Symptoms and Signs of Benzodiazepine Abuse

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 9/16/2021

Doctor's Notes on Benzodiazepine Abuse

Benzodiazepines are a type of medication known as anxiolytics or tranquilizers and they act on the central nervous system, producing sedation, muscle relaxation, and lower anxiety levels. Benzodiazepines are commonly abused for their sedative effects. Benzodiazepines are prescribed to treat anxiety and panic attacks, insomnia, alcohol withdrawal, seizures, muscle relaxation, and may be given before surgery. Commonly prescribed benzodiazepines include diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin), chlordiazepoxide (Librium), and temazepam (Restoril).

Side effects of high doses benzodiazepines or benzodiazepine overdose may include

  • drowsiness,
  • confusion,
  • dizziness,
  • blurred vision,
  • weakness,
  • poor judgment and decision making,
  • slurred speech,
  • loss of coordination,
  • difficulty breathing,
  • coma, and
  • death from respiratory arrest (ceased breathing).

Symptoms of chronic abuse of benzodiazepines can include

What Is the Treatment for Benzodiazepine Abuse?

Benzodiazepine abuse requires a multifactorial treatment plan, including the willful participation of the patient. Tapering with eventual abstinence, or drug substitution to either a less addictive benzodiazepine or another drug class are mainstays of treatment. High-risk patients with long-term addiction or abuse may do better with inpatient residential rehab treatment or intensive inpatient addiction services. 

Strategies for treatment of benzodiazepine abuse may include:

  • Tapering of amount and dose until abstinence
    • Lower and lower dose with less frequency until the medication is no longer needed
  • Low dose flumazenil
    • Given as a shot or infusion under a monitored setting over four days
  • Antiseizure medication substitution
  • Psychotherapy
    • Use with tapering the dose or drug substitution has been shown to be more effective than either approach separately
  • Maintenance therapy
    • Some patients cannot get off benzodiazepines and need to be on low-dose chronic medication therapy supervised by their healthcare provider

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.