opioids together. Benzodiazepines have been present in more than 30% of opioid overdoses as well.

Benzos intensify the effects of opioid painkillers, making this combo highly addictive. Some people inadvertently mix them in dangerous amounts. Increasingly often, though, many individuals seek a “high” from taking higher than prescribed doses of both medications.

Benzos and Suboxone

Suboxone (buprenorphine) is a medication used to treat opioid addiction. An individual taking it is more likely to abuse benzos due to their history with addiction. An Addiction study reported that about two out of three people who have used Suboxone also use benzos. Mixing these two substances can lead to excessive sleepiness, dangerously reduced blood pressure, coma and death.

Combining benzos and Suboxone increases the likelihood of overdose. While not all interactions of these drugs cause severe complications, high doses can result in serious adverse effects. In a small Finnish study, 82% of individuals whose death was related to buprenorphine had benzos in their systems.

Valium and Other Substances

Valium is relatively safe for most adults when taken as prescribed. Mixing this benzodiazepine with other medications, illicit drugs, or alcohol – intentionally or not – can cause excessive sedation, brain damage, or an overdose. Consuming Valium with other substances also increases the chances of developing an addiction.

Valium and other substances “boost” the user’s response to the drugs, creating a craving for the combined effects. The Substance Abuse and Mental Health Services Administration reports that people with substance use disorders (SUD) are more likely to misuse benzos such as Valium than the general population. A large proportion of patients in addiction treatment programs abuse benzos along with other chemicals.

Sometimes, people with valid prescriptions for Valium may drink alcohol or take other medicines that interact with it inadvertently, oblivious to the risks. As a tranquilizer, Valium can escalate the sedative effects of alcohol and some illegal drugs, leaving the user more vulnerable to confusion, grogginess, and injury. Valium users should avoid the intake of alcohol or other medications not prescribed by a physician.

Valium is commonly prescribed in some medical detox programs to help manage alcohol withdrawal symptoms. Some people attempt to self-administer Valium, but this is illegal and can be quite dangerous. A professional detox program with intensive clinical supervision, available at North Jersey Recovery Center, is the safest, most effective way to withdraw from benzos and multiple substances.

Mixing Xanax and Klonopin

Some people combine Xanax and Klonopin to alleviate anxiety and relax muscles. Both benzos produce similar effects on their own; using both together enhances their effects. This is especially true if an individual has built up a tolerance for one of the drugs or if they are trying to extend the duration of the “high”.

Chronic use of Xanax and Klonopin combined can exacerbate the long-term effects of benzo abuse. People who abuse these chemicals may have difficulty with concentration, focus, memory, and speech. Delirium, depression, and brain damage are possible as well.

Tapering off abuse of one benzodiazepine is difficult; weaning from more than one of these drugs is even more so. Withdrawal symptoms include sleep disruption, panic attacks, convulsion, and psychosis. Recovery is possible with professional assistance. Intensive addiction therapy is essential following withdrawal to reduce the risk of relapse.

Can you or your loved one get help for benzo addiction? Yes, you can, and you should – immediately. Abusing benzos is not normally fatal in itself, but many people combine them with other addictive substances such as alcohol or opioids. These are dangerous combinations with serious and potentially lethal health ramifications.

Benzos and Withdrawal 

Benzo withdrawal symptoms may develop in three phases: early withdrawal, acute withdrawal, and protracted withdrawal. Symptoms typically start to appear within 24 hours and could last several days or several months. About 1 out of 10 benzos abusers continue to experience symptoms years after cessation. The intensity and duration of weaning off the drugs depend on these and other factors:

  • Age
  • Dosage
  • Body size
  • Method of ingestion
  • Length of use or abuse
  • Overall physical condition
  • Level of hydration in the body
  • Type of drug(s) used or misused
  • Concurrent abuse of alcohol or other drugs
  • Mental health issues and co-occurring disorders

Short vs. Long Half-Life

Each benzo medication has a unique half-life that affects the amount of time it takes for the drug to exit the body. Withdrawal may begin once the benzo is purged from the system. Benzos with longer half-lives remain in the body longer, so the onset of withdrawal is delayed. On the other hand, withdrawal from short-acting benzos may produce withdrawal symptoms more quickly and acutely.

It may start as soon as 10-12 hours of cessation for shorter-acting benzos like Xanax. For longer-acting drugs like Valium, withdrawal symptoms may not appear for a few days. Discontinuing the use of a hypnotic benzo like Halcion or Restoril may cause more sleep disturbances. Stopping abuse of an anxiolytic (anti-anxiety drug) such as Xanax or Librium may trigger higher levels of anxiety.

