Updated on April 3, 2024
5 min read

Midazolam (Versed): Addiction & Treatment Options

Key Takeaways

Midazolam is commonly sold under the brand name Versed and is an FDA-approved medication. It’s primarily used for its sedative, anxiety-reducing, and sleep-inducing properties and belongs to the benzodiazepine class of drugs.

Doctors use this benzodiazepine for several situations, including:

  • Surgery preparation
  • Seizure treatment
  • Schizophrenia treatment (alongside other drugs)
  • Calming severe agitation

Despite these uses, midazolam carries addiction risks like any other benzodiazepine. Prolonged use or abuse can lead to physical and psychological dependence, causing people to seek out higher doses for a stronger high.

How Quickly Can Midazolam Addiction Develop?

Physical dependence can happen within just a few weeks of using Versed. Chronic exposure to the drug can also cause midazolam addiction.1 Some estimates show benzodiazepine dependence occurs in a third of those using these drugs for over a month.2

It’s also more likely that those with a midazolam addiction engage in substance abuse of other drugs.3 Or, they may already be abusing other substances before midazolam use begins.

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Midazolam Addiction Symptoms

Midazolam addiction occurs when you take higher doses of the drug than necessary. It also involves using it for longer than prescribed or combining it with substances like alcohol

The symptoms of midazolam abuse and addiction include:

  • Drowsiness
  • Lack of coordination
  • Slurred speech
  • Problems with concentration
  • Difficulty remembering things
  • Confusion
  • Dizziness
  • Intense cravings
  • Poor judgment and decision-making
  • Compulsive use of the drug
  • Inability to stop using the drug

Midazolam Withdrawal Symptoms

Withdrawal symptoms due to midazolam addiction are similar to other benzodiazepines and include:

  • Problems sleeping
  • Runny nose
  • Anxiety
  • Irritability
  • Panic attacks
  • Tremors
  • Sweating
  • Problems with concentration
  • Confusion and memory problems
  • Cognitive impairment
  • Nausea and vomiting
  • Headache
  • Muscle pain

Dangerous withdrawal symptoms involve seizures, hallucinations, psychosis, and suicidal thoughts or behaviors.

Midazolam Overdose Symptoms

Call emergency services or the Poison Help line at 1-800-222-1222 if you or a loved one exhibits overdose symptoms.

Signs of overdose include:

  • Impaired motor coordination and reflexes
  • Slurred speech
  • Involuntary eye movements
  • Dizziness or drowsiness
  • Extreme confusion
  • Hypotension
  • Respiratory arrest
  • Blurred vision
  • Hallucinations
  • Coma and death

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Treatment for Midazolam Addiction

The most effective treatment options to overcome midazolam addiction include:

These treatments are also essential for those with multiple substance addictions or co-occurring mental health disorders. The choice between inpatient and outpatient treatment depends on the severity and duration of the addiction. 

Guidance for Caregivers and Family Members

Here are some ways to provide support and help those struggling with midazolam abuse overcome their addiction:

  • Educate yourself about the drug: Research and learn more about midazolam addiction, its signs, symptoms, and effects on the body. The more knowledge you have, the better you understand your loved one's struggles.
  • Encourage them to seek treatment: Offer your support and encouragement to seek professional help. Let them know you're always by their side, and you can accompany them to appointments or even help them find a treatment facility.
  • Be patient and understanding: Recovery from addiction is a long process, and there will be setbacks along the way. It's essential to be patient and understanding with your loved one as they work towards sobriety.
  • Avoid enabling behaviors: It can be tempting to try and protect your loved one from the consequences of their drug abuse, but this can actually hinder their recovery. Avoid giving them money or making excuses for their behavior.
  • Take care of yourself: Supporting a loved one through addiction can be emotionally and physically draining. Take care of your well-being, and seek support from others if necessary.

How Can You Prevent Midazolam Addiction?

To help prevent midazolam addiction, it's essential to follow these steps:

  • Only take midazolam as prescribed: Don't take more than the necessary dose or for a longer period than your doctor prescribed.
  • Avoid sharing prescriptions: Never share your prescription with someone else or use someone else's medication. This can lead to dependency and other health risks.
  • Keep track of your medication: Keep them in a safe and secure place, and monitor how many you have left. This can help prevent accidental overdose or misuse.

Midazolam Drug Interactions

Before taking midazolam, discuss any allergies and tell your doctor if you are taking other benzodiazepines, such as diazepam. A total of 554 drugs can interact with midazolam, and 45 can produce serious interactions.1 

Serious drug interactions increase your risk for severe side effects. The most common drugs that interact with midazolam include:

  • Antidepressants (sertraline, nefazodone, and fluoxetine)
  • Antiepileptic drugs (phenytoin, phenobarbital, and carbamazepine)
  • Heart or blood pressure medications (diltiazem)
  • Seizure medications (phenytoin)
  • Certain antibiotics (clarithromycin and erythromycin)
  • Tuberculosis medications (rifapentine and rifampin)
  • Antifungal drugs (ketoconazole and itraconazole)
  • Protease inhibitors, antiviral medications taken for HIV/AIDS or hepatitis C
  • Grapefruit juice
  • Antihistamines
  • St. John's Wort
  • Central nervous system depressants

Toxicity can occur when midazolam combines with CNS depressants like sedatives and opioids, like fentanyl, codeine, and morphine. It can increase the risk of respiratory depression, airway obstruction, and hypoventilation.

Midazolam toxicity can also occur when the drug mixes with alcohol and other tricyclic antidepressants (sedatives in medical procedures.)

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Resources for Help and Support

If you or someone you know is struggling with midazolam addiction, there are resources available to help. Consider reaching out to:

  • National Helpline: 1-800-237-TALK (8255)
  • Substance Abuse and Mental Health Services Administration (SAMHSA): Treatment locator
  • National Institute on Drug Abuse (NIDA) Helpline: 1-800-662-HELP (4357)
  • National Alliance on Mental Illness (NAMI) Helpline: 1-800-950-NAMI (6264)
  • Your primary care provider or a mental health professional: Consult them for personalized guidance and treatment options

Summary

Midazolam is a benzodiazepine for sedation and anesthesia. It can be effective in managing various conditions, but it also has potential adverse side effects and addiction risks.

Follow your doctor's prescription and avoid combining it with other CNS depressants or substances like alcohol. If you or someone you know is struggling with midazolam addiction, seek professional help for a safe and successful recovery.

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Updated on April 3, 2024
11 sources cited
Updated on April 3, 2024
  1. Lerner et al. “Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development.” Brain Communications, 2019.
  2. Winstock, A. “Psychoactive drug misuse.” Core Psychiatry, 2012.
  3. Kerr et al. “High rates of midazolam injection among drug users in Bangkok, Thailand.” Harm Reduction Journal, 2010.
  4. midazolam injection, USP PRESERVATIVE FREE Dosage and Administration.” Pfizer.
  5. MIDAZOLAM.” RxList.
  6. Midazolam.” MedlinePlus, 2018.
  7. WHO Model List of Essential Medicines - 22nd list, 2021.” World Health Organization, 2021. 
  8. Lingamchetty et al. “Midazolam.” StatPearls Publishing, 2023.
  9. Prommer, E. “Midazolam: an essential palliative care drug.” Palliative Care & Social Practice, 2020.
  10. Manso et al. “Pediatric Anesthesia.” Wiley Online Library, 2019.
  11. Makkar et al. “Alcohol and Midazolam Dependence Syndrome.” The International Journal of Indian Psychology, 2021.

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