Benzodiazepines: 7+ Uses, Risks, & Signs of Benzo Addiction

Benzodiazepines Definition

What Are Benzodiazepines?

Benzodiazepines are substances used to treat anxiety, panic disorders, insomnia, and seizures. 

Common examples of Benzodiazepines include alprazolam (Xanax) and diazepam (Valium). They can also be used to manage epilepsy or for anesthesia before medical procedures. Other examples include Chlordiazepoxide (Librium), Oxazepam (Serax), Flurazepam (Dalmane), Midazolam (Versed), Flunitrazepam (Rohypnol), and Estazolam (ProSom). 

Long-term use of Benzodiazepines can lead to dependence and intense withdrawal symptoms.

Are Benzodiazepines a Depressant?

Yes, Benzodiazepines are central nervous system (CNS) depressants. 

They work by slowing the brain and body by increasing GABA levels, a neurotransmitter that has a calming effect. Similar to how barbiturates work, Benzodiazepines reduce activity in the nervous system, calm the brain, and reduce or stop panic, seizures, and stress by creating a sleepy or relaxed state.

Are Benzodiazepines Opiates?

No, Benzodiazepines are not opiates. 

Benzodiazepines enhance the effects of a calming brain chemical called GABA, helping calm the brain and body. Opioids are primarily used for pain relief by binding to opioid receptors in the brain and body to block pain signals. Examples of opioids include morphine, codeine, oxycodone, and heroin.

Are Benzodiazepines a Narcotic?

No, Benzodiazepines are not narcotics. 

Narcotics refer to opioids, such as heroin, morphine, and oxycodone, which work by affecting opioid receptors to relieve pain. Benzodiazepines, such as Xanax, Valium, and Ativan, are central nervous system depressants that work by affecting GABA neurotransmitters to treat anxiety (called anxiolytic Benzodiazepines), seizures, and insomnia.

Are Benzodiazepines Sedatives?

Yes, Benzodiazepines are considered sedatives. 

Sedatives such as Benzodiazepines decrease the speed of brain activity to create calming, sedative, and sleep-inducing effects. The effect they have on GABA (gamma-aminobutyric acid, a brain-calming chemical) lessens nerve activity, which also has a sedative effect.

What Are the Top 5 Benzodiazepines?

The top 5 Benzodiazepines are as follows:

• Alprazolam (Xanax): Treats acute anxiety and/or panic
• Diazepam (Valium): Works against anxiety, muscle spasm, seizures, and sedation
• Clonazepam (Klonopin): Used to treat panic or seizure disorders
• Lorazepam (Ativan): Treats anxiety, acute agitation, or as part of procedural sedation
• Temazepam (Restoril): Used for short-term insomnia

What Is the Strongest Benzodiazepine?

Alprazolam (Xanax) and Clonazepam (Klonopin) are considered the strongest Benzodiazepines.

Xanax is a highly potent, short-acting substance taken in smaller doses, while long-acting Klonopin is taken in larger doses for panic and seizure disorders. Clonazepam is a much stronger Benzodiazepine than Diazepam (Valium), with a 30 to 40-hour half-life that causes it to act more slowly and stay in the body much longer than Xanax.

Benzodiazepines Use

What Are Benzodiazepines Used For?

Benzodiazepines encourage a calm, sedated state in the body and mind, as well as muscle relaxation and seizure control.

They may also be used as part of withdrawal management to reduce the acute symptoms of alcohol or substance use withdrawal.

Benzodiazepines are all categorized as depressants that slow brain activity and have also been used as a way to calm patients before surgery.

What Do Benzodiazepines Treat?

Benzodiazepines are primarily used to treat the following conditions:

• Anxiety and panic attacks
• Preventing or stopping seizures
• Insomnia or sleep disturbances
• Muscle spasms or pain
• Acute alcohol withdrawal management
• Sedation before medical procedures or surgeries

Are Benzodiazepines Used With Other Medications?

Yes, benzodiazepines can be used with other medications under the supervision of medical professionals. 

They are often combined with serotonin reuptake inhibitors (SSRIs) for anxiety until the SSRIs take effect. Benzodiazepines may also be used with anticonvulsants for certain seizure disorders or with antipsychotics for conditions such as severe psychiatric distress or catatonia, or with other substances, such as anticoagulants or antidepressants. 

Combining Benzodiazepines with other central nervous system depressants or any substances requires medical oversight to avoid any possible risks.

How Do Benzodiazepines Work?

Benzodiazepines work by binding to the GABA-A receptor complex in the central nervous system, producing a calming effect.

During the binding process, they alter the receptor’s shape to boost the GABA effect, causing more chloride ions to enter the nerve cell. The nerve cell is then further stabilized, causing the channels to open more often. Benzodiazepines prevent nerve cells from firing too fast, producing a sense of calm in the brain and body. 

For this reason, Benzodiazepines are often prescribed to reduce anxiety.

Risks of Benzodiazepines Use

What Are the Risks of Benzodiazepine Use?

