Drug and Alcohol

Benzodiazepines: What Are Benzos, Side Effects, & Risk

What are benzos? These commonly-prescribed tranquilizers can be very dangerous when abused. Learn more about benzodiazepines in our blog.

Benzodiazepines: What Are Benzos, Side Effects, & Risk

Table of contents

Written by

Brian MooreBrian Moore

Content Writer

Reviewed by

Jeremy ArztJeremy Arzt

Chief Clinical Officer

March 31, 2023

The Edge Treatment Center

Benzodiazepine abuse and addiction have become serious public health issues in the United States in recent years. In order to address the rising rates of benzodiazepine abuse, healthcare professionals, policymakers, and communities must collaborate to raise public awareness of the risks and dangers of these medications, improve prescribing practices, and improve access to evidence-based treatment for those who require it.

By the Numbers:

According to data from the National Institutes on Drug Abuse's 2015–2016 National Surveys on Drug Use and Health, approximately 12.5% of Americans use benzos. This is roughly 30.5 million people. About 2.1% of them abuse these medicines. A little over 11.8 percent of people who misused benzos did it to get high, while others did it because they were addicted.

Just 20% of those who abuse this medication obtained it with a prescription from their doctor, indicating that many do not have one.

What are Benzos?

Benzodiazepines (often abbreviated as "benzos") are psychoactive drugs. Its properties include anxiolytic (anxiety-reducing), sedative, hypnotic, anticonvulsant, and muscle relaxant properties. In addition, they enhance the activity of the neurotransmitter gamma-aminobutyric acid (GABA), the primary inhibitory neurotransmitter in the central nervous system.

Benzodiazepines are among the most widely prescribed medications in the world. They are used to treat various conditions, including anxiety disorders, panic disorders, insomnia, seizures, muscle spasms, and alcohol withdrawal syndrome. Some of the commonly prescribed benzodiazepines include diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax), clonazepam (Klonopin), and temazepam (Restoril).

While benzodiazepines can be very effective in treating the conditions for which they are prescribed, they can also be habit-forming and can lead to dependence and addiction. Long-term use of benzodiazepines can also lead to a range of side effects, including drowsiness, confusion, impaired coordination, memory problems, and mood changes.

Additionally, benzodiazepines can interact with other drugs and alcohol, increasing the risk of overdose.

What are Street Names for Benzos?

Benzos often go by street names, especially when they're being sold illegally. Note: buying benzos from street dealers is incredibly risky. There are numerous counterfeit benzo pills out there, many of which are tainted with fentanyl. Some names include:

  • Footballs

  • Xannies

  • Xans

  • Totem poles

  • Handlebars

  • Z bars

How do Benzos Work?

Benzos are a class of psychoactive drugs commonly used to treat anxiety, insomnia, seizures, and other conditions. They work by enhancing the activity of a neurotransmitter in the brain called gamma-aminobutyric acid (GABA), which is responsible for inhibiting the activity of other neurotransmitters.

There are four kinds of benzos:

Amnestic Benzos

These benzos stop new memories from being formed (their name is derived from the Greek word for "forgiveness").

Anxiolytic Benzos

These benzos are used to treat anxiety. Again, this is reflected in the name: "anxio" is Greek for anxiety; "lytic" is Greek for "to loosen."

Hypnotic Benzos

Named for Hypnos, the Greek god of sleep, these benzos help make people feel sleepy.

Sedative Benzos

Named after the Latin word for "to settle," these benzos help slow down the nervous system.

Benzodiazepines bind to specific sites on the GABA-A receptor, an ionotropic receptor found throughout the brain. When benzodiazepines bind to these sites, they increase the affinity of GABA for its binding site on the receptor, which increases the activity of GABA in the brain. This leads to an overall reduction in the activity of other neurotransmitters, which results in a calming and sedative effect.

In addition to enhancing the activity of GABA, benzodiazepines also have anxiolytic (anti-anxiety), hypnotic (sleep-inducing), anticonvulsant (anti-seizure), and muscle relaxant properties. They achieve these effects through a variety of mechanisms, including:

  • Increasing the threshold for excitation in neurons, making it more difficult for them to fire action potentials and transmit signals

  • Reducing the rate of neurotransmitter release, thereby decreasing the number of neurotransmitters available to bind to receptors

  • Increasing the sensitivity of GABA receptors to GABA further enhances the inhibitory effects of GABA on neurotransmitter activity

  • Increasing the activity of certain neurotransmitters, such as dopamine, in specific areas of the brain can produce euphoria or other mood-altering effects

Benzos can also be classed in these ways:

  • Duration: Benzos can last for varying lengths of time. Short-acting benzos only last for a few hours but can be very strong. Long-acting benzos are often less strong but can last for a few days.

