Benzodiazepines, often called benzos, are among the most commonly prescribed depressant medications, or tranquilizers, in the United States today. More than 15 FDA-approved benzodiazepine medications exist to treat a wide array of both psychological and physical maladies based on dosage and implications. Commonly prescribed benzodiazepines include Xanax® (alprazolam), Librium® (chlordiazepoxide), Valium® (diazepam) and Ativan® (lorazepam).
Benzodiazepines are a class of drugs introduced in the late 1950’s to replace barbiturates in treatinganxiety, insomnia and seizure disorders. Although they can provide effective treatment for these conditions, benzodiazepines can be abused and this abuse can lead to dependency, injury and even death.
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Using benzos can be hazardous to your health
Each benzodiazepine displays one or more of the following drug actions: anxiety relief, hypnotic, muscle relaxant, anti-convulsant, or an amnesiatic (mild memory-loss inducer). Due to their sedative properties, benzodiazepines have a high potential for abuse, especially when used with other depressants such as alcohol or opiates. When combined with other drugs that depress central nervous system activity, such as alcohol or opioid pain relievers like oxycodone (OxyContin®), hydrocodone (Vicodin®), hydromorphone (Dilaudid®) or morphine, benzodiazepines may present serious or even life-threatening problems.
Another benzodiazepine that has been the focus of a great deal of media attention is flunitrazepam, trade name Rohypnol®, which is known widely as “the date-rape drug” due to its involvement in many sexual assault cases in recent years. Benzos can markedly impair and even abolish functions that normally allow a person to resist or even want to resist sexual aggression or assault. The drug is usually added to alcohol-containing drinks or even soft drinks in powder or liquid forms and can be hard to taste.
How are benzodiazepine drugs prescribed?
Methods of use vary greatly depending on the purpose of the administered benzodiazepine. The most common method of ingestion is orally, in tablet or capsule form. Valium®, Ativan® and Librium® are also sometimes dispensed intravenously, while midazolam (Versed®) is used exclusively as an intravenous medication. Ativan® comes in a tablet form that can be dissolved under the tongue.
Although most benzodiazepines trigger the same physical effects, their dosage and absorption time into the bloodstream can vary widely. A short-acting benzodiazepine is cleared from the body in a short period of time, whereas long-acting benzodiazepines may either accumulate in the bloodstream or take
a much longer period of time to leave the body. A particular benzodiazepine’s classification determines what it is prescribed for, as well as its potential for tolerance, dependence and abuse.
Benzodiazepines are prescribed in low to medium dosages for relaxation, calmness and relief from anxiety and tension. In some cases, side effects will occur; these vary widely depending on the type of benzodiazepine, the dose and the person. At high doses, benzodiazepines can cause extreme drowsiness.
Are benzodiazepines addictive?
Tolerance to certain benzodiazepines occurs most often in those who have used them for six months or more. Physicians counteract the effects of tolerance by increasing dosage in small increments or by adding another benzodiazepine to the prescription. Users most often develop tolerance to the milder effects of the drug, such as sedation and impairment of motor coordination. A fair amount of cross-tolerance exists between benzodiazepines and other depressants, such as alcohol and barbiturates, thususers may not feel the effects of these drugs as potently as they would otherwise.
Benzodiazepines are commonly abused. This abuse is partially related to the toxic effects that they produce and also to their widespread availability. They can be chronically abused or, as seen more commonly in hospital emergency departments, intentionally or accidentally taken in overdose. Death and serious illness rarely result from benzodiazepine abuse alone; however, they are frequently taken with either alcohol or other medications. The combination of benzodiazepines and alcohol can be dangerous.
According to a study by the Substance Abuse and Mental Health Services Administration, the vast majority of benzodiazepine-related abuse treatment admissions involved the abuse of another substance (95-percent) and in 82.1-percent of these cases, benzodiazepines were the secondary drug of abuse. Overall, opiates were the primary substance in most of these cases (54.2-percent), a pattern which roughly held true for nearly every age group except adolescents and those aged 45 and older. Among adolescents, marijuana was by far the most frequently reported primary substance of abuse used with benzodiazepines, while among those age 45 and older, alcohol as a primary substance of abuse rivaled opiates.
Despite their many beneficial uses, benzodiazepines can lead to physical and psychological dependence. Dependence can result in withdrawal symptoms and even seizures when the drugs are stopped abruptly. Dependence and withdrawal occur in only a very small percentage of people taking normal doses for short periods. Symptoms of withdrawal, which can be difficult to distinguish from anxiety, usually develop at three to four days from last use, although they can appear earlier with shorter-acting varieties.
To ease the symptoms of withdrawal, physicians recommend that users gradually reduce the amount of medication ingested until the dose is low enough that the individual will not feel discomfort. Withdrawal symptoms are most severe when a high dose of either a short-acting or intermediate-acting benzodiazepine is abruptly discontinued.
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