Among the variety of medications that are prescribed every day in the US, benzodiazepines, or benzos, are some of the most common. Although many mental health patients find relief from their ailments with benzos, they require a great deal of caution for proper use. Many people mistakenly believe prescription medications are safe because doctors prescribe them. This misconception has contributed greatly to the substance abuse epidemic in America. Addiction to benzodiazepines is a dangerous path that leads to a number of medical issues.
There are many health problems that doctors treat with over fifteen different benzodiazepine medications. When patients use these meds for an extended period, they can become dependent upon them, and many try to face the dangerous process of withdrawal from benzo pills alone. When an addict attempts to quit taking benzos, a medical detox program is the best course of action.
Medical detox programs for various types of addiction are similar in nature, but benzodiazepine addiction is unique in the way that patients typically use the medications. The majority of patients who go through benzo withdrawal were originally prescribed these meds for mental health issues such as insomnia and anxiety. When they attempt to stop using these prescriptions due to their addiction, the symptoms they first took the pills for return, and they have to battle these demons in addition to the benzodiazepine withdrawal symptoms.
What Exactly Are Benzodiazepines?
You may be asking, “what are benzos?” If so, you are not alone. The most common question people ask is “is Xanax a benzo?” The short answer is that yes, it is. Xanax is one of the many varieties of brand names that these commonly prescribed medications in the United States are called by. Oftentimes, patients are prescribed benzos and begin taking the pills without even knowing that the drug they are taking is a benzodiazepine. These meds fall under the category of psychoactive drugs that doctors use to ease the effects of mental health issues like alcohol withdrawal, generalized anxiety disorder (GAD), and insomnia. The effects of benzos often include muscle relaxation, which contributes to their ability to help patients sleep. Many times, these meds are prescribed to older patients.
The way these treatments work is by slowing down activity in the brain with tranquilizers, causing the body to relax. If a patient is using benzos to treat severe insomnia, they should only be taken for a short time. These meds are known for their effectiveness in quickly combatting the symptoms of anxiety, so they are beneficial to those suffering from panic attacks and anxiety disorders. Other treatments include easing symptoms of alcohol withdrawal and prevention of epileptic seizures. Their anticonvulsant ingredients make them effective for use in this area. The issues arise when they are used for more than one month.
The Complication of Benzos
Using benzos for a short time is considered to be safe and beneficial in the right situations. It is typically when patients continue using the drugs for an extended period that they become dependent. At times, individuals begin mixing benzodiazepines with other substances, which can lead to overdose and death. The dilemma in fighting benzo addiction arises because many people think they need to keep taking these meds to effectively manage their health problems. They don’t realize that the drugs lose effectiveness when they are taken for a long period of time.
One positive aspect of the benzo withdrawal timeline is that it is fairly short in comparison to withdrawal from other addictions. Patients with mental health disorders suffer their effects every day, which is why these individuals begin to believe they need to keep taking the medications to treat the distress they suffer from their ailments. The unfortunate result is that patients begin to use these short-term treatment options for problems they face on a long-term basis. The fact that these medications are only viable in treating acute episodes and should not be used for more than one month is the reason they quickly become addicted to benzos.
What Are Benzos Made From?
Benzodiazepine medications are derived from asperlicin, which is a mycotoxin. Its discovery was accidental. Scientists who found it were going to just throw it away but found it had tranquilizing effects upon further investigation. The misconception at the beginning was that they believed it was less toxic and less habit-forming than other medications used for this purpose. As the treatment became common for mental health disorders, medical professionals began to realize how easily patients became addicted, and they currently approach use with a more cautious attitude.
What Legitimate Health Problems Do Doctors Use Benzos to Treat?
Patients who suffer from mental conditions such as seizures, catatonia, alcohol withdrawal, tremors, insomnia, panic attacks, GAD, and social anxiety find relief through the use of benzodiazepines. They can also be beneficial in sedating patients before surgery. The effects of benzos are considered to be hypnotic, muscle relaxing, and anticonvulsant. They are used to treat these issues by slowing activity in the brain and relaxing a person’s muscles.
