Heartland Human Services

Benzodiazepine Warning:

Chasity Dunaway, CADC, LCPC

Benzodiazepines are a type of medication known as anxiolytics or tranquilizers or minor tranquilizers, as opposed to the major tranquilizers used to treat psychosis. Familiar names of these drugs include diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin), and alprazolam (Xanax). They are some of the most commonly prescribed medications in the United States. When people without prescriptions take these drugs for their sedating or intoxicating effects, then use turns into abuse. ◦Doctors may prescribe a benzodiazepine for the following legitimate medical conditions:
◦Anxiety and panic attacks
◦Insomnia (for only a brief period)
◦Alcohol withdrawal
◦Seizure control
◦Muscle relaxation
◦Inducing amnesia for uncomfortable procedures
◦Given before an anesthetic (such as before surgery)
•Benzodiazepines act on the central nervous system, produce sedation and muscle relaxation, and lower anxiety levels.
•Although more than 2,000 different benzodiazepines have been produced, only about 15 are currently FDA-approved in the United States. They are usually classified by how long their effects last. Types of benzodiazepines therefore include the following: ◦Ultra-short acting: midazolam (Versed), triazolam (Halcion)
◦Short-acting: alprazolam, lorazepam
◦Long-acting: chlordiazepoxide (Librium), diazepam

Benzodiazepines are commonly abused. This form of drug abuse is partially related to the toxic effects that they produce and also to their widespread availability. They can be chronically abused or, as seen more commonly in hospital emergency departments, intentionally or accidentally taken in overdose. Death and serious illness rarely result from benzodiazepine abuse alone; however, they are frequently taken with either alcohol or other medications. The combination of benzodiazepines and alcohol can be dangerous, even fatal.

Benzodiazepines have also been used as a "date rape" drug because they can markedly impair and even abolish functions that normally allow a person to resist or even want to resist sexual aggression or assault. In recent years, the detection and conviction of people involved in this practice has increased dramatically. The drug is usually added to alcohol-containing drinks or even soft drinks in powder or liquid forms and can be hard to taste.
The use of benzodiazepines during pregnancy is a risk factor for cleft lip or palate, lower muscle tone, and withdrawal symptoms in the developing fetus.

Benzodiazepine Abuse Symptoms and Signs

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:
◦Drowsiness
◦Confusion
◦Dizziness
◦Blurred vision
◦Weakness
◦Poor judgment and decision making
◦Slurred speech
◦Lack of coordination
◦Difficulty breathing
◦Coma
◦Death from respiratory arrest (ceased breathing)
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:
◦Anxiety
◦Insomnia
◦Anorexia
◦Headaches
◦Weakness
◦Tremors
◦Memory problems

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 Prevention

As is true in the prevention and treatment of most health problems, knowledge is power in preventing benzodiazepine abuse. Specifically, for example, educating individuals who are either being newly treated with benzodiazepines or have been prescribed a benzodiazepine for some time seem to be more often able to be appropriately taken off the medication when provided with sound information and encouraged to actively participate in the care for their condition and treatment. Psychologists advise those who have feelings of depression lasting more than two weeks to seek professional advice.  If you or a loved one are experiencing  any symptoms of depression, contact Heartland Human Services at 217-347-7179 or take a free screening at www.heartlandhs.org