A Guide to Benzodiazepine Addiction: Signs, Symptoms & Treatment

Benzodiazepines

Abusing benzodiazepines can cause serious harm, not to mention a deadly withdrawal syndrome should attempts be made to abruptly quit these drugs. Understanding how they work and their dangers could save a life, so read on to learn about benzo addiction and how to overcome it.

Benzodiazepine medications, or “benzos,” were responsible for nearly 9,000 overdose deaths in 2015, an 11% increase from 2014.¹ Of the 30 million people who used benzos in 2015, almost 5.5 million reported misusing them, and that’s a big problem.² They can be extremely difficult to quit, have the potential to be deadly if you try and quit cold turkey, and have severe consequences, including lethal overdose, especially when combined with other drugs like alcohol or opioids. Understanding what they are, how they work, and how to get help for benzo addiction is a vital part of staying safe.

What Are Benzodiazepines?

Benzodiazepines are prescription sedative medications, meaning they reduce or slow the activity of the central nervous system, including the brain. They are prescribed to treat a number of issues related to too much activity in the brain, including anxiety, insomnia, epilepsy, and muscle problems. Some common benzos include:³

• Xanax (alprazolam).
• Valium (diazepam).
• Librium (chlordiazepoxide).
• Ativan (lorazepam).
• Rohypnol (flunitrazepam), often called “roofies”.

Their psychoactive effects relate directly to the slowing of brain activity. Different benzos will have different properties, including how long it takes for their effects to kick in, how long they last, and even what their exact cocktail of effects will be.³ Some benzos may be rapid-onset, and shorter-acting, meaning their effects come on relatively quickly and wear off quickly as well. Others might have a slower-onset of action, and be longer-acting, meaning that the effects take a while to come on and can last for longer periods.

The most common benzodiazepine effects include:³

• Anxiety relief.
• Muscle relaxation.
• Extreme sleepiness.
• Amnesia (memory loss).

There are more than 15 different types of benzodiazepine medications, each impacting the user in slightly different ways to alleviate specific medical and mental health conditions. These drugs provide incredible medical help to many people, and the number of prescriptions seems to be on the rise.⁴ Unfortunately, benzodiazepine overdoses also seem to be increasing, so it is extremely important to understand these drugs and why abusing them can be so risky.⁴

Are Benzos Dangerous?

Benzodiazepines should be safe when taken as prescribed, but when they are misused, they can quickly turn dangerous. Because they reduce or slow activity in the brain, their effects can result in harm, especially if you try to do something risky while high (like driving).

Taking a benzodiazepine outside of prescription guidelines is considered abuse. This includes taking it:

• With other drugs.
• In higher doses than prescribed.
• More frequently than prescribed.
• In ways other than directed (e.g., snorting).
• Without a prescription altogether.

Abusing benzodiazepines is dangerous not only in the short term but the long run as well. The drowsiness, memory loss, confusion, motor control problems, and blurry vision may not seem like a big deal at first, but these effects can limit your ability to function in your work and home life, and the more you abuse benzos, the more problems you’ll have.

Nearly 426,000 emergency department visits in 2011 involved the use of benzos.⁵ Of those visits, almost 30% also involved alcohol.⁵ In fact, one of the most dangerous things you can do when taking a benzo is combine it with another drug that slows your central nervous system, like alcohol or opioids (i.e., heroin or painkillers). These combinations have a very high potential for abuse and often elicit the most dangerous symptoms due to their additive, or combination, effects. When taken together, the deadly effects of these other depressants, like slowed breathing and heart rate, are enhanced by the co-use of a benzo.^3,6,7

You might also be surprised to know that you can develop a cross-tolerance with benzodiazepines, a phenomenon where a tolerance to one drug produces tolerance to another.³ Tolerance means that you need increasing doses to feel the effects you used to feel. As you increase your tolerance to benzos, you will simultaneously build a tolerance to the effects of alcohol and barbiturates. For example, if you have already built up a tolerance to the effects of Xanax because you've been abusing it, you might find that alcohol seems to have a diminished effect. This may lead you drink more than you normally would, upping your risk of alcohol poisoning and the many other dangerous depressant effects that the combination of these drugs can bring about.

Even though taking them with other drugs is one of the riskiest aspects of benzo abuse, even taking these drugs alone can be a threat to your health if you’re misusing them. Eventually, you may even become dependent on them and need them simply to function normally. Being dependent on a drug often includes experiencing extremely unpleasant withdrawal symptoms when you don’t take it or you cut back your dose.

