Which Benzodiazepine Is Most Likely To Cause Dependence?

Key Takeaways

• Benzodiazepines treat anxiety, insomnia, and other disorders - Jump to Section
• Benzodiazepines can be addictive due to their effect on brain chemicals - Jump to Section
• Common side effects include drowsiness, confusion, and muscle weakness - Jump to Section
• Different benzodiazepines have varying risks of causing dependence - Jump to Section
• Benzodiazepine addiction is diagnosed based on DSM-5 criteria and symptoms - Jump to Section
• Withdrawal symptoms can include sleep issues and increased anxiety - Jump to Section
• Treatment includes therapy, support, and sometimes medication - Jump to Section

What Are Benzodiazepines?

Benzodiazepines, commonly known as benzos, are central nervous system (CNS) depressants that treat various mental disorders, including mood disorders, anxiety, and panic attacks. Doctors sometimes prescribe them as muscle relaxers.

In addition to treating anxiety and panic attacks, benzodiazepines can also treat:

• Depression
• Insomnia
• Seizures
• Nausea and vomiting
• Muscle tension

There are two main types of benzodiazepines:

• Short-acting benzodiazepines: Lasts between 3 and 8 hours
• Long-acting benzodiazepines: Lasts between 11 and 20 hours

The addictive nature of benzodiazepines (benzos) is due to enhancing the effects of gamma-aminobutyric acid (GABA) neurotransmitters. These transmitters induce a sense of calmness.

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Why is Benzodiazepine Addictive?

Benzodiazepines bind to particular receptors in the brain, causing a relaxing effect that mitigates stress, fear, and anxiety. Prolonged use of this medication can lead to the brain’s adaptation to these heightened GABA effects.

Upon discontinuation, it can result in:

• Tolerance
• Dependency
• Withdrawal symptoms

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Common Side Effects of Benzodiazepine

The most common side effects of benzodiazepine use include:

• Drowsiness
• Confusion
• Memory issues
• Speech problems
• Blurry vision
• Dry mouth
• Muscle weakness
• Unsteadiness
• Headaches
• Constipation
• Nausea and flu-like symptoms
• Light-headedness and dizziness

Less common side effects include rashes, double vision, low blood pressure, low libido, and difficulty urinating. Long-term benzo users, although rarely, can develop blood disorders and jaundice (yellowing skin)

Which Benzodiazepine Is Most Likely To Cause Dependence?

Benzos are highly addictive. If you take benzodiazepines in high doses, you can develop tolerance over time. This makes your body dependent on the drug to function normally.

Some benzodiazepines are more likely to cause benzodiazepine dependence than others. Here’s a list of benzo brand names and how their effects may lead to substance abuse:

Ativan

Ativan, also available under its generic name lorazepam, is a benzodiazepine. It’s an FDA-approved prescription tranquilizer and sedative that treats anxiety and insomnia.

Ativan is relatively safe when used under a doctor’s care. However, it might cause mild or severe side effects, especially after long-term drug use for over 4 months.

Etizolam

Etizolam is a thienodiazepine, an anxiolytic (anxiety inhibitor), and an anticonvulsant depressant. It’s a highly short-acting drug, with an approximate elimination half-life of 5 to 7 hours.

Etizolam’s concentration in the body will drop to half the starting dose after this time. Despite this, it’s more potent than diazepam (10 times more in hypnotic effects). Etizolam can help treat different medical conditions, such as anxiety disorders.

Halcion

Halcion (triazolam) is classified as a hypnotic medication often used to treat insomnia. It is a sedative, muscle relaxant, and an anticonvulsant.

Users can benefit safely from this drug short-term (7 to 10 days) under a doctor’s supervision.

Klonopin

Klonopin (Clonazepam) is a prescription benzodiazepine and sedative for panic disorder. It helps prevent and control seizures, especially for people with epilepsy. Klonopin also treats insomnia (sleeping difficulties) and alcohol withdrawal.

Librium

Librium is an FDA-approved short-term treatment for anxiety, especially for stress experienced before surgery. Doctors also prescribe it to people with alcohol use disorder (AUD) experiencing anxiety and other acute alcohol withdrawal symptoms.

Users sometimes consume it recreationally for its sedative effects or to enhance the high of other illicit or prescription drugs. It’s a schedule IV controlled substance due to its mild potential for abuse and addiction.

Valium

Valium is a pharmaceutical anxiolytic you can take safely for certain health conditions or medical procedures. However, this drug is among the most dangerous drugs users commonly abuse in the U.S.

Valium is a sedative with a metabolic span of around 8 hours, but its half-life depends on the user’s age, gender, and underlying health conditions.

Midazolam

Midazolam is a powerful, short-acting hypnotic-sedative medication that aids sleep by triggering sleepiness and reducing anxiety. The drug has anticonvulsant, hypnotic, anxiolytic, amnestic, and muscle relaxant properties.

Medical professionals rarely use it outside of hospital and clinical settings. Like other benzodiazepines, it has a high risk of addiction and can be dangerous when abused.

