Benzodiazepines are a class of drugs that are used as tranquilizers to treat anxiety, insomnia, and seizure disorders. Benzodiazepines work by bringing balance to the chemicals in your brain called neurotransmitters.
What Are the Uses of Benzodiazepines?
Benzodiazepines are prescription medications that may be used to treat the following conditions:
- Anxiety disorders
- Sleep problems caused by anxiety
How do benzodiazepines work?
Prescribed Benzodiazepines can have both sedative-hypnotic effects (make you drowsy) and mild stimulant effects (waken you up). These effects can sometimes make it difficult to fully function at your job or at school.
How are benzodiazepines taken?
You can take benzodiazepines in several different ways:
- Capsule: Swallow the capsule whole, with a glass of water. Do not break or chew the capsules. You may need to ask your pharmacist for a plastic pill cutter that can safely cut a hard-coated pill into appropriate doses.
- Liquid: Tighten the cap on the bottle with a childproof cap after each use. Put one dose in a small, empty cup and fill it with water from the bathroom tap just before taking the dose.
- Injection: You will be taught how to do this by your doctor or a nurse. Your dose depends on why you are getting the injection and what other medications you have been prescribed before your surgery date.
How Long Do Benzodiazepines Work?
Benzodiazepines can vary in their length of action, which is how long they last in your system. For example, Triazolam has a shorter active life than Diazepam, but both may help when taken less frequently.
If you take 10mg of Diazepam once daily for two weeks, it might still be working in your body after 20 days—20% of the original dose is still present in the body for that time period following the last dose.
Must Read: Mixing Benzos and Alcohol
What Are the Different Types of Benzodiazepines?
There are many different benzodiazepines, which differ by the way they act in your body and how long their effects last. Some common benzodiazepines include:
- Ativan (lorazepam)
- Halcion (triazolam)
- Klonopin (clonazepam)
- Lunesta (eszopiclone, a nonbenzodiazepine hypnotic medication). Lunesta causes less hangover than other sleep medications because it is not as sedating. It is also the only nonbenzodiazepine that can be used for longer-term treatment of insomnia—most other sleep medications are only approved for short-term treatment of up to two to four weeks.
- Valium (diazepam)
Note that these medications are all called “benzodiazepines,” even though they have different active ingredients and act in different ways; each medication has its own side effects, uses, and risks.
Side Effects of Benzodiazepines May Include:
- If taken with other CNS depressants including alcohol, the side effects are heightened. Also, any medication that is not prescribed to you should probably be avoided as it increases the risk for side effects, dependency, and addiction. Sedation, drowsiness, and dizziness are common side effects.
- It can be very risky to take benzodiazepines with other sedatives like sleeping pills and muscle relaxants because it may slow your breathing and lead to death.
- Benzodiazepines can be habit-forming and physical dependence may develop with long-term use leading to withdrawal symptoms if stopped abruptly. Withdrawal symptoms may include seizures, spasms, tremors, vomiting ataxia, headache, memory problems, lethargy, confusion, and irritability.
- One of the most serious side effects is amnesia. Amnesia may be permanent in some cases and can cause you to forget what happened while under the influence of benzodiazepines.
- Benzodiazepines can also affect your balance, coordination, or speech resulting in falls, motor vehicle accidents, or other dangerous situations that could potentially lead to multiple injuries.
- It is very important to not drive or perform other potentially dangerous tasks while taking benzodiazepines. Any side effects that impact your physical abilities would make it unsafe to drive or do anything that requires you to focus.
- Some people experience paradoxical reactions like anxiety, excitability, agitation, hostility, aggression, rage, and hallucinations.
Risks of Benzodiazepines
The combined effects of benzodiazepines with alcohol can be fatal. Even if you do not drink, mixing the two drugs is dangerous.
Benzodiazepines are especially dangerous for pregnant women because unborn babies are extremely sensitive to medication and the negative side effects that may result from taking benzodiazepines.
Benzodiazepines should be taken with caution when combined with certain medications such as cimetidine (Tagamet), isoniazid, theophylline, oral contraceptives, and anticoagulants. Benzodiazepines can also interact with MAO inhibitors such as furazolidone (Furoxone), procarbazine (Matulane), and selegiline (Eldepryl).
Benzodiazepines may interact with other drugs that you are taking by decreasing their effectiveness or causing adverse reactions.
Taking benzodiazepines while under the influence of alcohol is extremely dangerous because it can cause respiratory depression, coma, and death.
Benzodiazepine Withdrawal
Benzodiazepines can be highly addictive and it is possible to become dependent on them with long-term use. It is very dangerous to stop taking benzodiazepines suddenly without the help of a doctor because withdrawal symptoms may occur which include seizures, spasms, tremors, vomiting ataxia, headache, memory problems, lethargy, confusion, and irritability.
Taper Schedule for Withdrawal of Benzodiazepines (from Taper Schedule-Benzodiazepine Addiction)
- Day 1 – 20 mg. oxazepam (Serax); 3/4 Klonopin; 10 mg. Ativan; or any equivalent.
- Day 2 – 20 mg. oxazepam; 3/4 Klonopin; 10 mg. Ativan; or any equivalent.
- Day 3 – 15 mg. oxazepam (Serax); 1 tablet of klonopin, 7.5mg.; one-half tablet of ativan, 5mg.; or an any equivalent.
