- Table of ContentsPrint
- Benzodiazepine Abuse
- Signs and Symptoms of Abuse
- Effects of Benzodiazepine Abuse
- Benzodiazepine Statistics
- Teen Benzodiazepine Abuse
- Resources, Articles, and More Information
Benzodiazepines, or “benzos,” are a class of sedative drugs administered for the relief of symptoms associated with anxiety and panic disorders, seizures, muscle spasms, and alcohol withdrawal 1,2. Common benzodiazepines include 1:
Benzodiazepines were first introduced to the medical community to replace highly addictive and dangerous barbiturates 1. However, from 1998 to 2008, addiction treatment admissions involving benzo abuse nearly tripled, reflecting the addictive potential that benzodiazepines also present 2.
Benzodiazepines act primarily on the gamma-aminobutyric acid (GABA) receptors and, through this molecular interaction, increase levels of inhibitory brain signaling—depressing the central nervous system and resulting in sedation and feelings of relaxation 1. Long-term benzodiazepine use can lead to several neurological adaptations and, over time, decreased responsiveness to the use of benzodiazepines 1. These chronic adaptations serve as the basis for tolerance.
Tolerant individuals will require increasing amounts of benzodiazepine drugs to achieve the desired effect. Over time, the large amounts of drugs taken to overcome tolerance serve to speed the onset of physiological dependence and, if left unchecked, full blown benzodiazepine addiction.
Signs and Symptoms of Abuse
Benzodiazepine intoxication is frequently characterized by 1, 3, 4:
- Double vision.
- Slurred speech.
- Muscle weakness.
- Slowed reaction time.
- Poor concentration and memory.
The appearance of withdrawal symptoms upon cessation of use is a clear sign that the user has developed a dependence on the drug. Benzo withdrawal symptoms include 1, 3:
- Increased heart rate and blood pressure.
- Excessive sweating.
- Hand tremors.
Depression, anxiety, and insomnia may occur for extended periods of time (for several months) following acute withdrawal from benzodiazepines 1 and may contribute to relapse in recovering addicts.
Effects of Benzodiazepine Abuse
Benzodiazepines can be beneficial for short-term management of anxiety, seizure, and muscle spasm, but chronic use can lead to tolerance and subsequent dependence on benzodiazepines, resulting in longer-term side effects. Some of these risks are present even when benzodiazepines are used as prescribed.
Side effects can impact physical and mental health, occupational and social functioning, as well as cause serious injuries or fatalities. Other consequences may include 1:
Physical and Mental Health Effects:
- Gastrointestinal problems.
- Musculoskeletal issues.
- Impaired memory, focus, and attention.
- Cognitive deterioration in the elderly.
- Loss of self-confidence.
- Blunted or numbed emotions.
- Depression and suicidal ideation.
- Excessive work or school absences.
- Poor occupational or academic performance.
- Familial problems, such as child neglect or divorce.
- Neglect of hobbies and activities that were once enjoyable.
- Loss of close friends due to benzo abuse.
- Increased risk of injury or fatality due to accidents.
- Increased risk of polysubstance abuse (the abuse of more than one substance).
- Increased risk of overdose due to polysubstance abuse.
Overdose Signs and Symptoms
Abusing benzodiazepines with other central nervous system depressants increases the risk of respiratory depression, coma, and death by accidental overdose 1,2,5.
An overdose on benzos may consist of any of the following 5:
- Severe dizziness.
- Lack of coordination.
- Profound confusion and altered mental status.
- Blurred vision or other visual impairments.
- Extreme agitation.
- Abnormally low blood pressure.
- Respiratory depression.
If you suspect an overdose on benzodiazepines or a combination of drugs, call 911 or take the affected individual to an emergency room immediately.
Although benzodiazepines are legally prescribed medications, they are highly addictive and their misuse or abuse can have detrimental results, particularly when combined with other substances. The following statistics provide a picture of benzodiazepine abuse and the associated risks 1,2,6:
- Most people who are abusing benzodiazepines have been prescribed these medications for therapeutic reasons.
- Ativan, Xanax, Klonopin, and Valium are 4 of the top 100 prescribed medications.
- Klonopin is one of the most widely available benzodiazepines on the illicit market.
- Benzodiazepine treatment admissions most commonly include the following demographics: Caucasian (85%) and males (56%), between the ages of 18 and 34 (55%).
- Polysubstance abuse is estimated to be present in 95% of people seeking treatment for benzodiazepines.
- In about 82% of benzo-related treatment admissions, another drug is the primary substance of abuse. Benzodiazepines are often secondary to opiates, alcohol, and marijuana.
- Benzodiazepines accounted for an estimated 8,000 deaths in 2014 in the United States alone.
Teen Benzodiazepine Abuse
In adolescents, benzodiazepines are most commonly abused with marijuana 2. Therefore, it’s important to be aware of the signs and symptoms of teen benzodiazepine and co-occurring substance abuse. You can speak to a substance abuse therapist, a psychiatrist, your child's primary care physician, or an interventionist if you are concerned that your child may be abusing benzodiazepines or other substances.
- Increased excitement.
- Lowered inhibitions.
- Increased impulsivity.
- Aggression or attacks of rage and violence.
- Other antisocial behaviors.
This reaction may not happen in all children and teenagers but if you notice your child exhibiting these signs, it is critical that you contact your provider immediately to stop administration of the drug in the safest, most effective manner possible.
Resources, Articles, and More Information
To learn more about benzodiazepines and their abuse potential follow these links:
Test your knowledge about benzodiazepines with this quiz, and perhaps find out something you didn't know before.
Additionally, you can check out our forum which provides a supportive community for someone struggling with addiction or for someone who is worried about a loved one.
- Longo, L.P., & Johnson, B. (2000). Addiction: Part I. Benzodiazepines—Side Effects Abuse Risk and Alternatives. American Academy of Family Physicians, 61: 2121-8.
- SAMHSA. (2011). Benzodiazepine Abuse Treatment Admissions Have Tripled from 1998 to 2008.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Center for Substance Abuse Research. (2013). Benzodiazepines.
- Gresham, C. (2016). Benzodiazepine Toxicity: Practice Essentials.
- National Institute of Health. (2015). Overdose Death Rates.