Phenazepam

Phenazepam is a long-acting benzodiazepine and psychoactive drug which is potent at one-tenth of the usual dose of diazepam.

The drug’s powerful anti-anxiety and muscle relaxant properties make it twice as likely to be abused. It can be extremely dangerous or deadly when misused or combined with alcohol and other CNS depressants.

Although it isn’t a controlled substance, selling it in the U.S. is still illegal.

Restoril

Restoril (Temazepam) slows down CNS activity. It’s a short-term treatment option for sleep problems. Long-term use can lead to dependence, tolerance, and addiction.

People who mix Restoril with alcohol or illicit drugs can experience dangerous adverse effects, such as sleepwalking and eating while sleeping.

Rohypnol

Rohypnol is a fast-acting sedative. It slows down the CNS and can produce feelings of drowsiness, confusion, slowed reaction time, and loss of memory.  It takes effect within 15 to 20 minutes and lasts between 4 and 6 hours.

The drug is a Schedule IV drug which can lead to limited physical or psychological dependence. Therefore, it’s not approved for medical use in the U.S.

Xanax

Xanax is the most prescribed psychiatric medication in the U.S. The drug increases GABA (a neurotransmitter) in your brain, which calms the body and results in a relaxed state.

Some people may take Xanax with other medications, such as codeine, hydrocodone, fentanyl, methadone, and oxycodone, to increase its effects.

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How Do You Diagnose Benzodiazepine Addiction?

Medical professionals rely on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose Benzodiazepine addiction. It encompasses a range of criteria that delve into key indicators.

To be diagnosed with a benzodiazepine disorder, you must exhibit at least two symptoms within 12 months. These symptoms include:

• You take benzodiazepine in a higher volume or over a longer period than prescribed
• You spend considerable time seeking the drug, using it, and recovering from its effects
• When benzodiazepines aren’t in your system, you experience withdrawal and cravings
• You need more of the sedative over time to achieve the familiar desired effects
• You experience impaired performance at home, work, or school because of the drug’s effects

Common Symptoms of Benzo Addiction

The signs and symptoms of benzodiazepine abuse include:

Physical Signs and Symptoms

• Fainting
• Light-headedness
• Headaches
• Muscle weakness
• Extreme drowsiness
• Poor coordination
• Vision problems
• Tremors

Behavioral Symptoms

• Withdrawal and isolation from family
• Forging prescriptions from doctors
• No social life
• Missing work
• Neglecting daily responsibilities
• Not participating in previously enjoyed hobbies

Cognitive and Psychosocial Symptoms

• Anxiety
• Mood swings
• Confusion
• Trouble focusing
• Reduced inhibition
• Poor judgment
• Emotional detachment
• Memory issues
• Anger
• Hostility
• Irritability

In severe cases of misuse, users may experience a benzodiazepine overdose. This requires immediate medical attention.

What Are The Symptoms of Benzodiazepine Withdrawal?

Withdrawal occurs when you stop taking benzodiazepines abruptly, and these symptoms can be life-threatening.

Short-acting benzos cause more severe withdrawal symptoms, while long-acting benzos cause moderate withdrawal signs. The most common symptoms include:

• Sleep disturbances
• Increased stress and tension
• Mental health problems like anxiety, panic attacks, and mood disorders
• Trouble focusing
• Headaches and migraines
• Severe sweating
• Hypersensitivity
• Mild to moderate changes in perception
• Heart palpitations
• Muscle tension or discomfort
• Drug cravings
• Tremors
• Suicidal thoughts or tendencies
• Psychosis
• Visual, tactile, or auditory hallucinations
• Seizures

For short-acting benzodiazepines, withdrawal symptoms begin within 8 to 12 hours after the last dose. For long-acting benzodiazepines, withdrawal symptoms start within 24 to 48 hours.

How Do You Treat Benzodiazepine Misuse and Addiction?

Treatment for benzodiazepine misuse is similar to treatments for addiction to other dangerous drugs. It includes:

Inpatient and Outpatient Treatment

Since treatment for benzodiazepine addiction doesn’t end after detox, long-lasting sobriety requires ongoing therapy and support.

Inpatient treatment allows you to recover outside of your usual environment, free of drug use temptations. Outpatient treatment helps maintain your everyday life outside of addiction treatment.

Experts highly recommend detoxing at a professional treatment center. As with other drugs, seeking medical help is crucial when discontinuing benzodiazepines to manage withdrawal symptoms properly.

Medication-Assisted Treatment (MAT)

Physicians often use medications to ease benzodiazepine withdrawal symptoms during detox at a treatment center. You may be prescribed Flumazenil, Buspirone, or Clonidine to help recover.

Summary

Benzodiazepines act on the CNS to treat symptoms of anxiety, insomnia, and other psychiatric disorders. However, benzos pose a high risk of abuse.

To overcome benzodiazepine addiction, inpatient and outpatient programs and medication-assisted treatments help users recover.

Delaying intervention can make it challenging to overcome the effects of benzos. Seek professional help immediately if you or a loved one is struggling with benzodiazepine addiction.

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