Benzodiazepine meds come under a wide variety of brand names. They range in effectiveness from Short-acting, through intermediate, to long-acting. This classification is based on how fast they begin to work and how soon they leave the body. Benzodiazepine medications come under the following names:
The Z-drugs at the top of the list have similar effects to benzodiazepines and are often prescribed in their stead. Unfortunately, Z-drugs can also have negative health implications and can cause dependency. These drugs, Zaleplon, and Zolpidem, are not classified as benzos, though.
Triazolam, Midazolam, and Clorazepate act on a short-term basis. The hypnotic effects of Triazolam make it ideal for use in insomnia patients. The sedative Midazolam is often used prior to surgery. Clorazepate has anti-anxiety applications and is a treatment for seizures, insomnia, and anxiety.
Intermediate-acting meds include Oxazepam, Temazepam, Lorazepam, and Alprazolam. These medications are used primarily to treat patients suffering from depression and anxiety, as well as insomnia.
The long-acting meds in this list include Clonazepam, Quazepam, Flurazepam, Chlordiazepoxide, and Diazepam. The anti-anxiety applications of Chlordiazepoxide and Diazepam make them popular choices for treatment of anxiety and alcohol withdrawal. The sedative-hypnotic qualities of Quazepam and Flurazepam make them ideal choices for insomnia treatment. As an anticonvulsant, Clonazepam is often used for patients suffering from epileptic seizures, panic attacks, and anxiety.
Addiction to Benzodiazepines
Upon their initial medical use, medical professionals considered benzos to be non-addictive and relatively safe. However, after they had been in use for some time, it became clear that they can be addictive, especially when taken in larger doses and in long-term scenarios.
Benzodiazepines are no longer marketed to the extent that they used to be, however they have not lost popularity. Benzos are used by nearly one in ten people. The reason they should only be used for the short-term is because it is hard to determine who may become addicted to them. Sadly, many individuals take the medications inappropriately in higher doses and for longer periods of time.
In addition to their calming properties, benzos reduce worry and anxiety. The main dangers of benzodiazepine use are threefold: patient overdose is possible, withdrawal symptoms are both terrifying and physically painful, and the drugs have negative long-term effects on the brain.
In the time benzodiazepines have been in use, the rate of user overdose has grown exponentially. Over the course of about 20 years, there has been a 500% rise in benzo overdose death. Unfortunately, patients often combine these meds with alcohol and opioids, which increases the chance of overdose.
Who Is at Risk from Benzos?
The elderly population is at particular risk for negative effects of benzo use. They are often prescribed benzodiazepines for their health conditions but experience negative effects after using the pills for even a brief time. Some experience poor balance, while others develop slurred speech and memory loss. In some cases, these ill-effects cause elderly patients to fall, causing more extensive injuries that can even be fatal.
Even when a patient who has become addicted to benzos is fully dedicated to recovery, it can take quite some time to quit taking the drugs. Medical supervision is essential when patients attempt to stop using, because the dangerous withdrawal symptoms can be quite severe. The sad irony is that the panic attacks and anxiety that the meds were initially used to treat often return during withdrawal, with a ferocity that is worse than the original condition. Typical withdrawal symptoms when quitting benzos include insomnia, sweating, confusion, tremors, irritability, panic, and anxiety. In extreme cases, the effects of withdrawal from these meds vary from delirium and seizures to psychosis, and even death.
Frequent Side Effects of Benzodiazepine Use
The side effects of various benzodiazepines are different, but some are used more commonly than others. Alprazolam for instance, which most people know as Xanax, is used to treat anxiety and can cause dizziness, fatigue, and drowsiness. Then, at the opposite end of the spectrum, for some people it can cause insomnia. These, however, are just a few of the many side effects of Xanax. It can also cause dry mouth, weak muscles, nausea and vomiting, headaches, sweating, constipation, diarrhea and upset stomach, slurred speech, and difficulty concentrating.
