Signs of Benzodiazepine Addiction

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Benzodiazepines are a class of drug commonly prescribed for use as an anxiolytics, antiepileptic, muscle relaxants, and to treat alcohol abuse.  The effectiveness of benzodiazepines for the short-term treatment of a variety of disorders has resulted in their continued popularity since their discovery in the 1960’s.  Very quickly after the introduction of benzodiazepines, the risks of abuse and dependence on this class of drug became apparent. In this article, we’ll break down some of the signs and symptoms of benzodiazepine addiction.  Understanding the signs of addiction to benzodiazepines is an important step for addicts or their loved ones towards recognizing abuse and getting the addict the help they need to overcome their chemical dependency.  Benzodiazepine addiction is especially important to recognize as early as possible due to the severity of withdrawal symptoms and health risks associated with high-dose benzodiazepine use over time.

What are Benzodiazepines?

Benzodiazepines, commonly referred to as benzos, are a class of drug that is used to treat a variety of disorders.  The primary effect of benzodiazepines is as a sedative, which produces a profound sense of mental calmness and reduced tension.  Their effectiveness in treating anxiety and panic disorders led to their quick and wide adoption in Western medicine shortly after their discovery in the 1960’s.  Benzodiazepines produce their effect by interacting with and occupying the GABA receptors, which are inhibitory neurotransmitter receptors in the brain. Specifically, benzodiazepines work on the GABA “a” receptor, which results in inhibited neurological function and produces the sedative and calming effects associated with benzodiazepines.

The risk associated with developing a chemical dependence on benzodiazepines is high.  This is particularly true if a benzodiazepine is used over an extended period of time, or used outside of its prescribed dosage.  Even when used at therapeutic dosage levels, the risk of developing chemical dependence is still present. Because of this, benzodiazepines are typically only prescribed for short-term use, usually between 4-8 weeks.  Their effectiveness in treating certain disorders, like acute panic disorder, accounts for their continued acceptance and use for treatment.

Benzodiazepine Dependence

The signs and symptoms of benzo addiction are consistent with a variety of other substance abuse disorders.  The criteria by which benzodiazepine addiction is measured consists of looking at the benzodiazepine use as a whole and the effect of that use on the life of the addict.  The tolerance of the addict, the presence of withdrawal symptoms, the desire to continue using benzodiazepines, the inability to control the time and dosage, and the impact that seeking out more benzodiazepine has on the life and work of the addict are all signs of a benzodiazepine addiction.  

Tolerance

A high tolerance for benzodiazepines is considered a significant warning sign of benzodiazepine addiction.  Commonly prescribed benzodiazepines like Xanax for anxiety disorders have a very short half-life in the body, which results in the need to use more of the drug to continue the sedative effects.  The use of benzodiazepines over a short period of time will result in a tolerance to the drug and its effects, but if used within a prescribed treatment regimen this is generally recognized as safe so long as it is monitored and use is not continued.  In situations where a person begins to increase the dose of their own accord over time, their tolerance can rapidly increase. Eventually, these users are taking very high doses of benzodiazepines to achieve their desired effect. A high tolerance to the drug and its effects is tied not only to the dosage, but also the length of time that benzodiazepines have been used.  Use of benzodiazepines outside of the narrow window that they are prescribed for can very quickly result in chemical dependence.

Withdrawal

Withdrawal from benzodiazepines is widely recognized as one of the most difficult and dangerous of all substance abuse withdrawals.  Withdrawal occurs when a user has become chemically dependent upon the substance and the absence of that substance triggers a series of negative reactions in the body.  For mild to moderate benzodiazepine withdrawal symptoms are generally flu-like in nature. The person going through withdrawal may have symptoms that include vomiting, diarrhea, trembling, chills, muscle stiffness, insomnia, anxiety, or depression.  Early withdrawal symptoms from benzodiazepines are insomnia and anxiety, which can become acuter over time if more of the drug isn’t taken. Withdrawal from benzodiazepines can also carry with it more dangerous symptoms.

Users can experience hallucinations, seizures, severe panic attacks, sensory hypersensitivity, ataxia (the inability to control their movement and walking patterns), agoraphobia (fear of situations and places that might cause embarrassment), and paresthesia (burning and tingling of the skin).  Benzodiazepine withdrawal symptoms can begin as quickly as 6 hours after the last dose is taken. The timeline for the onset and intensity of benzodiazepine withdrawal symptoms is tied to the type of benzodiazepine being abuse, the dosage it is being used at, and the length of time that the user has been abusing benzodiazepines.

Craving

The desire to continue use of benzodiazepines is a key indicator of addiction.  Many users that have developed a chemical dependency upon benzodiazepines will experience strong cravings to continue the use of the drug.  These cravings to use benzodiazepines will exist despite the lack of a medical need or prescription. For people that have been prescribed benzodiazepines as part of a treatment for a specific condition, they may find that after their treatment has transitioned to a more long-term solution they continue to crave or use benzodiazepines.  The intensity of cravings a benzodiazepine addict feels is tied to the length of time that they have used the drug, their dosage levels, and the type of benzodiazepine they are abusing.