  • Strength: Benzos also come in different strengths. Here's an example: 0.25 mg to 0.5 mg of clonazepam is as strong as 15 mg to 30 mg of flurazepam.

Why do People use Benzos?

Benzodiazepines act as central nervous system depressants. As a result, healthcare professionals commonly prescribe them to treat a range of medical conditions, including:

Anxiety Disorders

Benzodiazepines are commonly used to treat anxiety disorders, such as generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder. These drugs enhance the activity of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain, which helps reduce anxiety and promote relaxation.

Benzos used to treat anxiety include:

  • Dalmane (Flurazepam)

  • Klonopin (Clonazepam)

  • Librium (Chlordiazepoxide)

  • Prasom (Estazolam)

  • Tranxene (Clorazepate)

  • Valium (Diazepam)

  • Xanax (Alprazolam)

Insomnia

Benzodiazepines are often used to treat short-term insomnia, as they can help to improve sleep quality and reduce the time it takes to fall asleep. However, they are generally not recommended for long-term use, as they can be habit-forming and may lead to dependence and withdrawal symptoms.

Benzos used to treat insomnia include:

  • Ativan (Lorazepam)

  • Dalmane (Flurazepam)

  • Doral (Quazepam)

  • Halcion (Triazolam)

  • Klonopin (Clonazepam)

  • ProSom (Estazolam)

  • Restoril (Temazepam)

  • Valium (Diazepam)

Seizures

Benzodiazepines can be used to treat seizures, particularly in emergencies. They work by increasing the activity of GABA in the brain, which helps to reduce the electrical activity that can lead to seizures.

Benzos used to treat seizures include:

  • Ativan (Lorazepam)

  • Klonopin (Clonazepam)

  • Valium (Diazepam)

Muscle Spasms

Benzodiazepines can be used to treat muscle spasms and stiffness, particularly in people with conditions such as multiple sclerosis, cerebral palsy, or spinal cord injuries. They work by relaxing the muscles and reducing muscle tension.

Alcohol Withdrawal

Benzodiazepines can be used to manage the symptoms of alcohol withdrawal, including anxiety, agitation, and seizures. They work by reducing the hyperactivity in the brain that can occur during alcohol withdrawal.

Benzos used to treat alcohol withdrawal include:

  • Ativan (Lorazepam)

  • Librium (Chlordiazepoxide)

  • Serax (Oxazepam)

  • Valium (Diazepam)

Sedation

Benzodiazepines can be used to induce sedation before medical procedures, such as surgery or diagnostic tests. They work by slowing down the activity in the brain and promoting relaxation.

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What are the Most Commonly Prescribed Benzos?

Many benzos are regularly prescribed in the US:

  • Ativan, Loreev (Lorazepam): Used for treating seizures, chemotherapy complications, and anxiety. It's also used as an anesthetic. Lorazepam is also the most commonly-prescribed benzo.

  • Estazolam: Used to treat insomnia

  • Flurazepam: Used to treat insomnia

  • Halcion (Triazolam): Used to treat insomnia.

  • Klonopin (Clonazepam): Used to treat anxiety and seizures.

  • Nayzilam, Seizalam (Midazolam): Used to sedate people on ventilators, treat seizure disorders and as an anesthetic.

  • Restoril (Temazepam): Used to treat insomnia.

  • Valium, Valtoco, Diastat (Diazepam): Used to treat seizures, muscle spasms, and withdrawal from alcohol.

  • Xanax (Alprazolam): Used to treat panic disorder, anxiety disorders, and premenstrual dysphoric disorder.

Are There Any Illegal Benzos?

Benzos aren't really illegal; they're controlled substances that require a prescription or a license to legally possess. However, there is one benzo that's illegal in the US: flunitrazepam. Better known as Rohypnol, this is a drug that is often used as a "date rape" drug to faciliate sexual assault.

What are Nonbenzodiazepines?

Nonbenzodiazepines are a class of drugs that act similarly to benzos but are thought to be less dangerous and addictive than benzos. Often called "Z-drugs," these were introduced to the market in the 1990s. Currently, they're only approved to treat insomnia.

Common nonbenzodiazepines include:

  • Ambien (Zolpidem)

  • Sonata (Zaleplon)

  • Lunesta (Eszopiclone)

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Are Benzos Effective?

Yes, when used correctly, benzos are effective and can help people live normal lives. Benzos are well-studied and have been available since the 60s. They're also safer than the drugs they've largely replaced: barbiturates. Barbiturates had serious side effects, were extremely addictive, and were easy to overdose on.

