What Are Benzodiazepines?
Benzodiazepines are a category of prescription medications classified as central nervous system depressants and are primarily prescribed for anxiety disorders, panic attacks, seizures, insomnia, and alcohol withdrawal. Benzodiazepines produce a relaxation effect in the body by increasing the effect of gamma-aminobutyric acid (GABA), which is the main inhibitory neurotransmitter in the central nervous system.[1]
Examples of commonly-prescribed benzodiazepines include: Xanax (alprazolam), Valium (diazepam), Klonopin (clonazepam), and Ativan (lorazepam).
While benzodiazepines have been used successfully in the short term with appropriate medical supervision, they also have a high potential for abuse and addiction.[2] As the brain builds tolerance with regular use, the person needs to use higher and higher doses to achieve the same effect and has difficulty functioning when not using. The FDA has ruled that the use of benzodiazepines (whether prescribed or not) is associated with withdrawal symptoms, physical dependence, and the risk of misuse and addiction.[3]
Benzodiazepine Addiction and Abuse
Benzodiazepine addiction typically occurs in one of two ways: someone is either prescribed benzodiazepines through a legitimate prescription and gradually develops a dependence without ever misusing the drug, or someone uses benzodiazepines recreationally without a prescription, sometimes combining them with opioids or alcohol for their sedative effect. No matter how usage starts, both can lead to a substance use disorder that takes professional treatment to safely address.
Benzodiazepine dependency and addiction develop as a result of how they affect the brain’s GABA production. When benzodiazepines are used for a prolonged period, the brain decreases its own production of GABA and increasingly relies on the benzodiazepine to feel relaxed or calm. Eventually, they will be both mentally and physically dependent on benzodiazepines to deal with normal day-to-day activities, cope with stress, sleep, and have a sense of well-being.[4] This neurological adjustment explains why no one should ever attempt to stop their use of benzodiazepines without proper medical supervision and why a medically supervised taper is the foundation for successful detoxification.
Some of the common risk factors associated with developing benzodiazepine addiction are: personal or family history of substance use issues, co-occurring mental health conditions such as post-traumatic stress disorder (PTSD) or anxiety, long-term, high-dose use of benzodiazepines, and concurrent use of other drugs such as opioids or alcohol.[5]
Signs of Benzo Addiction and Abuse
Because benzodiazepine addiction often starts with a legitimate prescription, many will overlook warning signs or symptoms.[6]
Some common signs and symptoms to watch for are:
- Taking higher dosages of benzodiazepines than prescribed by a physician
- Attempting to obtain multiple prescriptions for benzodiazepines from a variety of prescribers (doctor shopping)
- Continuing to use benzodiazepines despite causing problems with family, employment, and health
- Drowsiness, slurring of speech, or other symptoms of sedation
- Memory loss or amnesia after taking benzodiazepines
- Tremors or shaking when not using benzodiazepines
- Anxiety or panic if a dose is skipped
- Believing that they cannot function without benzodiazepines.
Why Are Benzodiazepines So Addictive?
Understanding why benzodiazepines are so addictive helps explain why so many people find themselves dependent, even though they likely had no intention to misuse the drug.[7] Several factors contribute to their high addiction potential:
- Quick Effect: Many benzodiazepines, particularly short-acting ones, provide immediate relief from anxiety. This rewards the brain quickly and leads to reinforcement within the reward pathway.
- GABA Reduction: The brain starts to decrease the amount of GABA it produces naturally because of the excessive amount of GABA effects received from the drug. This creates a dependency on the drug itself.
- Developing Tolerance: Tolerance to benzodiazepines develops relatively quickly. It can take only a few weeks of daily use for the brain to adjust. Once tolerance develops, the initial dose will stop having the same effect, leading to an increase in dosing.
- Rebound Anxiety: When benzodiazepines’ effects wear off, people frequently experience an increase in anxiety levels. This rebound anxiety reinforces continued use to avoid discomfort.
- Psychological Dependency: With continued use, many people find they cannot manage their anxiety or stress without the drug, making the psychological component of dependence as real as the physical component.
How Long Does It Take to Become Dependent on Benzodiazepines?
Research has indicated that people can develop a physical dependence on benzodiazepines sooner than expected. Physical dependence can occur within as little as 2-4 weeks of taking benzodiazepines on a regular, daily basis—especially with short-acting formulations like Xanax.[8] As time and quantity of use increase, so does the number of physical and emotional changes inside the body. This means the withdrawal process becomes progressively more complicated.
The quick time frame for developing a physical dependence is one of the reasons that many people are shocked when they find they cannot stop. A prescription taken for months or years might at some point transition into a situation that is out of control. Once this happens, it becomes necessary for the individual to seek professional assistance in order to stop usage safely.
Benzodiazepine Addiction Treatment at Meridian Recovery
At Meridian Recovery, we treat both the physical and psychological components of benzodiazepine addiction. Our team provides a treatment experience based on current medically and therapeutically accepted clinical practices, tailored to your needs.
Because of the potential for life-threatening complications—including anxiety, psychosis, and seizures—detoxification is often the first step. Meridian Recovery works closely with reputable medical detoxification providers in New Jersey to ensure the client is medically stable before transitioning into one of our outpatient programs.
Usually, detoxification from benzodiazepines is done through a tapering protocol to allow the brain to adapt as the dosage is reduced. The pace and structure of the tapering process will be determined by the prescribing physician and staff.
Benzodiazepines and Co-Occurring Disorder Treatment
Anxiety disorders, PTSD, panic disorder, and depression are the primary reasons benzodiazepines are prescribed.
At Meridian Recovery, we offer integrated dual diagnosis treatment for both substance use and co-occurring mental health diagnosis together. Addressing the underlying mental health condition is not an optional part of benzo recovery; it is critical. If the underlying condition is not treated, those issues are likely to cause relapse.[9]