The risks associated with the use of Benzodiazepines include the following:

• Sedation and drowsiness, including slowed motor reflexes
• Short-term memory issues, confusion, and even psychotic reactions
• Motor coordination or dizziness
• Tolerance that requires higher doses to achieve the same effect
• Dependence leading to addiction
• Drug-induced coma
• Seizures, including grand-mal seizures
• Miscarriage when taken during pregnancy

Can Benzos Cause Withdrawal?

Yes, benzodiazepines can cause severe withdrawal symptoms when reduced or stopped. 

The National Institutes of Health states that Benzodiazepines alter brain chemistry, which makes a medically supervised detox the safest option. Withdrawal symptoms for Benzodiazepines include the following:

• Severe anxiety and panic disorders
• Insomnia and sleep disorders
• Hand tremors, sweating, and muscle pain
• Heart palpitations and high blood pressure
• Memory loss or sensory issues

Can You Die From Benzodiazepine Withdrawal?

Yes, benzodiazepine withdrawal can be fatal if not supervised due to the intensity of the way the central nervous system reacts once stopping to take it. 

Stopping Benzodiazepines abruptly after chronic or high-dose use can lead to grand mal seizures or put severe strain on the heart during withdrawal. 

Additional factors, such as using Benzodiazepines with alcohol or other substances, age, underlying heart conditions, or a history of seizures, can also contribute to or increase the risks associated with withdrawal.

Can You Overdose on Benzos? 

Yes, it’s possible to overdose on benzodiazepines (known as benzos), though overdoses are rare when taking only Benzodiazepines. 

The risk of a severe or fatal overdose can occur when taking a combination of Benzodiazepines and other central nervous system depressants, such as alcohol or opioids. An overdose occurs when the amount taken is greater than the body’s ability to process it. 

An overdose often presents as slow breathing and impaired consciousness. Overdose risks increase when taking Benzodiazepines with other substances, such as alcohol or opioids.

Benzodiazepine Addiction & Signs

Are Benzodiazepines Addictive?

Yes, Benzodiazepines are addictive, especially when taken for a long time.

Benzodiazepines are associated with physical dependence and tolerance, when higher doses are needed to achieve the same calming effect. The risk of Benzodiazepine use disorders also increases for individuals with past substance issues. 

Those taking Benzodiazepines may experience severe withdrawal symptoms if suddenly stopped due to a triggered dopamine change in the brain’s reward centers.

How Do Benzodiazepines Cause Dependence?

Benzodiazepines cause dependence when suddenly stopped, which causes the central nervous system to be overexcited.

As central nervous system depressants, Benzodiazepines bind to GABA-A receptors in the brain, thereby boosting nerve signaling. After prolonged use, the nervous system reduces natural GABA activity to compensate for the Benzodiazepine use. During withdrawal, the lack of the Benzodiazepine-triggered boost in the brain causes intense symptoms and often rebound anxiety.

What Are Physical Signs of Benzo Addiction?

Ahead are the key physical signs of Benzodiazepine addiction:

• Slowed, slurred speech
• Drowsiness or nodding off 
• Unsteady gait or lack of physical coordination
• Muscle weakness and fatigue
• Hallucinations that include blurred or double vision

Does Benzo Addiction Cause Mood or Behavioral Changes?

Yes, chronic use of Benzodiazepines can cause changes to mood and behavior, including the following:

• Depression, including suicidal ideation
• Lacking a normal emotional response or being unable to cope with stress
• Anxiety disorders or panic attacks
• Irritability, agitation, or aggressive moods
• Drug-seeking actions, including “doctor shopping” (obtaining duplicate prescriptions)
• Social withdrawal or isolation from family and friends
• Inability to maintain responsibilities at work, school, or home 
• Risk-taking behaviors, such as driving while sedated

Treatment for Benzodiazepines

What Are the Most Effective Treatments for Benzodiazepine Addiction?

Effective treatments for Benzodiazepine addiction include a medical detox, including medication-assisted treatment (MAT) and therapy to address co-occurring mental health conditions.

Align Recovery Center’s medically-assisted detox program for substance use disorder provides a 6—7—day detox with gradual tapering to safely manage withdrawal symptoms. 

In addition to 24/7 nursing and medical oversight, clients have access to MAT, which may include methadone or buprenorphine, as well as cognitive-behavioral therapy and dual diagnosis treatment to address the underlying issues of addiction. 

Do You Need Medical Detox for Benzodiazepine Dependence?

Yes, detox under the supervision of medical professionals with a gradual taper is preferred to detox from Benzodiazepines safely.

Withdrawal without medically-assisted detox can lead to severe withdrawal symptoms and potentially life-threatening issues, including grand mal seizures and cardiovascular distress. The Benzodiazepine detox program at Align Recovery Centers includes continual medical monitoring to manage withdrawal symptoms effectively.

What Is Tapering For Benzo Addiction?