Benzos also treat a wide variety of conditions, and there's even an antidote. Flumazenil helps reverse benzo overdoses.

Are There Downsides to Benzos?

Unfortunately, benzos come with many risks. They're addictive and have the potential to be abused. It can be dangerously easy to overdose on benzos as well, especially when they're mixed with other drugs like alcohol.

Should I Avoid Taking Benzos?

This is a question that's best answered by a doctor. Benzos can have nasty interactions, especially with prescription opioids. Also, pregnant people shouldn't use benzos, either. Finally, people who have movement disorders should be aware that benzos can affect a person's balance and coordination.

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What are the Symptoms of Addiction to Benzos?

Drugs in the benzodiazepine class have a high potential for addiction and dependency. When someone becomes addicted to benzodiazepines, they may experience a range of symptoms that can affect their physical and mental health, relationships, and overall quality of life.

Here are some of the common symptoms of addiction to benzodiazepines:

  • Tolerance: Over time, the body can become tolerant to the effects of benzodiazepines, which means that higher doses are needed to achieve the same effect.

  • Withdrawal symptoms: When someone tries to stop or reduce their use of benzodiazepines, they may experience a range of withdrawal symptoms, including anxiety, insomnia, tremors, sweating, nausea, vomiting, and seizures.

  • Cravings: People with a benzodiazepine addiction may experience strong cravings for the drug, which can be difficult to resist.

  • Loss of control: People with a benzodiazepine addiction may find that they cannot control their drug use, despite negative consequences such as relationship problems, financial difficulties, and health issues.

  • Obsession with obtaining and using the drug: People with a benzodiazepine addiction may spend a lot of time and effort obtaining and using it, to the point where it interferes with their daily life and responsibilities.

  • Social withdrawal: People with a benzodiazepine addiction may withdraw from social activities and relationships, preferring to spend time alone or only with others who also use the drug.

  • Cognitive impairment: Chronic benzodiazepine use can impair cognitive function, including memory, attention, and decision-making.

  • Mood changes: Benzodiazepine addiction can also cause mood changes, including depression, irritability, and anxiety.

Thus, benzodiazepine addiction can seriously affect a person's health and well-being.

How Long Do Benzos Stay in the System?

The class of benzodiazepines is frequently prescribed to address disorders like insomnia and anxiety. They can have a long half-life, meaning they may remain in the body for an extended period after use.

The exact duration that benzodiazepines stay in the system can vary depending on several factors, including the specific drug used, the dosage, the individual's metabolism, and other personal factors.

The half-life of benzodiazepines can range from a few hours to several days. The half-life refers to the amount of time it takes for the body to eliminate half of the drug from the bloodstream. For example, the half-life of alprazolam (Xanax) is typically around 12 hours, while the half-life of diazepam (Valium) can range from 20 to 50 hours.

However, even after the half-life has passed, benzodiazepines can still be detected in the body for several days to weeks, depending on the sensitivity of the testing method used. For example, some drug tests can detect benzodiazepines in urine for up to a week after use, while others can detect them in hair samples for up to 90 days.

Thus, chronic use of benzodiazepines can lead to accumulation in the body, which can prolong the drug's effects and increase the amount of time it takes for the body to eliminate it.

The length of time that benzodiazepines stay in the system can vary widely depending on several factors.

Withdrawal From Benzos: A Timeline

Benzo withdrawal can be a difficult process. Symptoms can be intense, and in extreme cases, even include seizures. In general, benzo withdrawal begins very quickly after the drugs were last used. For fast-acting benzos like Xanax, symptoms can start in mere hours.

Another complication of benzo withdrawal is rebound anxiety. Benzos are often prescribed to treat mental disorders like anxiety, and when benzos use is stopped without tapering off, it's not unusual for anxiety symptoms to return, often in greater severity. This is the reason benzo detox should never be done alone. Detoxing from benzos should always be done in a professional setting for safety. Plus, it's more likely to be successful.

In general, withdrawal symptoms from benzos peak a week after the drug was last used, and taper off after that. However, for some benzo withdrawal can last for over a year. It all depends on factors like age, length of time spent abusing benzos, personal physiology, and more. Again, detoxing with professional help makes benzo withdrawal symptoms easier to bear.

Benzo Withdrawal: A Timeline
Dangers of Benzo Withdrawal
Early Benzo Withdrawal
Acute Benzo Withdrawal
Late Benzo Withdrawal
Risks of Benzo Withdrawal
Get Help for Benzo Addiction Today
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What are the Side Effects of Benzos?

While Benzodiazepines can be effective for short-term use, they can also have potential side effects, particularly long-term use or misuse.