- Day 4 – 15 mg. oxazepam; 1 tablet of klonopin, 7.5mg.; one-half tablet of ativan, 5mg.; or an any equivalent.
- Day 5 – 10 mg. oxazepam (Serax); 1 half-tablet of Klonopin, 3.75mg.; ½ tablet Ativan, 2.5mg.; or any equivalent to a total of 15 mg.
- Day 6 – 10 mg. oxazepam; 1 half-tablet klonopin, 3.75mg.; ½ tablet ativan, 2.5mg.; or any equivalent to a total of 15 mg.
- Day 7 – 10 mg. oxazepam; ½ tablet klonopin, 1.875mg.; ¼ tablet of ativan, .625mg.; or any equivalent to a total of about 5-6 mg.
- Day 8 – 10 mg. oxazepam; ½ tablet klonopin, 1.875mg.; ¼ tablet of ativan, .625mg.; or any equivalent to a total of about 5-6 mg.
- Days 9 to roughly day 50 – reduce the daily dose by 2 mg every three days (e.g., 7, 5 and finally 2). At this point you’re down to about 1 mg.
- Day 51 – 1 mg of clonazepam (Klonopin) or any equivalent. You can do this by taking one ¼ tablet of Klonopin, .1875mg; 7½ grains of ativan, .049mg; or an even combination of these like ½ tablet each.
- Day 52-60 – reduce the daily dose by 1/10th every two to three days (e.g., day 1 =1 mg; day 2= .9 mg; day 3= .8 mg and so on). At this point you’re down to about .5-.7mg which is how many people will feel after tapering roughly two months.
Please note that these are general guidelines only. Everyone is different, and tapering should be undertaken at your own pace based on how you feel depending on the method you choose (e.g., taping down to .5mg over nine months; or dropping 10 mg in one week). The point here is to control the downward slope of withdrawal symptoms, not necessarily the length of time it takes to reach zero dosage.
Must Read: Alcohol PAWS
Are Benzodiazepines Addictive?
Yes, benzodiazepines are addictive. While the common belief is that only those with a history of substance abuse become addicted to benzodiazepines, physicians report seeing dozens of patients who have never used other drugs develop a dependency on these medications.
How to address Benzodiazepine abuse and addiction
When a patient is suspected of being addicted to benzodiazepines, physicians must help the person understand that he or she has a medical problem. There are several treatment options, including community support groups such as Narcotics Anonymous (http://www.na.org/), and participation in specially designed counseling programs.
Patients with an addiction to benzodiazepines should be aware that this condition will require lifelong care and monitoring; it will not go away on its own after stopping medication use. The best outcome for these patients involves their participation in both physical and psychological treatment methods tailored specifically to their needs and goals for abstinence from benzodiazepines.
Doctors who work with addicts can provide referrals for therapists, counselors, psychiatrists, psychologists, and other health care providers with experience in helping people who have abused benzodiazepines.
Patients with an addiction to benzodiazepines should be advised of the lifelong need for careful monitoring by physicians and family members. Many self-help support groups are available for addicts, including Narcotics Anonymous, Adult Children of Alcoholics, Alanon, and other 12-step groups that encourage abstinence from all drugs.
Conclusion
Benzodiazepines are useful for short-term relief of anxiety and insomnia. They should be used with extreme care, however, since they can lead to severe dependency problems. Benzodiazepine use is especially taboo in the United States because the drugs are often obtained illegally or through family members or friends who have prescriptions. Addiction to benzodiazepines is a common problem among patients who do not follow the suggested dosages and schedules prescribed by their physicians.
Frequently Asked Questions about Benzodiazepines
What happens if I miss a dose?
If you forget to take your pill at the normal time, simply do so as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the one you missed and return to your regular dosing schedule. Do not double up doses or take more than what is prescribed by your doctor because this could lead to adverse effects such as oversedation or even death due to respiratory distress.
Are Benzodiazepines safe?
While benzodiazepines are very effective in treating the conditions they are prescribed for (such as insomnia, seizures, panic attacks, and anxiety disorders), they do possess the ability to create physical and/or psychological dependence in some people. If you or someone you know has taken benzodiazepines for longer than advised by your doctor, you should cease use immediately.
What are common Benzodiazepine street names?
A number of street names exist for this class of drug; however, these terms are used mostly among recreational users (i.e., drug abusers) who purchase their tablets on the black market. These include benzos , downers , forget-me pills , yellow jackets , zombies , barbiturates , tranks, goons, blue bullets , nembies and hoods .
During withdrawal from Benzodiazepines, what are common symptoms to expect?
Benzodiazepine withdrawal is associated with both physical and psychological symptoms including elevated heart rate, blood pressure, respiration, temperature, and pulse; panic attacks; headache; fatigue; nausea; vomiting; hand tremor; irritability; insomnia/hypersomnia (excessive sleeping); muscle spasms or cramps in the back of the neck or other areas of the body that might resemble seizures.
How much does Benzodiazepine withdrawal cost?
The price of benzodiazepine dependence can be high. It’s not just about money either. The true costs are emotional and physical but they masquerade as financial because it seems like there isn’t another way out. However, there is help. There are plenty of free or low-cost options, so you do not need to proceed through withdrawal alone.