Lack of Control over Benzodiazepine Use

An important sign of benzodiazepine addiction is an erosion of the addict’s ability to control their dosage of benzodiazepine and how frequently they take the drug.  Loss of control over the size and frequency of the dose is a good early indicator that benzodiazepine use is sliding towards addiction, but noticing the transition in the early stages can be difficult for outsiders to see.  The loss of control usually begins small, with an extra dose here or there to help, or re-dosing before the full effects of the previous dose have worn off. This results in highly concentrated levels of the drug in a user’s system when the dosages overlap, creating powerful sedative effects which may be appealing but can also be dangerous.  Increasing the frequency of dosages is a sign that the addict isn’t achieving their desired effect, which is a result of an increasing tolerance. It is also a sign that the user is experiencing cravings for the effect of the drug itself.

Benzodiazepine Seeking

Like other drug addictions, one key sign that someone is an addict is their drug-seeking behavior.  Drug seeking behavior can have a number of profound effects on the life of the addict, and is usually a sign to those closest to an addict that their loved one no longer has control over their substance abuse.  One hallmark of benzodiazepine addiction is that long-term addicts have an overriding need to continue using the drug. This is both to stave off withdrawal symptoms and to satisfy their craving for the drug’s effects.  

Long-term benzodiazepine abuse results in intense withdrawal symptoms, which contributes to the urgency with which an addict must seek out and acquire more of the drug.  The impact of drug-seeking behavior for benzodiazepine addicts is seen throughout their lives. Benzodiazepine addicts typically have difficulty holding down a job due to missed days that result from the effects of the drug or time spent seeking out more of the drug.  Economic instability in the lives of benzodiazepine addicts is also common, as an increasing share of their assets is goes towards maintaining their addiction.

Factors That Contribute to Benzodiazepine Addiction

There are a variety of internal and external factors that contribute to benzodiazepine addiction.  External factors are largely related to the manner in which benzodiazepines were first taken. Many benzodiazepine addicts have been legally prescribed the drug.  The length of time they have been prescribed the drug, how closely they follow the dosage, how clearly the use instructions are outlined, and a failure to clearly warn a patient of the risk of addiction associated with benzodiazepine use can all contribute to the development of addiction.  Additionally, external factors in the life of the addict, such as the loss of a family member or loved one, an accident, or some other traumatic event can contribute to their likelihood of abusing the drug.

Internal factors contributing to developing a benzodiazepine addiction are psychological in nature.  The presence of a number of psychological and personality disorders can increase the likelihood a user will abuse the drug.  These include borderline disorder, anxiety, depression, and neuroticism. Additionally, the presence of substance or alcohol abuse is a key factor that can contribute to benzodiazepine abuse and addiction.

Getting Treatment

Getting the proper medical treatment for benzodiazepine addiction is crucial to long-term health and well-being.  Treatment for benzodiazepine abuse first seeks to address the significant withdrawal symptoms associated with benzodiazepines through a medically managed detox, and then during recovery seeks to treat the underlying factors that contributed to the addiction.  There are many different types of benzodiazepines, but quick acting benzos like Xanax that have a powerful effect but a short half-life in the body are the most commonly abused.

For all types of benzodiazepines, it is important to have medical supervision throughout the detox and recovery process, but it is especially important in users that abused benzodiazepines like Xanax at high dosages for long periods of time.  Even people have used benzodiazepines like Xanax as part of a treatment plan, for a short period of time, and at therapeutic doses will have a medically managed withdrawal process. In these cases, the prescribing physician will generally taper the individual off of the prescribed drug by slowly lowering the dosage over time and concurrently treating any withdrawal symptoms that arise with other medication.  

Although tapering off of benzodiazepines will work for many people who don’t meet the criteria to be considered an addict, for users that have abused benzodiazepines at high dosages or over a long period of time treatment in an inpatient recovery program is recommended.  Treatment in an inpatient recovery program carries a number of advantages for benzodiazepine addicts. Detoxing in an inpatient setting is much safer than quitting “cold-turkey” and results in much greater chances of a successful recovery. Quitting without medical supervision in an inpatient setting often results in relapse, which can be dangerous.  At the same time, there are a number of serious health complications that can arise during a benzodiazepine withdrawal. Because of this, medically supervised benzodiazepine detox is much safer. Additionally, in an inpatient setting medical professionals can minimize the symptoms of withdrawal through drug replacement therapy and the application of drugs to treat withdrawal symptoms.  This is especially important when detoxing from benzodiazepines, as many users experience powerful feelings of anxiety, panic, and extended periods of insomnia.

If you have a loved one that exhibits many of the signs of benzodiazepine addiction, work quickly to get them started on the path to recovery.  Recovery from benzodiazepine addiction isn’t easy, but it is possible. Enrolling them in an inpatient recovery program will give them the best chances for a successful recovery, while also reducing the health risks associated with withdrawal and the chances they will relapse.  Treatment in an inpatient setting is also ideal because it allows qualified health professionals that are trained in dual-diagnosis treatment to identify and address any underlying mental health disorders that contributed to the addiction.

Recognizing the signs and symptoms of benzodiazepine addiction is an important first step towards getting the addict in your life the help they need.  The next step is working with qualified medical professionals at an accredited and licensed treatment facility, which will craft a personalized treatment plan for outline the necessary steps to take to get your loved one the treatment they need.  Treatment for benzodiazepine addiction should not be delayed, as prolonged use can lead to serious and lasting health complications

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