The crisis of addiction to prescription opioids — and the accompanying grave statistics about overdose and related deaths — has overshadowed another class of prescription drugs that has proven to be extremely dangerous and addictive: benzodiazepines.
These prescription medications, often prescribed to treat anxiety, depression and a range of other mental and physical disorders, have a lot of similarities to opioids in their addictive nature and likelihood to be abused, even when a person is originally prescribed them.
In this piece, we’ll discuss the ins and outs of benzo addiction, including how addictive drugs of this class are, the long-term effect on the body and when treatment is necessary.
What Is Benzo Addiction?
Like addiction to any other drug, addiction to a benzodiazepine means that your body and brain begin to function as if they need the drug at all times. At this point, if a person stops taking benzos, their body will go into withdrawal and they would experience powerful cravings for the drug (or another drug of the same type).
To understand how addiction happens from benzo use and abuse, it makes sense to talk a little about why they’re prescribed. In the 1950s, when the first benzodiazepine was developed, it was supposed to be a less addictive (and less dangerous) alternative to the previous standard treatment: prescription barbiturates. Consequently, benzos are now far more likely than their predecessors to be prescribed for depression, anxiety, panic disorders, bipolar disorder and other mental health conditions.
Benzodiazepine abuse affects the body in a similar way as heavy alcohol consumption does. When the drugs are consumed, molecules bind to GABA receptors in the brain, stimulating the removal of dopamine inhibitors. Dopamine, a neurotransmitter that causes feelings of pleasure and euphoria, is released in high concentrations, decreasing the negative emotions that cause depression, anxiety and other mental health conditions.
Simply put, benzos make the user feel good, which is why they’re candidates for abuse and, over time, addiction.
How Does Benzo Use Turn Into Benzo Addiction?
The invention of benzos as a safer alternative to barbiturates in treating mental health disorders like depression and anxiety was, in general, a success. However, as of 2013, benzos were involved in 31% of overdose deaths due to the massive availability of prescriptions as well as users’ tendency to mix benzos with other drugs.
Because of their addictive potential, benzos are often prescribed for a shorter term than other drugs. If a person is diagnosed with an anxiety disorder, for example, a doctor will likely start them on benzodiazepine to address acute symptoms of the disorder at the same time as an SSRI antidepressant, which takes a longer time to present its effects.
Like other addictive prescription drugs — opioid pain pills, for example — benzos are often used as prescribed at first but then cause the user to become dependent on them. This is because dependency and even addiction can take hold more quickly than patients are taken off of their prescriptions. It’s recommended that benzo prescriptions only be written for one to two weeks because symptoms of withdrawal from the drug can be experienced after only three or four.
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How Many Benzos Are Addictive?
Are benzodiazepines addictive, and if so, which ones? The answer is simple; all benzodiazepines are addictive, but there are variations in how different people respond to the influence of different formulas within the class. Different benzos are also designed to produce their effects over different lengths of time. Short-acting benzos include brand names Versed and Halcion, which remain active for between three and eight hours, depending on the user. Xanax and Ativan are two examples of drugs that stay in the system longer — 11 to 20 hours on average.
There are also long-acting benzos, including Klonopin — one of the most commonly prescribed for acute and anxiety and depression — as well as Valium and Librium.
There are no fully non-addictive benzodiazepines, but there are alternatives to treating anxiety and depression, including SSRIs (most well-known prescription antidepressants like Lexapro, Prozac and Zoloft) and SNRIs.
What Are Benzo Addicts Chasing?
A large proportion of benzo addicts start down their road to addiction on a well-meaning quest to improve their mental health. The problem starts to arise when they try to get off of the drug, and they start experiencing cravings or early symptoms of physical withdrawal and find themselves in the grips of addiction.
Others start off by abusing the drug, either as a means for coping or an avenue to get high. The former is due to benzos acting in a similar way to alcohol, causing a quick release of dopamine and a way to dissociate from stress, trauma and countless other negative influences in life. The latter is usually the result of a parent not keeping their prescriptions out of reach of teenage children who may experiment with pills and end up forming a habit.
Long-Term Health Effects of Benzo Addiction
Like other addictive substances, benzodiazepines enact changes in a user’s brain. Over long-term use, these changes are at risk of becoming more permanent. Part of the reason for this is because the longer benzos are taken, the more of a tolerance they cause in the user. If a person starts on a certain dosage per month, they’ll eventually have to increase the amount they take to get the same effects.
People who take benzos often feel as though they’re living in a haze, something that may become permanent over time to a degree. Other reflexes of the body that are controlled by the central nervous system may slow down or stop entirely. These may include libido, pain response, emotional response and other crucial human functions.
Consequences of Stopping Benzos
If someone who is addicted to benzos stops taking them abruptly, the consequences will take the form of benzodiazepine withdrawal. This describes the series of negative symptoms that an addict experiences when they stop taking their drug of choice. This is the reason why people who are addicted to any substance have a hard time quitting. When they try, they experience severe negative side effects and powerful cravings that convince them to keep using.
Withdrawal isn’t the only negative aspect of abruptly quitting benzodiazepines, however. There’s a phenomenon called “rebound anxiety,” in which people who suddenly stop taking their anxiety medication experience their condition in greater severity than they did before they started taking benzos. There’s also “benzo belly” a condition that isn’t experienced by all users but that can cause long-term bloating, abdominal pain and loss of appetite for up to a year after ceasing these drugs.
Why Benzo Addiction Needs Treatment
Based on the fact that benzodiazepines are considered to be highly addictive and also that long-term use carries significant health risks, treatment for benzo dependency cannot happen quickly enough. Like other prescription drugs, benzos may be difficult to quit if the user is worried about the consequences of abstaining, but when faced with the alternatives, it may be the best possible choice.
Over time, as addiction sets in, it becomes harder and harder to quit. People taking benzos because they need them shouldn’t look at them as a long-term solution. Rather, they should be viewed as something that treats acute symptoms of a wide range of diseases while a more sustainable solution like slow-acting antidepressants or the benefits of therapy take effect.
If you or a loved one have taken a benzodiazepine — whether prescribed or not — for longer than three to four weeks, you could be at risk, but at FHE Health, we’re here to help. Reach out today to learn about your options.