Benzodiazepine (BZD) abuse has reached epidemic levels and results in poor outcomes, particularly when combined with concomitant central nervous system depressants. In the absence of other medications or illicit substances, BZDs are rarely the sole cause of death. Prescription drug abuse has received more attention in recent years, yet much remains unknown about BZD abuse. A subset is at elevated risk of abuse, especially those with a history of a substance use disorder. A Boxed Warning, the FDA’s most stringent safety warning, exists on all benzodiazepine product information.

When To Call the Doctor

Some patients are reluctant to consider ceasing their benzodiazepine and are at high risk of relapse or harm. This involves using a long half-life substitute to prevent intoxication and withdrawal phenomena, and allowing the patient to engage in holistic treatment of their dependence, before slowly reducing the dose. An overview of findings on sociodemographic correlates of benzodiazepine misuse is presented in Table 3. The findings on substance use and psychiatric correlates of benzodiazepine misuse presented below have been replicated in numerous samples; details and further citations in support of these findings are included in Supplementary Materials. Shorter-acting drugs produce a brief and more intense withdrawal reaction that usually begins within 24 hours of discontinuation. Longer-acting benzodiazepines have a slower development of withdrawal symptoms that typically begin several days after discontinuation, but peak at about 7 days.

Benzodiazepine Side Effects

Benzodiazepines work by blocking excessive activity of nerves in the brain and other areas in the central nervous system. Depending on which benzodiazepine you are currently taking, your doctor may want to switch you to a different one before your taper begins. severe benzodiazepine withdrawal syndrome Short-acting benzodiazepines complicate withdrawal with too many ups and downs. Diazepam, a long-acting benzodiazepine, is the most common choice for dose tapering. The primary difference between these drugs is the length of time they stay active in the body.

When to Seek Medical Care for Benzodiazepine Abuse

See Table 2 for characteristics of U.S. general population surveys included in the present review, including specific medications included in broader prescription drug categories, such as sedatives and tranquilizers. We will use the terms sedatives and tranquilizers when reporting prevalence data extracted from these general population surveys. Elsewhere, to balance accuracy with ease of interpretation, we use the term “benzodiazepines” to refer both to studies of benzodiazepines exclusively and in combination with other sedatives/tranquilizers. Unfortunately, it’s also possible with long-term use of these drugs even when you take them as prescribed. If you have concerns about dependence and withdrawal from benzodiazepines, your healthcare provider can help you plan the timeline for your treatment.

• When BZDs interact with GABA-A receptors, ion channels open more frequently, increasing the inflow of chloride ions which increases membrane polarization and inhibits neuron firing resulting in central nervous system (CNS) depression [15].
• If you become dependent on the drugs, you can have withdrawal symptoms and even seizures when you suddenly stop taking them.
• This can involve living at a detox facility or hospital for several weeks, where you can receive constant medical monitoring and psychological support.
• If your healthcare provider prescribes one of these medications, don’t hesitate to ask for guidance, and take the medications exactly as prescribed.
• Although these studies suggest, or imply, that this constitutes problematic use, these studies may have included participants who were using benzodiazepines as prescribed.
• In addition, health care professionals should make necessary interventions and referrals when problematic alcohol consumption is suspected or identified.

Long-Term Treatment for Benzodiazepine Withdrawal

• Accordingly, such approaches may also have promise for the treatment of benzodiazepine misuse, particularly given the strong link between anxiety and benzodiazepine misuse (McHugh et al., 2018; McHugh et al., 2017).
• See Supplementary Materials for additional details on methods, including search terms, inclusion criteria, and data extraction methods.
• Stringent requirements impeded access for appropriate medical use.53-56 Health care providers and lawmakers must be cautious when implementing laws and strategies to tackle prescription drug abuse to avoid hindering appropriate care.
• Taking opioids in combination with other central nervous system depressants—like benzodiazepines, alcohol, or xylazine—increases the risk of life-threatening overdose.1,2 Learn more about the effects of taking more than one type of drug (polysubstance use) from the U.S.
• For example, lorazepam has a much shorter duration than diazepam, allowing quicker clearance of the drug and theoretically less side effects.

Benzodiazepine Abuse Causes and Risk Factors