Tapering for benzodiazepine addiction includes a gradual, medically supervised reduction.

Align  Recovery Center’s medical detox program lasts 6—medically assisted detox program for substance use disorder provides a 6—7—day 7 days, with 7 days preferred to include Benzodiazepine tapering. Tapering lowers the risk of health complications and can assist in easing withdrawal symptoms.

How Can Behavioral Therapies Help With Benzodiazepine Addiction?

Behavioral therapies help individuals seeking lasting recovery address root causes of addiction, including co-occurring mental health conditions, such as anxiety, depression, PTSD, or chronic stress.

Our comprehensive, personalized treatment program at Align Recovery includes cognitive-behavioral therapy (CBT) to identify thoughts, feelings, and behaviors surrounding substance use. CBT also teaches clients coping strategies to manage cravings, develop healthy behaviors, and prevent relapse.

How Does Treatment Help Manage Poly-Substance Abuse?

Medically-assisted treatment through detox and therapy manages poly-substance abuse by lowering withdrawal risks and treating co-dependencies. 

Medical detox, gradual tapering, and behavioral therapy help lower life-threatening withdrawal risks and manage symptoms safely. 

Align Recovery’s detox program includes medical oversight, which also monitors withdrawal symptoms from other substances, such as opioids or alcohol, when addressing poly-substance use disorder (the misuse of 2 or more substances at once).

FAQs

How Long Do Benzodiazepines Stay in Your System?

Benzodiazepines stay in the system anywhere from 12 hours to 90 days.

The amount of time the substance remains in the system depends on the drug’s half-life and how long or how regularly it was used. Short-acting Benzodiazepines leave the body more quickly than longer-acting ones.

How Long Do Benzodiazepines Stay in Urine?

Benzodiazepines can remain in the urine for 1-30 days. 

Short-acting Benzodiazepines such as Triazolam leave the urine in roughly 24 hours, while others like Alprazolam or Lorazepam can last between 1 and 5 days. Diazepam can be detected in the urine for approximately 10 to 30 days after heavy, prolonged use.

What Over the Counter Drugs Will Test Positive for Benzodiazepines?

Over-the-Counter Diphenhydramine, Dextromethorphan, Naproxen, and Ibuprofen may test positive for Benzodiazepines.

Diphenhydramine is found in many allergy and sleep aids, such as Benadryl, while Dextromethorphan is commonly found in cough syrups. NSAIDS, such as Naproxen and Ibuprofen in high doses, may also test positive, as can some cold medications containing certain antihistamines or decongestants.

Do Pre-Employment Drug Tests Test for Benzodiazepines?

Whether pre-employment drug tests test for Benzodiazepines depends on the panel used by the testing company.

Standard 4- or 5-panel tests do not test for Benzodiazepines, but many custom 10-panel screenings may.

Is Xanax stronger than benzodiazepines?

Xanax (also referred to as alprazolam) is a Benzodiazepine itself, but is not stronger than other benzodiazepines.

It is considered a high-potency substance that is much stronger than other benzodiazepines, such as Valium (diazepam). Xanax has a higher risk for misuse and severe withdrawal symptoms because the effects of Xanax wear off quickly, which can produce intense highs and lows. 

Xanax is also thought to contain a higher level of toxicity than other long-acting benzodiazepines when an overdose occurs.

Is Ambien a benzodiazepine?

No, Ambien (zolpidem) is not a Benzodiazepine. 

It is considered a sedative-hypnotic and is sometimes called a “Z-drug.” Ambien contains a different structure than Benzodiazepines, but similarly targets GABA receptors in the brain to promote relaxation and sleep. Ambien is an imidazopyridine, whereas Benzodiazepines contain a benzene and diazepine ring structure.

Is Suboxone a Benzodiazepine?

No, Suboxone is not a benzodiazepine. 

Suboxone is a brand-name prescription medication that combines both buprenorphine (a partial opioid agonist) and naloxone (an opioid antagonist). It is primarily used to treat opioid use disorder withdrawal symptoms, in addition to anxiety and insomnia, through medications such as Xanax or Valium. 

Benzodiazepines fall under a different class of sedative drugs used for anxiety and sleep. 

Is Zoloft a Benzodiazepine?

No, Zoloft is not a benzodiazepine. 

Zoloft is a selective serotonin reuptake inhibitor (SSRI) that is used as an antidepressant as part of long-term treatment for anxiety and mood disorders. Benzodiazepines belong to a different group of fast-acting sedative medications. Unlike Benzodiazepines, Zoloft works by increasing serotonin levels in the brain over time, is considered non-addictive, and is approved for daily, long-term use.

What Are the Top 5 Benzodiazepines?

The top 5 most common Benzodiazepines are Alprazolam (Xanax), Clonazepam (Klonopin), Diazepam (Valium), Lorazepam (Ativan), and Triazolam (Halcion). 

Each of these Benzodiazepine substances works to calm the brain, treat anxiety and panic, stop seizures, and assist with sleep.