Method of Ingestion

How benzodiazepine has been taken affects the withdrawal process. Injecting or snorting these drugs sends the chemicals directly into the bloodstream for an immediate effect. Swallowing a pill sends the substance through the digestive tract, creating a less intense euphoria and slower onset of withdrawal.

Withdrawal and Poly-Substance Abuse

Poly-drug abuse influences the severity of withdrawal symptoms. Misusing illicit substances with benzos likely increases the number and type of withdrawal symptoms that arise. Individuals weaning off usage of multiple substances may experience sharp post-acute withdrawal symptoms known as PAWS.

Don’t Go Cold Turkey with Benzos

Depending on the drug and the dosage used, weaning off benzos can take weeks or months. Trying to quit cold turkey could induce severe withdrawal symptoms such as:

  • Coma
  • Confusion
  • Depression
  • Muscle pains
  • Blurred vision
  • Erratic heart rate
  • Breathing problems
  • Elevated body temperature
  • Full-blown, life-threatening seizures
  • Delirium tremens – the same kinds of shakes and hallucinations seen in alcohol withdrawal

Because withdrawal from benzo use is so risky, expert help is essential. Professional treatment specialists understand how to taper off dosages to help the body adjust with minimized withdrawal complications. North Jersey Recovery Center is an evidence-based treatment center with years of experience in treating benzo addiction. We can give you the resources and support you need to detox and rehabilitate as safely and comfortably as possible.

Get Help for Benzos and Opioid Abuse Now in New Jersey

If someone you know overdoses on benzos, opioids, or a combination of these drugs, call 911 and remain with the person until emergency help arrives. Individuals who struggle with an addiction to either or both medications need intensive addiction rehabilitation. At North Jersey Recovery Center, we offer a variety of options to help you break free and live sober.

Helping A Loved One with Benzo Addiction in New Jersey

People with a benzo addiction often need the help and support of family and friends to break free. The users suffer from cognitive impairment and physical dependency on the drugs, so they feel an intense, relentless craving for it. Still, families can appeal to the conscious mind of the benzo addict to foster deep, lasting change.

Interventions

A planned intervention gives families space and time to discuss how benzo addiction has affected the person they love as well as the benefits of drug treatment. This brings the addict face to face with their illness and informs them regarding what to do about it. Typical interventions for benzos abuse follow these steps: 

  • Family members and friends invite the person with benzo addiction to a meeting.
  • Each person shares a prepared speech or letter detailing changes observed and memories of the person before drugs.
  • The family respectfully yet firmly insists that the person with addiction seeks treatment, fully prepared to help the individual obtain treatment or implement consequences if the person refuses.
  • Once the person agrees to getting treatment, the meeting closes.

An interventionist can be very helpful in this process. This mental health professional is experienced in dealing with individuals with addiction and their families. They can bring an objective perspective to help all involved parties prepare for the meeting, minimize conflict, and ensure that the meeting stays on track. This person may also transport the addicted person to a rehab facility.

Types of Treatment for Benzo Addiction Recovery at NJRC

Partial-Care Program

The first step in treating benzo addiction is detox. Close monitoring during this critical period helps professionals spot and address withdrawal symptoms before the symptoms escalate beyond control. NJRC offers a Partial-Care program with daily clinical care to help keep addicts comfortable and safe during this transition.

The Partial-Care Program removes recovering benzo users from everyday temptations and guides them through early recovery. Our highly-trained, compassionate team customizes treatment plans for each individual, recognizing that each person has a unique physical, mental, and social background. This care includes individual and group counseling and coaching to help people uncover the roots of their addictions and cultivate tools for recovery.

Outpatient Care

Recovery from benzo addiction is rarely a quick fix. Our intensive Outpatient Treatment program builds a foundation for a life of lasting sobriety. At our sober living residences, you’ll continue learning skills for life management and relationships. Weekly 12-step meetings and check-ins with a recovery coach provide accountability in a real-life setting to instill confidence and consistency.

Addiction is a chronic disease, like asthma, hypertension, and diabetes. Now you have hope for healing and recovery! If the crutch of benzos has crippled you, our team at North Jersey Recovery Center is ready to empower you for sober living. Contact us for help today. 

Reviewed for Medical & Clinical Accuracy by Brian Ostertag

brian-ostertag-150x150Brian Ostertag, BA, MA, LCADC, CCS, is the Clinical Director for North Jersey Recovery Center. Brian is a compassionate leader with a desire to see others exceed, and who believes that people want to work hard at something they find meaningful and believe in. He is a strong addiction services professional with degrees in Psychology Addiction Studies, and Pastoral Counseling.