Benzodiazepine Dependence


Benzodiazepines are sedative-hypnotic medications, that have as primary pharmacological effects, reduction of anxiety and induction of sleep. They’re also among the most frequently prescribed drugs.

Not all sedative hypnotics are benzodiazepines but benzodiazepines do make up the majority of sedative hypnotics. Benzodiazepines possess hypnotic, sedative, anti-anxiety, anticonvulsant and muscle relaxing properties. They include such medications as alprazolam, clonazepam, diazepam and lorazepam.

Benzodiazepine After Effects

The most frequent side effects of benzodiazepines are an extension of the drug effect i.e. drowsiness or light-headedness. Significant benzodiazepine side effects unrelated to extended pharmacological activity include, but are not limited to, hostility, aggressiveness, insomnia, depression and amnesia. What’s more, certain subsets of the population are inclined to abuse benzodiazepines, which can lead to physical dependence and addiction.

The following adverse events have been reported in association with the use of alprazolam (XANAX): seizures, hallucinations, depersonalization, taste alterations, double vision, elevated bilirubin, elevated hepatic enzymes, and jaundice.

Benzodiazepine Risks

The fact is that no drug is 100% safe, but benzodiazepines are particularly problematic especially in relation to dependence and addiction. Furthermore, they have the potential to be harmful to fetus development when administered to pregnant women.

If a person takes benzodiazepines too often they may develop side effects, which resemble the reason they started taking the medication in the first place. Benzodiazepine users may become incapable of dealing with life or getting to sleep without benzodiazepines. In this way, benzodiazepines actually wind up causing anxiety and insomnia.

Dependence Liability

The term dependence liability refers to benzodiazepine’s tendency to produce dependence. There is clear evidence that prolonged use of even therapeutic doses is likely to result in dependence. Even after relatively short-term use at the doses recommended for the treatment of transient anxiety and anxiety disorder there is risk of dependence.

There are certain subsets of the population who are at greater risk for benzodiazepine dependence. These groups include polysubstance abusers, patients with histories of alcoholism, and the elderly. With respect to polysubstance abuse, benzodiazepines are often co-abused with opioids and/or alcohol. Upwards of one-third of opioid addicts have reported taking benzodiazepines in combination with opioid drugs, particularly with methadone. Clinical and preclinical evidence suggests that benzodiazepines enhance the effects of opioids, i.e. they intensify intoxication.

Benzodiazepine Dependence

Physiological dependence to benzodiazepines means an individual is susceptible to withdrawal symptoms whenever benzodiazepine consumption is discontinued. It typically takes a significant length of time of daily use to become physically dependent to benzodiazepines. Dependence typically develops after prolonged treatment with therapeutic doses. It is unknown to what extent the risk of physiological dependence is dependent upon a minimum duration of exposure or dosage of these drugs. However, dependence on alcohol or other sedatives may increase the risk of benzodiazepine dependence.

Benzodiazepine Withdrawal

Benzodiazepine withdrawal is a set of recognizable signs that occur shortly after abrupt cessation, or rapid tapering from benzodiazepines for any person physically dependent to benzodiazepines. Benzodiazepine withdrawal is characterized by sleep disturbance, irritability, increased tension and anxiety, panic attacks, hand tremor, sweating, difficulty in concentration, dry wretching and nausea, weight loss, palpitations, headache, muscular pain and stiffness and a host of perceptual changes.

The medical event voluntary reporting system shows that withdrawal seizures have been reported in association with the discontinuation of XANAX. In most cases, only a single seizure was reported; however, multiple seizures, and acute, prolonged epileptic crisis were reported as well.

List of Significant Benzodiazepine Withdrawal Symptoms:

The risk of developing significant withdrawal symptoms is related to dosage and duration of treatment.

  1. Severe anxiety
  2. Fatigue
  3. Irritability
  4. Dysphoria (unease)
  5. Insomnia
  6. Nightmares
  7. Tremor
  8. Muscle pain
  9. Seizure
  10. Perceptual changes (hallucinations)

Benzodiazepine withdrawal symptoms are typically more severe when detoxing from higher doses. Benzodiazepine withdrawal can be very severe and that is why the most important benzodiazepine detox tool is a detox doctor. The reality is that benzodiazepine detox comes with serious health risks including seizure, stroke and death. Withdrawal from normal dosage benzodiazepine treatment can result in a number of symptomatic patterns. The most common is a short-lived “rebound” anxiety and insomnia, coming on within 1-4 days of discontinuation, depending on the half-life of the particular drug. The second pattern is the full-blown withdrawal syndrome, usually lasting 10-14 days; finally, a third pattern may represent the return of anxiety symptoms which then persist until some treatment is re-instituted.

Sedative-Hypnotic Withdrawal Syndrome

Sedative hypnotic withdrawal syndrome is a distressful condition caused by cessation of sedative-hypnotic drugs such as benzodiazepines for any person physically dependent to sedative hypnotics.

Sedative-hypnotic withdrawal syndrome is typically characterized by sleep disturbance, irritability, increased tension and anxiety, panic attacks, hand tremor, sweating, difficulty in concentration, dry wretching and nausea, some weight loss, palpitations, headache, muscular pain and stiffness and a host of perceptual changes.

Benzodiazepine Addiction Treatment

There is no one size fits all type of treatment for benzodiazepine addiction. However, benzodiazepine detoxification treatment is often the first step in the recovery process. The reason why benzo detox is the first step is because benzodiazepine withdrawal is potentially harmful to include seizure, stroke and death.

When choosing a treatment program for benzodiazepine addiction make certain they have a history of treating benzodiazepine withdrawals. Nothing is more certain to disrupt the recovery process than a bad detox.

Learning how to get off benzodiazepines is not something you can just read in a book. It requires the skill of a knowledgeable physician, qualified counselors and a detoxification center that knows how to make the recovery process safe, effective and comfortable.