Benzodiazepines
Benzodiazepines, prescribed to treat anxiety and insomnia, are highly addictive controlled substances. Overuse can lead to dangerous conditions like low blood pressure, liver and kidney damage, and overdose.
What Are Benzodiazepines?
Benzodiazepines, often called “benzos”, are medications classified as central nervous system depressants.
There are dozens of benzodiazepines available by prescription, and there are uncontrolled and counterfeit versions of benzodiazepines available on the illicit market. Prescriptions for outpatient use often take the form of tablets or capsules intended to be swallowed, and injectable benzodiazepines are used in hospital settings. They have different potencies, with some being short-acting (effects lasting several hours) while others are long-acting (effects lasting several days).
Benzodiazepines are not intended to be used daily for long periods of time, although some people end up taking them that way. They are classified as either Schedule IV or Schedule III controlled substances (depending on the specific medication), and it is illegal to have them without a prescription from a healthcare provider.
There is also a high risk for accidental overdose when benzodiazepines are combined with other depressants like opioids or alcohol.
Different Types Of Benzodiazepines
There are dozens of medications in the benzodiazepine class, and their generic pharmaceutical names typically end with -pam, -lam, or -zam. Each specific benzodiazepine has a unique molecular structure, and they have different potencies, rates of onset, and duration of effects. For example, 10mg of diazepam (Valium) is roughly equivalent to 0.5mg of clonazepam (Klonopin) and 1mg of alprazolam (Xanax).
Some of the most prescribed and misused benzodiazepines include:
- Alprazolam (Xanax)
- Clonazepam (Klonopin)
- Diazepam (Valium)
- Lorazepam (Ativan)
- Chlordiazepoxide (Librium)
Benzodiazepines are processed by the liver and kidneys and excreted through urine, and the rate of metabolism is impacted by age, health, body weight, and other substances in the body.
The duration of effects is related to the “half-life” of the medication, which is the amount of time it takes for half of the medication to be processed and excreted.
Benzodiazepines with the longest duration of effects include:
- Chlordiazepoxide (Librium): half-life of 24 – 48 hours
- Clonazepam (Klonopin): half-life of 18 – 50 hours
- Diazepam (Valium, Diastat, Valtaco): half-life of 20 – 80 hours
- Flurazepam (Dalmane): half-life of 47 – 100 hours
- Quazepam (Doral): half-life of 39 – 73 hours
What Are Benzodiazepines Prescribed To Treat?
Benzodiazepines are used to treat a range of medical and mental health problems and are commonly prescribed for:
Specific benzodiazepines are also prescribed for:
- Alcohol withdrawal symptoms
- Preventing seizures and treating epilepsy
- Muscle spasms
- Premenstrual dysphoric disorder
- Chemotherapy-related nausea and vomiting
Benzodiazepine Effects And Adverse Reactions
Like most medications, benzodiazepines have intended effects that provide relief and potential adverse effects that can be unpleasant or dangerous. They are not intended for long-term use, although they are sometimes prescribed that way.
Acute effects of benzodiazepines can include:
- Lower blood pressure and heart rate
- Slower breathing
- Reduction in anxiety
- Muscle relaxation
- Relaxation, calmness, and feelings of well-being
- Seizure prevention
Potential health consequences of benzodiazepines include:
- Chronically low blood pressure
- Drowsiness, dizziness, sleepiness, or loss of consciousness
- Impaired coordination
- Lowered inhibitions
- Death, particularly when combined with alcohol or opioids
- Memory impairment
- Increased risk of tolerance, dependence, withdrawal, and addiction
- Increased risk of pneumonia and other breathing problems
- Liver and kidney damage
- Difficulty concentrating
- Increased risk for dementia later in life
- Slurred speech
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How Benzodiazepines Work
Once benzodiazepines are absorbed into the bloodstream, they cross the blood-brain barrier and change brain functioning, which then impacts the rest of the body.
Neurotransmitters are the chemical messengers in the brain, and psychoactive drugs produce their effects by altering typical patterns of neurotransmitter activity. Benzodiazepines are central nervous system depressants, which means they slow down activity in the brain and body.
More specifically, benzodiazepines are GABA-Agonists, meaning they amplify the effects of GABA, which is the neurotransmitter responsible for slowing down brain signals. Benzodiazepines are similar enough to the chemical structure of GABA that they can bind to the GABA receptors in the brain but in a different place than GABA itself. The result is that GABA and benzos can activate the same receptor at the same time. That double-action hyperpolarizes the neuron, which makes it much more difficult for the neuron to send a brain signal.
GABA receptors are found throughout the body but are highly concentrated in the limbic system of the brain where emotions originate and emotional memories are stored. That makes GABA-agonists, like benzodiazepines, particularly influential over emotional states like anxiety.
Get Help Today
An addiction to benzodiazepines can negatively affect and disrupt your life. If you are interested in finding out more about treatment options available to you, contact a treatment provider today.