Here are some of the common side effects of benzodiazepines:

Drowsiness

Benzodiazepines can cause drowsiness and sedation, particularly at higher doses or with long-term use.

Impaired coordination

Benzodiazepines can impair motor coordination and balance, increasing the risk of falls and accidents.

Memory problems

Chronic benzodiazepine use can cause memory impairment and difficulty learning new information.

Confusion

Benzodiazepines can cause confusion, particularly in older adults or those with pre-existing cognitive impairment.

Mood changes

Benzodiazepine use can cause mood changes, including depression, irritability, and anxiety.

Respiratory depression

High doses of benzodiazepines can cause respiratory depression, which can be life-threatening.

Addiction and withdrawal

Benzodiazepines have a high potential for addiction and dependence, and withdrawal symptoms can be severe and even life-threatening.

Increased risk of falls and accidents

Benzodiazepines can impair coordination and balance, increasing the risk of falls and accidents, particularly in older adults.

Reduced sex drive

Benzodiazepines can reduce libido and sexual function.

Tolerance

Over time, the body can become tolerant to the effects of benzodiazepines, which means that higher doses are needed to achieve the same effect.

Thus, benzodiazepines can have various potential side effects, particularly with long-term use or misuse.

What are Alternatives to Benzos?

While benzodiazepines can be effective in treating certain medical conditions, they are associated with several potential risks and side effects, including dependence, tolerance, and withdrawal symptoms. As a result, healthcare professionals may recommend alternatives to benzodiazepines, including:

Cognitive Behavioral Therapy (CBT)

CBT is a form of talk therapy that can effectively treat anxiety disorders and other conditions often treated with benzodiazepines. CBT can help people identify and change negative thought patterns and behaviors contributing to their symptoms.

Antidepressants

Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can effectively treat anxiety disorders, depression, and other conditions often treated with benzodiazepines. These medications work by increasing the levels of certain neurotransmitters in the brain, which can help to reduce symptoms.

Buspirone

Buspirone is a medication often used to treat anxiety disorders. It works by binding to particular receptors in the brain and increasing the activity of serotonin, a neurotransmitter associated with feelings of well-being and relaxation.

Beta-blockers

Beta-blockers are medications commonly used to treat high blood pressure and other cardiovascular conditions. However, they can also effectively treat anxiety disorders, particularly social anxiety. Beta-blockers work by blocking the effects of adrenaline, which can help to reduce symptoms such as sweating, rapid heartbeat, and trembling.

Relaxation Techniques

Techniques such as deep breathing, progressive muscle relaxation, and mindfulness meditation can effectively reduce anxiety and promote relaxation. These techniques can be used alone or in combination with other treatments.

Treatment of Addiction to Benzos

The treatment of addiction to benzodiazepines (benzos) involves a combination of medical and behavioral interventions. Benzodiazepine addiction is a serious condition requiring professional help, and attempting to quit alone can be dangerous.

Here are some common treatments for benzodiazepine addiction:

Medical Detoxification

The first step in treating benzodiazepine addiction is often drug detox. This involves gradually tapering the drug dose over days or weeks under the supervision of a healthcare professional. This can help to minimize withdrawal symptoms and reduce the risk of complications.

Medications

Certain medications may be used during detoxification and beyond to help manage withdrawal symptoms and cravings. These medications may include antidepressants, anticonvulsants, or other drugs that can help ease withdrawal symptoms and reduce the risk of relapse.

Therapy

Behavioral therapies can help people with benzodiazepine addiction address the underlying psychological and emotional factors contributing to their drug use. For example, cognitive behavioral therapy (CBT) can help individuals develop new coping skills and strategies for managing anxiety and stress without relying on benzodiazepines.

Support Groups

Support groups can provide individuals with a supportive community of peers who understand what they are going through. These groups can also provide tools and strategies for managing cravings and avoiding relapse.

Lifestyle Changes

Besides medical and behavioral interventions, lifestyle changes can also help treat benzodiazepine addiction. This may include regular exercise, stress-reduction techniques like meditation or yoga, and healthy dietary changes.

Thus, the treatment of benzodiazepine addiction typically involves a combination of medical and behavioral interventions and may require ongoing support and maintenance to prevent relapse.

Benzo Addiction is Treatable. Reach out to The Edge Treatment Center

The Edge Treatment Center offers resources that help people overcome their benzodiazepine addiction in a comprehensive and personalized manner. To assist people in quitting these drugs and starting the road to recovery, we offer safe, controlled environments and medical and psychological support. Additionally, The Edge offers resources and support to assist people in smoothly transitioning to their regular life after treatment.

Want to leave benzos behind for good? Contact The Edge Treatment Center today to get started.

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