Benzodiazepine Abuse and Addiction
Drug abuse and addiction impacts many people across the country. In 2019, 4.8 million people misused prescription benzodiazepines.2 Benzodiazepines are a controlled substance, available by prescription only for good reason—a number of serious side effects and risks are associated with their use.
What Are Benzodiazepines?
Benzodiazepines, often called benzos, are commonly prescribed medications to treat sleep disorders, seizure disorders, and anxiety disorders, including post-traumatic stress disorder (PTSD).3 Some common benzodiazepines include Xanax, Ativan, Klonopin, and Restoril.
Benzodiazepines produce a calming, sedative effect and result in feelings of well-being that may lead people to misuse them. When a drug is used in ways that are not intended, or not as prescribed, it is considered misuse or abuse. This can include using more of the drug than prescribed, ingesting the drug in ways that are not intended such as snorting the drug, using medication that is not prescribed to you, and using the medication for longer than intended.11
Research has shown that benzodiazepine abuse is increasing in the United States, particularly in young adults.14 According to the 2019 National Survey on Drug Use and Health, 4.8 million people misused prescription benzodiazepines in the past year.2
There are more than 12 different types of benzodiazepines. The most commonly prescribed (in order of highest to lowest) are Xanax (alprazolam), Ativan (lorazepam), Klonopin (clonazepam), Valium (diazepam), and Restoril (temazepam).15 On the street, benzos are sometimes referred to as nerve pills, downers, benzos, and tranks.3
Are Benzodiazepines Addictive?
Benzodiazepines can quickly produce feelings of relaxation and sedation which make them effective for short-term or episodic treatment for mood, anxiety or panic disorders. When taken regularly, and this can happen over just a few weeks of use, the body begins to adapt and tolerance develops, and a person requires a higher dose of the medication to achieve the desired effects.
Long term, regular use can also lead to dependence, where a person will experience physiological symptoms of withdrawal if they stop taking a benzodiazepine or significantly reduce their dose. A person who has developed a dependence to benzodiazepines is at risk of becoming addicted, which is when a person continues to chronically misuse a substance, despite experiencing any of the significant negative consequences identified above.12,13
Benzodiazepines and Polysubstance Abuse
Benzodiazepines are considered a Schedule IV drug in the United States and have addictive properties which makes them susceptible to abuse, dependency, and addiction; however, it is rare for benzodiazepines to be the preferred or sole drug of abuse. It is estimated that 80% of benzodiazepine misuse occurs in conjunction with the other drugs, most commonly with opioids, but also withalcohol.16,4
- Roughly 1 out of 5 Americans who abuse alcohol also abuse benzodiazepines.
- Using benzodiazepines together with opioids increases the risk of an opioid-related overdose.17 In 2019, 16 percent of overdose deaths involving opioids also involved benzodiazepines.18
- Using benzodiazepines concurrently with opioids is associated with a 5-fold increase in the risk of opioid-related overdose during the initial 90 days.17
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Benzo Abuse and Substance Use Disorders
A person who is addicted to benzodiazepines and other drugs can be diagnosed with a substance use disorder (SUD), which is a chronic, treatable medical illness characterized by the compulsive use of substances (whether drugs or alcohol) despite substance use causing significant health problems or problems at home, school, or work.7 An SUD can look a bit different on each person; however, there are some common behaviors to look out for if you suspect you or your loved one may be struggling with an SUD.
Signs of abuse of benzodiazepines and other substances can be behavioral, physical, and mental. Some common signs and symptoms of a potential SUD can include:7
- Missing school or work obligations and responsibilities.
- Socially withdrawing from friends and family.
- Creating a new social circle that includes other drug and alcohol users.
- Spending time thinking about drug use and finding ways to get drugs.
- Losing interest in once pleasurable and pleasant activities.
- Low motivation.
- Developing a physical tolerance to the drug (needing more of the drug to achieve the desired effect).
- Legal problems.
- Financial problems.
- Health problems.
- Suicidal thoughts and behaviors.
- Significant interpersonal problems with friends and family.
Am I Addicted to Benzos or Other Substances?
If you think you may be struggling with an addiction to benzos, there are some questions you can ask yourself to determine whether you may have a problem. Some questions to consider include:9
- Have I neglected myself, including my personal hygiene and overall health?
