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Benzodiazepines and alcohol are both central nervous system depressants and are highly addictive. The main reason why people combine benzos and alcohol is that they have developed tolerance to either alcohol or benzos. Tolerance to an addictive substance means your brain and body demand more of the substance to get high. When taking several benzos doesn’t get a person high anymore, they may start combining alcohol and benzos. Alternatively, an alcoholic may take benzos to enhance the effects of alcohol.
But mixing benzos and alcohol can be deadly. According to the National Institute on Drug Abuse (NIDA), overdose deaths attributed to benzos and alcohol frequently occur because of the following:
- The misconception is that since benzodiazepines are prescribed by a physician, they are safer to abuse than “street” drugs
- The fallacy is that since alcohol is readily accessible, affordable, and legal, it is a relatively harmless way to enhance the effects of benzos and other opioids
- People with an alcohol use disorder (AUD) seem to experience stronger psychoactive effects from benzos so consequently, the risk of overdosing on alcohol and benzos is significantly higher in those with AUD.
What are Benzodiazepines and Why Are They So Addictive?
Benzodiazepines are one of the most prescribed drugs in the U.S. The latest information provided by the CDC reports that over 65 million benzodiazepine prescriptions were written between 2014 and 2016. While the number of benzo prescriptions has decreased over the past several years, doctors are still routinely prescribing benzodiazepines for anxiety, insomnia, mood disorders, panic disorders, hypertension, and even metabolic disorders.
Brand names of most prescribed benzodiazepines include:
By enhancing the anti-anxiety effects of a neurotransmitter called GABA in the brain, benzos induce anxiolytic, sedative, and hypnotic feelings that make users experience a type of relaxing euphoria. Valium is also commonly given to patients before they undergo extensive dental or minimally invasive medical procedures. Ativan is often prescribed for insomnia and sleep disorders. To treat withdrawal symptoms in people recovering from alcoholism, physicians prescribe Librium because of its longer-acting properties.
Benzodiazepines are considered safe and effective when taken for no longer than 30 days. However, the potential for rapid addiction exists in people who may be genetically and/or psychologically predisposed to addiction. For example, individuals with a family history of mental illness and addictions (behavioral, food, Internet, etc.) may be at risk for becoming addicted to benzodiazepines in as little as two weeks.
How are the Effects of Alcohol Different from the Effects of Benzodiazepines?
Alcohol and benzos both activate GABA in the brain by acting as an agonist on GABA receptors. For this reason, both substances are labeled as central nervous system depressants that cause similar physical and mental effects—sedation, drowsiness, and loss of coordination. reduced impulse control and euphoria.
However, the long-term side effects of alcohol abuse differ from the long-term effects of benzodiazepines. For example, people who drink several times a day for a long time inevitably suffer one or more of the following:
- Heart disease
- Cognitive problems (memory, executive functioning)
- Hypertension
- Liver disease (cirrhosis)
- Pancreatitis
- Cancer (particularly esophageal, breast, colorectal, and liver cancer)
Alternately, long-term abuse of benzodiazepines increases one’s risks of:
- Severe cognitive impairment (significant decline in short-term memory, focus, concentration, and comprehension of verbal/written materials)
- Being involved in a car accident (people who drive while high on Benzos are comparable to people who drive while intoxicated)
- Personality changes similar to changes seen in dementia patients
- Reduced psychomotor abilities
When individuals with a benzo addiction complete a treatment program and stay sober, they typically find their cognitive abilities returning to normal. With alcoholics, this is not always the case. Alcohol does much more damage to the brain and body when abused. Unfortunately, this damage may be permanent.
How Long Does It Take to Become Addicted to Benzodiazepines?
Within days of taking benzodiazepines, the brain starts adapting to higher levels of GABA. Tolerance for benzos builds quickly, which compels users to take more pills than prescribed. When the original dosage no longer gives users the intense feeling of relaxation and euphoria they initially experienced, this indicates they have developed tolerance to the drug. Instead of two pills, users may now take three pills or tell their physician the pills are “not working anymore” and ask for a stronger benzodiazepine. Growing tolerance for any drug is a definitive sign of potential addiction.
Dangers of Combining Benzos with Alcohol
Risk of Overdose
Benzodiazepines not only accelerate and amplify the effects of alcohol but also impair a user’s ability to remember how much alcohol and benzos they’ve consumed. In most non-fatal overdose cases involving the mixing of alcohol and benzos, the individual simply forgot how many pills and drinks they consumed over some time.
Respiratory Depression
Central nervous system depressants like benzodiazepines and alcohol slow down the activity of all physiological systems. Respiratory depression deprives the brain and body of oxygen essential for normal functioning. Without enough oxygen, the brain starts shutting down, which leads to organs shutting down as well. Signs of acute respiratory distress syndrome (ARDS) include:
- Severe breathlessness/shortness of breath
- Labored breathing
- Confusion/delirium
- Tachycardia (rapid heartbeat)
- Lips and fingernails turn blue as blood oxygen levels drop
- Low blood pressure/shock
- Unconsciousness
- Respiratory arrest
Coma
Overdosing on a combination of benzos and alcohol can cause a coma when neurons stop signaling to other neurons in the brain. Respiratory distress, low blood pressure, and heart arrhythmia can also contribute to a comatose state from overdose. In some cases, an extreme lack of oxygen can force the heart to stop beating just before an overdose victim slips into a coma. Hypoxia (oxygen deprivation) interferes with chemical processes essential for brain functioning and cell activity throughout the body.
How is an Addiction to Alcohol and Benzodiazepines Treated?
Recovering from a dual addiction begins with completing a medical detoxification program. Detoxing involves staying in a hospital-like setting while you withdraw from drugs and alcohol. Medications are provided to ease symptoms and reduce cravings while supportive care is given as needed. Patients in detox are not discharged until they are healthy enough to enter an outpatient or inpatient treatment program.
If you are mixing alcohol and benzos, whether one day a week or several days a week, it’s likely a sign of a much larger problem than just a desire to get high. Consider the fact that it may be time to seek help for a life-threatening addiction. Call FHE today for immediate assistance with getting treatment for you or someone you know.
