What is Benzos (Benzodiazepines)?

What is Benzo?

“Benzo” is a common shorthand for benzodiazepines, a class of psychoactive drugs used primarily to treat anxiety, insomnia, seizures, and muscle spasms. They work by enhancing the effect of the neurotransmitter GABA in the brain, producing a calming effect. Common examples include diazepam (Valium), alprazolam (Xanax), and lorazepam (Ativan).

Benzodiazepines are typically prescribed for short-term use due to risks of dependence, tolerance, and withdrawal symptoms. Side effects can include drowsiness, confusion, and impaired coordination. Misuse or long-term use can lead to addiction or serious health issues.

What Are Benzodiazepines Usually Prescribed For?

Benzodiazepines (commonly called “benzos”) are prescribed to treat a range of medical conditions due to their calming and sedative effects on the central nervous system. They enhance the activity of GABA, a neurotransmitter that inhibits brain activity, leading to relaxation. Common conditions they are prescribed for include:

• Anxiety disorders: To manage symptoms of generalized anxiety disorder, panic disorder, or social anxiety (e.g., alprazolam/Xanax, lorazepam/Ativan).
• Insomnia: Short-term treatment for sleep difficulties (e.g., temazepam/Restoril).
• Seizure disorders: To control seizures, such as in epilepsy (e.g., diazepam/Valium, clonazepam/Klonopin).
• Muscle spasms: To relieve muscle tension or spasticity (e.g., diazepam).
• Alcohol withdrawal: To manage withdrawal symptoms and prevent seizures (e.g., chlordiazepoxide/Librium).
• Sedation: For procedures like surgery or dental work (e.g., midazolam/Versed).

They are typically prescribed for short-term use (2-4 weeks) because of the risk of dependence with prolonged use.

How Do People Become Addicted to Benzodiazepines?

Benzodiazepine addiction can develop through both prescribed use and misuse. The process often involves:

1. Physiological Dependence:
   • Regular use, even as prescribed, can lead to tolerance, where the body requires higher doses to achieve the same effect. This happens because the brain adapts to the drug’s presence, reducing GABA receptor sensitivity.
   • Within weeks, the body may rely on the drug to maintain normal function, leading to dependence.
2. Psychological Dependence:
   • Users may feel they need the drug to cope with stress, anxiety, or sleep issues, reinforcing psychological reliance.
   • The calming effects can be reinforcing, leading some to use benzos to self-medicate for non-prescribed issues like stress or emotional distress.
3. Misuse or Abuse:
   • Some individuals take benzos in higher doses, more frequently, or without a prescription to achieve euphoria or enhance the effects of other substances (e.g., opioids or alcohol).
   • Obtaining benzos illicitly or “doctor shopping” increases the risk of misuse.
4. Risk Factors:
   • Long-term prescriptions (beyond 4 weeks).
   • History of substance abuse or mental health disorders.
   • Combining benzos with alcohol or other drugs, which amplifies effects and dependence risk.
   • Lack of medical supervision or inadequate monitoring.

Symptoms of Benzodiazepine Addiction

Addiction involves both physical dependence and behavioural changes. Symptoms include:

• Physical and Psychological Symptoms:
  • Craving the drug or feeling unable to function without it.
  • Tolerance (needing higher doses for the same effect).
  • Withdrawal symptoms when not taking the drug, such as anxiety, irritability, sweating, tremors, nausea, insomnia, or seizures (in severe cases).
  • Continued use despite negative consequences (e.g., health issues, impaired work or relationships).
• Behavioural Symptoms:
  • Taking more than prescribed or using someone else’s prescription.
  • Obsessing over obtaining or using the drug.
  • Neglecting responsibilities or hobbies in favour of drug use.
  • Doctor shopping or seeking multiple prescriptions.
  • Using benzos to cope with emotions or stress unrelated to the prescribed condition.
• Cognitive and Physical Signs:
  • Memory problems, confusion, or difficulty concentrating.
  • Drowsiness, slurred speech, or impaired coordination.
  • Mood swings, depression, or increased anxiety when the drug wears off.

How Do People Quit or Stop Taking Benzodiazepines?

Quitting benzodiazepines can be challenging due to withdrawal risks, which can be severe or life-threatening (e.g., seizures). Stopping requires a careful, medically supervised approach. Steps include:

1. Medical Supervision:
   • Consult a doctor or addiction specialist to create a personalized tapering plan. Abruptly stopping (“cold turkey”) is dangerous and can cause severe withdrawal symptoms like seizures, psychosis, or extreme anxiety.
   • Tapering involves gradually reducing the dose over weeks or months to minimize withdrawal effects.
2. Tapering Process:
   • The doctor may reduce the dose by small increments (e.g., 10–25% every 1–2 weeks), depending on the drug, dose, and duration of use.
   • Switching to a longer-acting benzo (e.g., diazepam) during tapering can smooth the process, as it has a longer half-life and less intense withdrawal.
   • The timeline varies: short-term users may taper over weeks, while long-term users may need months.
3. Supportive Therapies:
   • Cognitive Behavioural Therapy (CBT): Helps address underlying anxiety or insomnia, teaching coping strategies without relying on medication.
   • Counseling or Support Groups: Groups like Narcotics Anonymous or therapy can provide emotional support and accountability.
   • Lifestyle Changes: Stress management techniques (e.g., mindfulness, exercise, sleep hygiene) can reduce reliance on benzos.
4. Managing Withdrawal:
   • Withdrawal symptoms (anxiety, insomnia, irritability, muscle pain, etc.) are common but can be managed with medical support.
   • In severe cases, doctors may use adjunct medications (e.g., anticonvulsants or antidepressants) to ease symptoms, though these are carefully selected to avoid new dependencies.
   • Inpatient detox or rehab may be recommended for severe addiction or co-occurring substance use.
5. Aftercare and Relapse Prevention:
   • Ongoing therapy or support groups to maintain sobriety.
   • Addressing co-occurring mental health issues (e.g., anxiety, depression) to prevent relapse.
   • Avoiding triggers, such as stress or environments associated with drug use.

Additional Notes

• Risk of Relapse: Cravings and underlying conditions (e.g., anxiety) can make relapse common. Long-term support is crucial.
• Individual Variation: The quitting process depends on the individual’s health, duration of use, and dosage. A healthcare provider tailors the plan.
• Resources: If you or someone you know is struggling, contact a doctor, addiction specialist, or helplines like SAMHSA (1-800-662-HELP in the U.S.) for guidance.