- Have I lost interest in some of my favorite activities?
- Have I been isolating myself from my loved ones?
- Am I experiencing intense mood swings?
- Have I failed to adhere to my work and family responsibilities?
- Am I experiencing problems at work or at school?
- Am I experiencing conflict with loved ones?
- Am I facing criminal charges because of my substance use?
Treatment for Benzodiazepine Addiction and Substance Use Disorders
There are effective treatments available to treat an addiction to benzodiazepines as well as other substances of abuse. Overcoming any addiction can seem overwhelming and may be discouraging, however, it doesn’t have to feel that way. Yes, overcoming an addiction is difficult, but recovery is possible. With a treatment provider and support systems in place, you can overcome addiction. Addiction treatment varies from person to person and treatment is tailored to each person’s individual needs.
Effective treatment may include:10
- Behavioral counseling.
- Evaluation for co-occurring disorders.
- A relapse prevention plan.
- Medical interventions and equipment to ensure a safe and comfortable detox.
- Attending self-help or mutual help groups, such as Alcoholics Anonymous or Narcotics Anonymous.
Many people begin the treatment process with a medical detoxification period followed by inpatient, residential, or outpatient drug rehab treatment. The length of time required for treatment will vary based on individual factors. Inpatient/residential treatment provides constant, around-the-clock support while you live in a facility. Intensive outpatient treatment allows the patient to live at home and requires a commitment of usually 3–5 days a week.10
Individual and family outpatient therapy is another form of treatment that allows the patient to live at home, and possibly continue working or attending school, while going to a treatment facility during the day.
Treatment plans are created with medical and addiction professionals to ensure your unique physical and mental health needs are met. If you have another mental health disorder in addition to an SUD, which is usually referred to as co-occurring disorders, consider a program that addresses both your mental health and SUD together;. Across the U.S., there are a variety of public and private treatment providers that address benzodiazepine addiction.
Find Out If Your Insurance Plan Covers Benzodiazepine Rehab
American Addiction Centers provides comprehensive rehabilitation services for those seeking recovery from addiction and substance abuse, including benzodiazepine abuse and SUD. To find out if your insurance covers treatment at an American Addiction Centers facility, click here or fill out the form below. Your information is kept 100% confidential.
- Center for Disease Control and Prevention. (2021). Understanding the epidemic.
- Substance Abuse and Mental Health Services Administration. (2020). Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health.
- United States Drug Enforcement Agency. (n.d.). Benzodiazepines.
- Schmidt, A. (2016). Benzodiazepine use, misuse, and abuse: A review. Mental Health Clinician, 6(3), 120-126.
- NPS Medicinewise. (2015). Benzodiazepine dependence: Reduce the risk.
- U.S. Department of Justice Drug Enforcement Administration. (2017). Drugs of abuse.
- U.S. National Library of Medicine. (2021). Substance use disorder.
- An, H. & Godwin, J. (2016). Flumazenil in benzodiazepine overdose. CMAJ, 188, 17-18.
- National Institute on Drug Abuse. (n.d.). What are some signs and symptoms of someone with a drug use problem?
- National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction: Drug facts.
- U.S. National Library of Medicine. (2021). MedlinePlus: Drug Use and Addiction.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Is there a difference between physical dependence and addiction?
- National Institute on Drug Abuse. (2018). Media Guide: The Science of Drug Use and Addiction: The Basics.
- Maust, D.T., Lin, L.A., Blow, F.C. (2018). Benzodiazepines Use and Misuse Among Adults in the United States.
- Drug Enforcement Administration. (2019). Benzodiazepines.
- Longo, L.P., Johnson, B. (2000). Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. Am Fam Physician, 61(7): 2121-2128.
- Hernandez, I., He, M., Brooks, M.M. (2018). Exposure-Response Association Between Concurrent Opioid and Benzodiazepine Use and Risk of Opioid-Related Overdose in Medicare Part D Beneficiaries. JAMA Netw Open, 1(2):e180919. doi:10.1001/jamanetworkopen.2018.0919.
- National Institute on Drug Abuse. (2021). Benzodiazepines and Opioids.