People with psychiatric symptoms and disorders also appear to be more vulnerable to benzodiazepine misuse. This is consistent with findings that regulating negative affective and somatic states is the most common motive for benzodiazepine misuse. Yet, it is unclear if psychiatric distress is an antecedent or consequence of benzodiazepine misuse (or both), and findings from the reviewed studies provide partial support for both explanations. It is likely that greater psychiatric distress motivates misuse to relieve symptoms, and symptoms of psychiatric distress are also a consequence of acute or protracted benzodiazepine withdrawal. The association between psychiatric distress and benzodiazepine misuse underscores the importance of first considering non-benzodiazepine treatments (e.g., cognitive-behavioral therapy, antidepressants) for psychiatric symptoms among those who are most likely to misuse benzodiazepines.
Benzodiazepine Use or Misuse
They are added as an adjunct to rest, physical therapy and / or heat and ice. Table 1 lists U.S. generic and brand name benzodiazepines, their common uses and duration of action. Many of the brand name products have been discontinued by their manufacturers; however, equivalent, lower-cost generics are available for these brands. Depending on your situation, your doctor may think it best to prescribe very small amounts of medication at a time. This will prevent you from altering the taper, but it might mean frequent trips to the pharmacy.
- Qualitative and descriptive results indicate that coingesting benzodiazepines with alcohol increases the intoxicating effects of both substances (Calhoun et al., 1996; Dåderman and Lidberg, 1999; Perera et al., 1987).
- This drug is best known as Rohypnol (or by the slang term “roofies”), and it’s infamous for its use as a “date rape” drug.
- Rohypnol is used illegally to lessen the depression caused by the abuse of stimulants, such as cocaine and methamphetamine, and in cases of sexual assault where is induces memory loss in the victim.
What safety concern is FDA announcing?
Drowsiness, sleepiness, or dizziness are the most commonly reported side effects with this drug class. Driving or operating machinery or perform other hazardous tasks can be dangerous while using these drugs. Drinking alcohol in combination with benzodiazepines may heighten these effects. Common benzodiazepines used for GAD include alprazolam, clonazepam, diazepam, and lorazepam. Mirtazapine (Remeron) and buspirone are also effective in GAD for patients who do not respond to at least two trials of SSRIs or SNRIs.
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The benzodiazepine-dependent population is heterogeneous and this influences management. A frail 70 year old with falls prescribed flunitrazepam as a sedative hypnotic for 20 years requires a different management approach from a 25-year-old intravenous drug user buying street alprazolam. The principles of management of dependence with ‘z-drugs’ such as zolpidem and zopiclone are the same as the management of benzodiazepine dependence. Benzodiazepines can also be obtained from people who are not drug dealers – friends, a friend of a friend, coworkers, or family members may share or sell their pills. For instance, when drug sellers do not have benzodiazepines available, they may offer other dangerous drugs to the person, which can lead to polydrug abuse.
Benzodiazepine Abuse Symptoms, Side Effects, and Addiction Treatment
Nayzilam (midazolam) and Valtoco (diazepam) are nasal sprays now approved for the treatment of seizure clusters (also known as acute repetitive seizures). Nayzilam is approved by the FDA to be used in patients 12 years of age and older, and Valtoco in used in those 6 years and older. Benzodiazepines may be used at the beginning of therapy to lessen symptoms while the antidepressants take effect, which may take 4 to 6 weeks. Benzodiazepines such as clonazepam (Klonopin), lorazepam (Ativan), diazepam (Valium) and alprazolam (Xanax) are useful for panic attacks.
Behavioral therapy and treatment with the antidepressants such as selective serotonin-reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and/or behavioral therapy are first-line treatments. As controlled substances, all benzodiazepines have the potential for abuse, addiction and diversion. Before you drive, go back to work, use heavy tools and machinery, or participate in other potentially dangerous activities, talk to your healthcare provider. They can guide you on what you can do to take your medications as prescribed and stay safe at the same time. While there are separate types because they have different primary effects, there’s a lot of overlap between them. For example, most benzodiazepines have a sedative effect in addition to their primary effect.
Risk Factors
Little is known about benzodiazepine misuse in older adults, despite high rates of prescribing in this group (Maust et al., 2018; Schepis et al., 2018b). Rates of tranquilizer and sedative misuse are lower in adults over the age of 50, as compared to younger age groups (Maust et al., 2018; Schepis et al., 2018b), and are lower than rates of prescription opioid misuse in this age group (Blazer and Wu, 2009). Yet, the prevalence of lifetime and past-year tranquilizer misuse increased among this age group severe benzodiazepine withdrawal syndrome from 2002–2003 to 2012–2013 (from 4.5% to 6.6% and 0.6% and 0.9%, respectively; Schepis and McCabe, 2016). In addition, the proportion of individuals with past-year tranquilizer misuse who are over the age of 50 doubled from 2005–2006 to 2013–2014 (from 7.9% to 16.5%; Palamar et al., 2019). Benzodiazepine misuse and dependence appears to be more common among older adults with a prescription or who are treated in psychiatric settings (Landreat et al., 2010; Voyer et al., 2009; Yen et al., 2015).
Patients on maintenance therapy may eventually reach a period of stability in which withdrawal to a lower dose or abstinence may be considered. High-risk patients or those with unstable medical conditions or a significant seizure history may benefit from admission to an inpatient service for stabilisation or withdrawal. These range from 25% at 12 months for those with complicated dependence15 to 80% for older adults in general practice.16 Abrupt cessation of benzodiazepines after a period of 1–6 months of use can cause life-threatening seizures so the dose should be gradually reduced.
Facts about Benzodiazepines
- Fraudulent and counterfeit medications are often marketed and sold online to unsuspecting consumers.
- If any serious symptoms emerge such as signs of benzodiazepine overdose the best practice is to seek immediate help, which can include going to a local emergency room or contacting a doctor.
- An overview of findings on sociodemographic correlates of benzodiazepine misuse is presented in Table 3.
- They will need someone to drive them home and are usually drowsy until the next day, so will need to take a full day off of work.
- No standard benzodiazepine tapering schedule is suitable for all patients; therefore, create a patient-specific plan to gradually reduce the dosage, and ensure ongoing monitoring and support as needed to avoid serious withdrawal symptoms or worsening of the patient’s medical condition.