Early intervention is important if problematic use arises, such as seeking professional help or therapy to address stress or anxiety without over-reliance on medication. Complementary coping strategies, including mindfulness, counseling, or lifestyle changes, serve as effective alternatives to mitigate reliance on benzodiazepines. This drug can also cause life threatening breathing problems, sedation, or coma when used alongside opioid pain relievers, alcohol, or certain illegal drugs. Withdrawal from this type of prescription drug can be severe and even life-threatening, so a medically supervised drug detox is essential to prevent dangerous complications.
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There was no difference in the success rate of BZD discontinuation between the control and experimental groups in this case 72. Pregnant women and fetuses are at increased risk for adverse effects of withdrawal; they both metabolize BZD slowly, and the drug can cross the placenta to cause concentrations to build up to significant levels in the neonate 18. While a therapeutic dose has not been proven teratogenic, use during pregnancy has been linked to low birth weight, preterm labor, and intrauterine growth restriction. The unborn fetus is at high risk for alcoholism “floppy infant syndrome,” characterized by muscle laxity, failure to suckle, and oversedation. Approximately two weeks after birth, the infant experiences withdrawal consisting of continued difficulty feeding, high pitched cries, hyperexcitability, and consequently possible failure to thrive.
Management of benzodiazepine dependence in “therapeutic” users who wish to stop
Benzodiazepines act by enhancing the effect of gamma-aminobutyric acid on the GABA-A receptor, thereby resulting in CNS depression.1 They are anxiolytic, hypnotic, anticonvulsant and muscle relaxants. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may find the Benzodiazepines and Z drugs article more useful, or one of our other health articles.
Are medications for opioid use disorder safe to use during pregnancy and breastfeeding?
Similarly, middle-aged adults struggling with insomnia overuse benzodiazepines as a quick fix for sleep, unintentionally enabling addiction. Individuals recovering from other substance use disorders misuse benzodiazepines to alleviate withdrawal symptoms or enhance other substances’ effects, putting them at a higher risk of dependency. Despite the adverse effects of long term prescribing, benzodiazepine prescribing and use continues to escalate. This is largely because no superior alternative pharmacotherapeutic treatment has been developed to treat anxiety and insomnia. Benzodiazepines are fast acting and at least on initial prescribing are safe and predictable in their effects. It is possible that flumazenil may not only have application in the management of benzodiazepine withdrawal but may be able to manage some of the adverse iatrogenic effects and development of tolerance which occur with long term use.
A head CT without contrast may be considered to rule out an intracranial abnormality related to the patient presenting with an acutely altered mental status. Food and Drug Administration (FDA), benzodiazepines are categorized as a Pregnancy Category D or X drug, indicating there is evidence of risk to the fetus. It’s important that pregnant women only take these medications when the benefits outweigh the potential risks and under the guidance of a doctor who will evaluate safer alternatives. Benzodiazepine use leads to addiction because it alters the brain’s reward system, particularly by affecting neurotransmitters like GABA, dopamine, and serotonin. This results in a reinforcing cycle, where users feel compelled to take higher doses to achieve the same effect or prevent withdrawal symptoms.
The ultimate benzodiazepine withdrawal concern is that such fetuses will later be susceptible to autism, learning difficulties, attention deficit disorder, and general hyperactivity 24. One of the main categories of people with BZD prescriptions is those with insomnia. Manconi et al. explored the effects of long-term BZD use on sleep architecture and microstructure in those with insomnia. They found significant changes in sleep microstructure in chronic insomnia with high dosage abuse of BZD, but sleep architecture changes were not significant.
- Long-term use is defined as two or more months at a therapeutic dose and when used long-term, BZDs pose potential harmful effects.
- Benzodiazepines work by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain.
- They can provide guidance and support for managing dependence and finding alternative treatments for underlying conditions.
- In general, at higher doses (e.g. greater than 10 mg diazepam equivalents per day) the dose may be tapered more rapidly.
- This process is usually performed under medical supervision in a medical detox center to ensure safety and provide supportive care.
- Depending on patient characteristics, benzodiazepines can be withdrawn or the patient stabilised on a maintenance program.
Current studies are aimed to decrease this rebound anxiety effect while also decreasing relapse into BZD use using different medications, counseling, BZD dosing strategies, or different tapering techniques. The risk of falls leading to injuries in elderly BZD users is significantly increased in patients greater than 80 years old, while the increased risk is not significant in patients under 80 22. Passaro et al. described an increased risk of falls in elderly hospitalized patients prescribed short-acting BZD 23.
Read more about medications for opioid use disorders
Existing data suggest that the lifetime prevalence of tranquilizer and sedative use, which includes benzodiazepines and barbiturates in the United States, are around 1% and 1.1%, respectively. In 2013, 2% of the United States population (12 years or older) had consumed benzodiazepines or barbiturates for nonmedical use. From 1996 to 2013, benzodiazepine prescriptions increased by 2.5% each year, making it one of the most prescribed medications in the world.
What Are The Different Types Of Benzodiazepine Addiction?
- Glutamatergic and GABA neuroanatomical interplay suggests a possible role of glutamatergic sensitization in benzodiazepine tolerance and withdrawal.
- Given their lipid solubility, BZDs have a high volume of distribution in the body, which translates to higher tissue concentrations than blood.
- Information provided by NIDA is not a substitute for professional medical care or legal consultation.
Physical side effects may include drowsiness, confusion, slurred speech, and impaired coordination. Psychological side effects can manifest as depression, memory problems, mood swings, and a lack of motivation or interest in activities that were once enjoyed. Social and interpersonal side effects may include strained relationships, isolation, difficulties at work or school, and a decline in overall functioning. Other street names vary by region and the specific drug but are used to disguise their illegal trade or recreational use. Benzodiazepines work by enhancing the effect of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits excessive brain activity and promotes calmness.
If you or someone you know is struggling with benzodiazepine addiction, know that help is available. From sedative addiction treatment centers to Xanax addiction treatment programs, there are resources out there specifically designed to address this issue. Don’t be afraid to reach out – taking that first step towards recovery is an act of courage and self-love. Long-term recovery from benzodiazepine addiction is possible, but it requires ongoing effort and support. Relapse prevention strategies might include continued therapy, regular check-ins with a support group, and developing healthy coping mechanisms to replace the role benzos once played in your life. It’s like building a toolkit for life – the more tools you have, the better equipped you’ll be to handle whatever challenges come your way.