In the case of benzos, withdrawal can be severe. In fact, benzodiazepine withdrawal is one of the few potentially deadly withdrawal syndromes. Many of the symptoms of benzo withdrawal reflect the opposite of their psychoactive effects. Think about it this way: when you take a benzo, you experience the effects of decreased brain activity (relaxation, calmness, sleepiness), but when you are in withdrawal from benzos, your brain experiences more activity than it is used to, which can lead to symptoms like:8

• Anxiety.
• Insomnia.
• Body tremors
• Deadly seizures.

If you are planning to detox from benzos, you must have proper medical care throughout the process to stay safe.

It’s important to realize that while a building tolerance and physical dependence can and likely will occur among those who take the drugs according to their prescriptions, they are also diagnostic criteria for a sedative use disorder, commonly called addiction, a disease that can wreak havoc on your body, mind, and life. Continue reading to learn about other signs that you or someone you love may be addicted to benzodiazepines.

Signs and Symptoms

There are many signs that a person is abusing benzodiazepines. If you’re unsure whether you or someone else has a problem with benzo abuse, the following lists of signs and symptoms may help you get a better idea of the severity of the situation.

Physical Symptoms

Benzos can have a powerful impact on the body. Certain symptoms of abuse will be apparent to an outside observer, while others will only be felt by the user. Some of the most common symptoms of benzodiazepine abuse include:³

• Problems with coordination.
• Muscle weakness.
• Extreme drowsiness.
• Vision problems.
• Slurred speech or stuttering.
• Body tremors (shaking).
• Vertigo (extreme dizziness).
• Slowed reflexes.
• Slowed breathing.
• Dry mouth.

Psychological Symptoms

The effects of benzos can also extend into the user’s psychological well-being. They certainly exert their calming, relaxing effects, but they can also cause a range of other more dangerous symptoms:3

• Reduced ability to think clearly.
• Memory problems.
• Extreme confusion or disorientation.
• Mood swings.
• Hostile or unpredictable behavior.
• Depression.

Signs of a Benzo Abuse Disorder

Even with the distressing physical and psychological side effects listed above, many people continue to abuse benzos. Some even develop an addiction to them. It is important to recognize when problematic benzodiazepine use actually crosses the line into addiction. It may be time for you to get treatment if:⁹

• You consistently take more benzos than you planned to.
• You crave benzos.
• You use them for longer than you meant to.
• You spend a lot of time trying to get them, use them, or recover from their effects.
• You lie about your use.
• You feel defensive when asked about your benzodiazepine use.
• Your use of benzos has hurt your work, school, or home life.
• You continue to use benzos despite interpersonal or social problems related to your use.
• You want to stop using or cut back but can’t seem to follow through.
• You use benzos in situations where it is physically dangerous, like driving.
• You feel generally unsatisfied with life.

Long-Term Consequences

Beyond the ravages of addiction, long-term use and abuse of benzodiazepines has been linked to numerous troubling consequences to a user’s health. Some of the most concerning of these are the effects on the brain’s functioning. Long-term benzo abuse has been found to cause problems with:10, 11

• Visuospatial abilities (hand-eye coordination).
• Verbal learning and memory.
• Sensory processing.
• Attention/concentration.
• Working memory (like recognition or short-term memory).
• Problem-solving.
• Body movement control.

Some of these cognitive impairments may improve with time after an individual completely stops using benzodiazepines.¹¹

What Happens During Benzo Withdrawal?

Benzodiazepine withdrawal could kill you. You should not, in any situation, try to detox from benzos without professional help.

Detox professionals will know what to expect and how to handle potentially dangerous symptoms so that you can get through withdrawal as safely and comfortably as possible.

Managing Symptoms through Detox

Detoxing from a drug means clearing it out of your body through a period of abstinence. Many drugs, including benzodiazepines, have a withdrawal syndrome that arises during detox as your body adjusts to not having a regular supply of drugs. The benzo withdrawal syndrome can be uncomfortable at best and lethal at worst. Having an idea of what to expect can help you mentally prepare for what’s to come.

During benzodiazepine withdrawal, you may experience symptoms such as:⁸

• Difficulty sleeping.
• Irritability.
• Heightened anxiety.
• Panic attacks.
• Uncontrollable shaking of the hands.
• Excessive sweating.
• Trouble concentrating.
• Nausea and dry heaving.
• Irregular heartbeat.
• Weight loss.
• Headaches.
• Muscle pain and stiffness.
• Seizures.
• Psychotic symptoms.

These symptoms can start as early as 1-4 days after use is stopped and may last for approximately 10-14 days.⁸

How Is Withdrawal Treated?