Clonazepam, more commonly known as Klonopin, is used as a treatment for seizure disorders and anxiety. In addition to the same side effects as many other benzos, Klonopin may cause blurred vision, runny nose, and sore gums. Diazepam, which you probably know as Valium, can be used for muscle spasms, alcohol withdrawal, seizures, and anxiety. Besides the other common side effects of benzodiazepines, Valium may cause certain people to itch or skin rash, drooling, and the feeling of spinning.
Ativan, which is the name most people call Lorazepam, is prescribed for patients who suffer panic attacks, insomnia, alcohol withdrawal, and anxiety. When taking this drug, individuals often experience rash, changes in appetite, and amnesia. If a patient is pregnant or breastfeeding, they should not take these medications. The danger of sudden cessation of Valium or Klonopin use, however, can cause side effects like anxiety, lightheadedness, tremors, and seizures.
The Dangers of Withdrawal from Benzos
The thing that makes benzodiazepine withdrawal more challenging than that of other drugs is the fact that the symptoms are so severe. Many of the symptoms of withdrawal are mentally based. This makes symptom management difficult, as the side effects can change every week, as opposed to reaching a peak, and then lessening in severity. When the dosage is lowered too quickly, potentially fatal seizures may occur. Recovery efforts are most effective when a patient seeks the help of professionals, who can monitor dosage reduction to ensure that it is spread out appropriately and not too hastily.
After months of long-term use, benzos become increasingly dangerous. Not only does a person become dependent, but their body develops a tolerance to the meds. Quitting very abruptly comes with extreme danger, if the patient is not engaged in a clinical benzodiazepine recovery program, including a network of recovery specialists, friends, and family who can provide the necessary support. A feeling of extreme discomfort in one’s body, known as dysphoria, emotional instability, tremors, muscle tension and aches, memory loss, and difficulty concentrating are among the symptoms of benzo withdrawal.
One of the most unfortunate aspects of benzodiazepine withdrawal is that it often causes more extreme symptoms of the initial issues the patient received the benzo prescription to treat. As an example, a patient who was prescribed benzos to treat generalized anxiety disorder and later became addicted may experience withdrawal from the drug would likely include symptoms like a heightened feeling of anxiety, racing heartbeat, panic attacks, and the other common troubles people suffer when they experience GAD. Patients who were given benzodiazepines to treat their affliction with insomnia will often be unable to sleep during withdrawal.
As these symptoms return with a vengeance, the patient in recovery often falls deeper into their benzo addiction. Quitting suddenly, and without proper supervision, is extremely dangerous, and can be just as bad as overdosing. Quitting cold turkey often causes seizures, which are potentially fatal, so it is never recommended to try to fight a benzo addiction without outside help. The process of benzo addiction treatment usually involves tapering off of the drugs gradually. The patient is weaned off of the drugs, by decreasing the dosage by small fractions until it is safe to stop taking the drugs altogether.
How Long Does Benzo Withdrawal Last?
Unfortunately, the process of recovery from benzodiazepines is a slow-going endeavor. It involves various stages of treatment, beginning with a proper clinical detox, and then management of withdrawal symptoms. The type and severity of addiction varies from one individual to the next, which makes the benzo detox recovery period a bit hard to nail down. As the last bit of the addictive drug leaves a person’s body, they begin to crave another fix, and then to suffer the effects of withdrawal when they don’t get the drug. Two terms that are used to describe the phases of benzo withdrawal are acute and protracted.
About a week after detoxing from benzos, the acute withdrawal starts. It can last as little as two weeks but often goes on for several months. The protracted withdrawal phase is something fewer than 15% of patients experience. This phase can involve months or years of withdrawal symptoms related to their addiction to benzodiazepine medications. These ongoing symptoms are best managed with the aid of doctors and medical professionals.
