Are prescription benzodiazepines connected to drug abuse?
While benzodiazepines, also known as benzos, do not have a high risk of abuse potential alone, they are often abused with other drugs and alcohol. The use of a sedative with alcohol, opiates and other drugs is very dangerous. There is a risk of depressing the central nervous system and slowing breathing. This can lead to a dangerous drug overdose.
What is the Ashton Manual?
You may have heard of the Ashton Method, based on the famous Ashton Manual, written by british psychopharmacologist, Dr. Heather Ashton. This groundbreaking work details various strategies for tapering off of different benzodiazepines. Dr. Ashton also makes a strong argument for using Valium (diazepam) as the benzo of choice for the tapering process.
Is the Ashton Method for everyone?
In some cases, tapering at home over a period of months is not a good idea. There are people who are heavily addicted to benzodiazepines, using dosages far above what is considered therapeutic or safe. And, there are people who are abusing other dangerous drugs at the same time who are at high risk of overdose.
Is benzodiazepine addiction the same as benzodiazepine dependence?
The majority of people who consider themselves to have a benzo addiction are actually benzo dependent. Benzodiazepines cause dependence and have a serious withdrawal syndrome. Many people have difficulty quitting benzos because they get physically sick, but they do not use them in an obsessive, compulsive, addictive manner.
What is benzo belly bloating?
Benzodiazepine withdrawal can be intense. Most people are concerned about seizures, which they should be, because seizures can be dangerous. However, there are other symptoms that are very uncomfortable that occur when a person stops benzos cold turkey.
Benzo belly is a common symptom, characterized by gastrointestinal upset. It can include bloating, constipation, pain, and other GI symptoms. Benzo withdrawal stomach pain can be managed by tapering properly and with additional treatment if needed.
What are some common benzodiazepines?
There are many benzos. It is a large class of drugs that mostly work the same, other than how fast they start working and how fast they wear off. Klonopin (clonazepam) and Ativan (lorazepam) are commonly prescribed by psychiatrists for anxiety. There are also many other benzos commonly prescribed by family doctors and other primary care prescribers.
Temazepam for sleep.
Also known as Restoril, temazepam is a popular sleeping pill. Doctors prescribe it often to patients who have trouble sleeping. Lorazepam, known by the brand name, Ativan, is also used for helping patients get to sleep as well as reducing anxiety. If you take these drugs for sleep, you may have difficulty sleeping after you stop the drug. Rebound withdrawal symptoms are a serious problem with benzodiazepines.
Alprazolam is the most abused of the benzos.
Known as Xanax, alprazolam is found often in the systems of drug abusers who have overdosed. Because of the fast onset and short half-life, alprazolam is thought to cause dependence and addiction more often then other benzodiazepines. For this reason, psychiatrists often prefer Klonopin, or clonazepam, as an alternative because of the long half-life. Both anti-anxiety, sedative-hypnotic drugs are effective for treating anxiety disorders. Yet, doctors can explore other options first, such as cognitive-behavioral therapy or other medications with less abuse potential.
Valium is used for sleep, anxiety and as a muscle relaxer.
Valium, or diazepam, has many uses. It is probably the benzodiazepine with the most FDA approved indications. Doctors prescribe it as a muscle relaxer for patients who have pain and related muscle spasms. It is also used for sleep and anxiety due to its sedative effects.
Librium and alcohol and drug detox.
While other benzos can be used, Librium, or chlordiazepoxide, is a sedative that is often used in detox programs. When patients are detoxing from alcohol or drugs, chlordiazepoxide can calm their anxiety and reduce the risk of seizure. While rarely abused, chlordiazepoxide is a habit forming drug, so it must be used carefully in the treatment of addiction.
Serax for elderly patients.
Also known as oxazepam, Serax is a benzodiazepine that is considered to be safer for the elderly. Yet, doctors must be careful in prescribing any of the benzos to elderly patients who are at higher risk for serious fall injuries. Oxazepam is also used to treat alcohol-related disorders and alcohol withdrawal.
Other benzodiazepines that are less frequently used.
There is quazepam, or Dural, often prescribed for sleep. Another of the benzos used for sleep is flurazepam, or Dalmane or Dalmadorm. It is longer-acting with a very long half-life. Etizolam is a related drug that is known to work on the GABA-A receptor. Tranxene, or clorazepate, is used to prevent seizures and is also used to treat alcohol withdrawal. Estazolam, or Prosom, is used for sleep. Loprazolam, or triazulenone, is an infrequently prescribed benzodiazepine used short term for sleep and other uses. As you can see, there are a long list of benzos. Doctors often stick to the more mainstream and better known benzodiazepines. Mental health specialists are more likely to prescribe the less-used forms of these drugs for sleep, panic disorder and the treatment of drug and alcohol abuse.
Halcion days: a cautionary tale of sleeplessness and amnesia.
Triazolam is best known by the brand name, Halcion. There was a time when triazolam, a sleeping pill, had a lot of bad press due to a reputation for causing temporary, short-term memory loss. Interestingly, amnesia is a common side effect of many benzodiazepines. In fact, one particular benzodiazepine, midazolam, also known by the brand name, Versed, is used especially for its potent amnesiac effects. Midazolam is administered for medical procedures, such as colonoscopies, where it is good for the patient to be awake during the procedure, but also good that they have no memory of it.
Slipping them a Mickey: Illegal use of illegal benzos.
The amnesiac effects of benzos has also led to their sinister use as date-rape drugs. Rohypnol, known on the street as roofies, is a benzodiazepine that is not even legal in the US. It is best known for a drug that is given secretly, known on the streets as a Mickey Finn, or slipping someone a mickey. The drug causes the victim to be sedated and have little or no memory of the attack. The danger of date-rape attacks and public drugging has led woman, and even men, to carry drug test kits with them such as drink spike tests and date rape drug detection kits. These kits are used to test bar drinks to see if a drug has been secretly added. It is always a good idea to not drink from a glass that has been left unattended. Also, stay close to trusted friends when out at bars and clubs.
Long-term use of benzodiazepine prescriptions drugs.
It is not unusual for a doctor to prescribe benzodiazepines, such as alprazolam, diazepam or lorazepam to a patient for many years for pain disorder. If there are no adverse effects and the patient functions better in their daily activities, these long-acting and short-acting benzodiazepines can be used safely long-term. However, if the patient decides to stop taking benzodiazepines at some point, they have to work carefully with their doctor to reduce benzodiazepine use. These drugs should be tapered gradually over time. If benzodiazepine use is stopped to abruptly, there is a serious risk of rebound anxiety and even dangerous seizures.
Addiction and benzodiazepine overdose.
People do become addicted to drugs such as Xanax and Valium. While alprazolam and diazepam are probably most associated with abuse, clonazepam, lorazepam and many other benzos can be abused as well. Doctors must exercise care in prescribing benzodiazepines and be aware of signs of overuse and abuse. The treatment of benzodiazepine addiction should be handled by an addiction specialist with experience in detoxing patients off of benzos in a safe setting.
Call Dr. Leeds for help overcoming benzo dependence and addiction.
Our concierge program is private, discreet, caring, compassionate, and customized to your needs. Tapering programs are tailored to your specific situation. The program is continually updated to make your journey to a benzo-free lifestyle as comfortable as possible. Please call today or reach us through the contact page on this website for more information.