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 anxiety, insomnia, loss of appetite, headaches, weakness, tremors, and memory problems.
Benzodiazepine Abuse Symptoms
At normal or regular doses, benzodiazepines relieve anxiety and insomnia. They are usually well tolerated. Sometimes, people taking benzodiazepines may feel drowsy or dizzy. This side effect can be more pronounced with increased doses.
- High doses of benzodiazepines can produce more serious side effects. Signs and symptoms of acute toxicity or overdose may include the following:
- Signs of chronic drug abuse can be very nonspecific and include changes in appearance and behavior that affect relationships and work performance. Warning signs in children include abrupt changes in mood or deterioration of school performance. Chronic abuse of benzodiazepines can lead to the following symptoms that mimic many of the indications for using them in the first place:
- Despite their many helpful uses, benzodiazepines can lead to physical and psychological addiction. Dependency on benzodiazepines can result in withdrawal symptoms and even seizures when they are stopped abruptly. Dependence and withdrawal occur in only a very small percentage of people taking normal doses for short periods. The symptoms of withdrawal can be difficult to distinguish from anxiety. Symptoms usually develop at three to four days from last use, although they can appear earlier with shorter-acting varieties. In addition to withdrawal, some other signs and symptoms of benzodiazepine addiction can include the following:
- The individual develops tolerance to the medication (for example, the same dose having diminishing effects/needing increasing amounts of the drug to achieve the desired effects).
- Larger amounts of the drug are taken or the drug is taken for longer than intended.
- The individual experiences a persistent desire to take the drug or has made unsuccessful attempts to decrease or control the substance use.
- Significant amounts of time are spent either getting, using, or recovering from the effects of the substance.
- The individual significantly reduces or stops participating in important social, recreational, work, or school activities as a result of using the substance.
- The individual continues to use the substance despite being aware that he or she suffers from ongoing or recurring physical or psychological problems that are caused or worsened by the use of the drug.
Benzodiazepine Abuse Causes
Although some people may have a genetic tendency to become addicted to drugs, there is no single cause for addiction. Some biological risk factors for benzodiazepine abuse include female gender and elderly age group. A noteworthy statistic about benzodiazepine abuse is that women are more likely than men to be prescribed and therefore exposed to a benzodiazepine compared to men. Being of the elderly age group is also a risk factor for the abuse of benzodiazepines since physicians may inappropriately prescribe benzodiazepines for elderly individuals with depressive symptoms.
There is little doubt that environmental factors also play a significant role. Some of the more common environmental influences for benzodiazepine abuse are low socioeconomic status, unemployment, and peer pressure.
Drug abuse, now also referred to as drug use disorders, refers to using substances, over-the-counter (OTC) medications, prescription drugs, or illegal street drugs for the purpose of getting high. Substance abuse can lead to significant, even life-threatening, health problems. It also increases the risk of accidents, suicide, unsafe sex, and violence. Teens are more likely to abuse substances if they suffer from depression, low self-esteem or impulse control, have a history of being abused, or family history of substance abuse. Teens who receive low parental supervision or communication, or who feel different than their peers are also at risk for drug abuse.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.