Why Does Benzodiazepine Detox Require Professional Help?
Complete and successful recovery from a benzo addiction is typically only achieved when the patient goes through a treatment facility where they can constantly be monitored and supervised. The medical professionals are experienced in reducing dosage amounts gradually, so that the withdrawal symptoms patients experience are less severe. The unpredictability of benzo withdrawal requires the assistance of professionals who can help to gain control of withdrawal side effects that may threaten the patient’s life.
One of the most important factors in benzodiazepine addiction treatment is ensuring that the patient’s original reason for being prescribed benzos is given the proper attention. In a situation where a person was prescribed benzos to treat anxiety and then goes on to become addicted, for instance, one must effectively treat the anxiety as part of the recovery process to overcome the addiction. The complexity of co-occurring addictions and the mental health conditions the medications are intended to treat makes the recovery process incredibly difficult. If you find that you are in this situation, you must enter into treatment with the understanding that the recovery process involves intense comprehensive treatment for your mental health concerns, as well as the addiction you have developed, and that this process may take time.
Medications for Benzo Detox
There are several medication options on the market to aid in detox from benzodiazepines. One such treatment is Buspirone, which can help with treatment of anxiety and is not addictive. Some choose not to go with this option, because it can take several weeks to be effective. However, it can be a great tool after the beginning stages of detoxing. Flumazenil is a drug that is often used in an overdose scenario but has proven to be helpful with benzo detox. It works by leading the body to believe it is still getting its benzodiazepine fix, when it is actually not. For withdrawal symptoms like anxiety, jitters, and restlessness that are similar to those of alcohol detox, Acamprosate is often an effective choice.
If a patient wants to ensure the best results in beating a benzo addiction, they must accept that they are looking at a lengthy process of recovery. The treatment they receive will involve cognitive behavioral therapy, treatment of physical symptoms, counseling, and group therapy to battle the psychological factors that contribute to their addiction to these drugs.
How to Get Help for Benzodiazepine Dependency
The opioid crisis that has inflicted our country has taken over most of the news reports on the hotly debated topic of substance abuse. The toll this epidemic has taken on our communities has begun to shift legislation on the topic. Benzo addiction, however, seems to have largely fallen through the cracks, as many Americans are uneducated about how serious the problem is and the dangers it poses for citizens from many varied backgrounds. In the period between 1999 and 2013, overdoses on benzos saw an increase of over 500%. The margin of increase was about the same again between 2014 and 2017. The sheer increase in overdose numbers between 1999 and 2017 saw a devastating ten-fold increase, going from 1,135 to an out-of-hand 11,537.
This outrageous increase in overdose deaths can be attributed to a number of factors. The first problem is that benzos are often over-prescribed. This has led to many doctors around the U.S. taking a more in-depth look at proper applications for these drugs. The abundance of misinformation is yet another facet of the problem, as many people who use benzodiazepines don’t believe that the drugs are as dangerous as they in fact are. Yet another factor that has led to the many overdoses is the fact that benzo addiction can proceed for quite a long period of time before a person comes to the realization that they need to seek help for their dependence on the meds.
Addiction to benzodiazepines is a critical and terribly dangerous problem facing our country. If you are in need of help overcoming your benzo addiction, call on our compassionate team. At Maryland Recovery, we take benzo dependency just as seriously as other addictions.
Dr. Bhalavat is Board Certified in General Psychiatry and Addiction Medicine, and provides inpatient evaluation and consultation services at the University of Maryland Upper Chesapeake Medical Center, University of Maryland Harford Memorial Hospital, Maryland Recovery Partners, and Citizens Care & Rehabilitation Center. Dr. Bhalavat’s background includes treatment of depression, anxiety disorders, schizophrenia spectrum disorders, bipolar disorder, substance abuse and dementia.
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