Benzodiazepines are medications that are frequently prescribed for the symptomatic treatment of anxiety and sleep disorders.
Benzodiazepines are also used as sedatives before some surgical and medical procedures, and for the treatment of seizure disorders and alcohol withdrawal.
However they can be highly addictive for some people in addition to being abused. For example someone who has taken speed might also take benzodiazepines to bring themselves “down” when they need sleep.
Any person being prescribed benzodiazepines should discuss the nature of their job with their physician (to the extent of obtaining written assurance from the physician that the prescribed dosage will not adversely impact upon the person’s ability to safely carry out their work and to fulfil normal daily tasks such as driving to work).
- They can be highly addictive for some people.
- They need to taken exactly as prescribed.
- The dose needed is different from person to person.
- Medicines are usually only a part of treatment. Psychotherapy, skills training and lifestyle are important too.
- It can be very dangerous to stop taking them abruptly. The dose needs to be reduced slowly and gradually when stopping
The effects of any medication depend on several factors, including
- The type and severity of the disorder for which the medication is prescribed
- The amount taken at one time
- The form in which the medication is taken
- The patient's age
- Prior or concurrent use of psychoactive drugs
- The circumstances under which the medication is taken (i.e., the user's psychological and emotional state, simultaneous use of alcohol or other drugs, etc.)
A therapeutic dose of benzodiazepines (i.e., medically prescribed) can relieve anxiety and insomnia. Generally, benzodiazepines are well tolerated and have a wide margin of safety. But some people may experience drowsiness, lethargy dizziness or difficulty with co-ordination.
High doses lead to heavier sedation and can impair both mental sharpness and physical co-ordination. Lower doses are recommended for older people and for those with some chronic diseases, since they may be more sensitive to medications and may metabolise them more slowly. It has also been suggested that benzodiazepines can impair the ability to learn and remember new information
Studies show that anti-anxiety agents, even when correctly prescribed, may interfere with the ability of some users to perform certain physical, intellectual and perceptual functions. Most side-effects usually occur early in treatment and wane over time
For these reasons, individuals should assess their response to benzodiazepines with their medical practitioner before they operate a motor vehicle or engage in tasks requiring concentration and co-ordination. Such activities may become more dangerous if benzodiazepines are used together with alcohol and/or other sedative hypnotics or antihistamines (found in many cold, cough and allergy remedies)
Because some benzodiazepines (such as diazepam and flurazepam) are metabolised and eliminated from the body quite slowly, the medication can accumulate in body tissues with long-term use and may heighten such effects as lethargy in some individuals. Some users may feel drowsy or "hung over," even on the day after they take the medication. Seniors, in particular, may be at increased risk of falls, fractures and confusion
There have been very rare reports of unexpected stimulation resulting from Benzodiazepines use, with cases ranging from agitation to violent behaviour.
Overdoses of benzodiazepines, either accidental or intentional, do occur. While death rarely results from benzodiazepine overdose alone, these medications may be fatal when used in combination with alcohol and other drugs that depress the central nervous system.
Tolerance is the need to increase the dose of a drug to maintain the desired effects. Tolerance to the anxiety-relieving effects of benzodiazepines is uncommon and most individuals do not increase their benzodiazepine dose. But tolerance to the sedative and other effects of benzodiazepines can develop in some people with regular use.
Risk of physical dependence increases if benzodiazepines are taken regularly (e.g., daily) for more than a few months, especially at higher than normal doses. However, problems have been reported after shorter periods of use. The user's body adapts to the presence of the medication and experiences withdrawal symptoms when use is stopped. The frequency and severity of these symptoms depend on the dosage, the duration of use, and whether the medication is stopped abruptly or tapered off.
Stopping abruptly can bring on such symptoms as trouble sleeping, gastrointestinal upset, feeling unwell, loss of appetite, sweating, trembling, weakness, anxiety, and changes in perception (e.g. numbness and altered sensitivity to light, sound and smells ). In rare cases after high doses, psychosis and convulsions may occur.
While most patients call tolerate such symptoms a physician may decide to gradually taper the benzodiazepine dose to minimize discomfort, especially after long-term use. Gradual discontinuation of the medication is preferred, but it may not entirely eliminate withdrawal symptoms
Diagnostic manuals recognise the occurrence of psychological or behavioural dependence on benzodiazepines. The main signs of psychological dependence on any drug are
- A strong desire or craving for the drug
- Seeking out the drug, often at the expense of other activities
- Difficulty Stopping or cutting down
- Continued use despite physical or psychological consequences
People who use benzodiazepines on a long-term basis to treat specific chronic disorders (such as panic disorder, social phobias or agoraphobia) rarely exhibit such symptoms or behaviours. On the other hand, psychological dependence has been clearly demonstrated among certain groups, such as poly-drug abusers and methadone-treated heroin addicts
The period of time that Benzodiazepines can be detected varies from individual to individual and depends on many factors such as the amount of drug taken, frequency, route of administration, and type of drug itself. Generally a positive result can be detected in a urine sample for between one to 12 days.
- Highly Addictive
- Don't exceed Prescription
- Considered part of treatment
- Manage withdrawal carefully
- Effects depend on a variety of factors including the history of use, physiological factors of the person taking the drug and their psychological state
- Therapeutic use can provide relief however one adverse safety effects include drowsiness, dizziness and co-ordination.
- Potential linkage with learning problems due to the impairment on memory
- Care required with driving vehicles, machinery or any safety sensitive task
- Dangerous if taken with alcohol
- Some reports of unexpected stimulation leading to agitation or violent behaviour
- Overuse from Benzo's alone not normally fatal, however can be fatal when used in combination with alcohol or other drugs
- Tolerance to anxiety-relieving effects is uncommon, however - tolerance to sedative and other effects can develop with regular use.
- Physical dependence with regular use especially higher doses.
- Withdrawal symptoms are
- less severe when use is tapered off rather than stopped abruptly.
- more acute in quickly eliminated benzo's
- Generally Detected In urine for 1 to 12 days