As your body is clearing itself of benzos, you may find that you are facing many different challenges: physical discomfort, psychological issues, or cravings. Working through detox and treatment in a professional program can make a huge difference in your recovery. Not only can these programs keep you alive during withdrawal, they can help reduce these discomforts as much as possible.

During a formal detox or treatment program, you will likely be tapered off benzodiazepines slowly. What this means is that the dose is reduced bit by bit until you have removed benzos from your body completely. During this process, you may be given another longer-acting benzodiazepine to keep you safe while the drug of abuse is cleared. This process of tapering is not only safer than a “cold-turkey” approach, it can be much more comfortable. Slowly reducing your benzo intake may help alleviate extreme cravings and ease you back into sobriety with as little physical and psychological distress as possible.

The process of detox utilizing medical care is commonly referred to as “medically monitored,” “medically assisted,” or simply, “medical detox.” We cannot emphasize the importance of medical supervision and intervention during detox from benzodiazepines enough. These drugs are not like opioids, which will cause an uncomfortable flu-like withdrawal that you can tough out on your own. You need professional care during acute benzodiazepine withdrawal.

On top of this, supervised detox programs can provide psychological, emotional, and social support during this critical first step in your recovery. The anxiety and depression that can accompany benzodiazepine detox can be difficult to cope with alone, and professionals have useful techniques to help you get through especially challenging phases.

Why Is Treatment Needed?

One of the most dangerous things you can do to try and get clean from benzodiazepines is go it alone. You could get so uncomfortable that you relapse—or worse, you could die. The numerous physical and psychological strains that benzo detox and recovery can put you through make recovering alone extremely difficult. It can be all too easy to go back to abusing them just to make the awful withdrawal symptoms stop, but this is a step backward.

In a treatment program, you will be on a clear path to sobriety, with set action plans for the times when you’re faced with particularly strong cravings or temptations to use. Once the detox period is complete, you will begin working through formal addiction treatment to build up your abstinence skills to maintain long-term sobriety.

Treatment Options for Benzo Addiction

One of the first considerations you’ll have when selecting a treatment program is whether you prefer an inpatient or outpatient environment. Detox should always take place in a facility that can provide adequate medical care, but when it comes to post-detox treatment, you can choose to live at home or stay at a treatment center.

Outpatient programs involve regular check-ins with the treatment program for group and individual therapy sessions, all the while allowing you to continue to live and sleep at home. These programs tend to cost a little less than inpatient programs, but they do not provide the same level of around-the-clock care. Many people find that beginning their treatment in an outpatient program can be difficult, as they are unable to escape the triggers to use that come with living in the environment where they did drugs. However, for some, leaving home is simply not an option due to certain responsibilities or financial limitations. In this case, outpatient programs are the best option for recovery.

Inpatient programs involve staying at the treatment center throughout your duration of treatment. You will work through recovery challenges in an entirely sober environment, free of your normal triggers. These programs allow you to take a step away from your everyday life and stressors so that you can focus entirely on strengthening your recovery skills. As an added benefit, you’ll be able to build a sober support network, as you’ll live with people who are going through similar struggles and building new sober lives.

During treatment, whether inpatient or outpatient, you will work through group and individual therapy. These sessions will help you identify why you began abusing benzodiazepines in the first place and how you can resist future cravings. Some common therapy techniques that treatment programs use include:

• Cognitive-behavioral therapy: You will learn how to identify high-risk situations and develop action plans to avoid relapse and cope with cravings.
• Contingency management: You will earn rewards for reaching recovery goals, like staying sober for a certain amount of time or passing a clean urine test.
• Family therapy: You will work with a therapist to heal family relationships and better understand each other’s struggles and points of view.

Dual Diagnosis

Many people who struggle with benzodiazepine addiction started with a prescription. Because these are anti-anxiety medications, benzodiazepine abusers may also be struggling with anxiety or mood disorders.¹² Having both a substance use disorder (addiction) and a mental health disorder is called a dual diagnosis. Learning how to cope with a dual diagnosis takes special care. Treatment has to address both issues at the same time.

Because co-occurring disorders take extra care, if you have a dual diagnosis, make sure you look for programs that offer specialized care to comprehensively address your needs.

How to Quit Abusing Benzodiazepines Today

Working your way out of benzodiazepine addiction is a serious challenge, and you shouldn’t have to do it all alone. We’ve been there, we understand the struggles you are facing, and we want to help! Finding your way to a life free from the bonds of benzo addiction is absolutely worth the fight.

We are available 24 hours a day, 7 days a week, just waiting to help you get started on the path to recovery. Healing from addiction is possible. Reach out today.