Tranquilisers/Benzodiazepines: Harm Reduction Advice

Drug Information – Tranquilisers/ Benzodiazepines
Benzodiazepines, a variety of tranquilizer, are a group of prescribed sedative drugs used to treat problems such as severe anxiety and insomnia. The most well known is Valium.
They usually come in pill form and work by slowing down the central nervous system. Consequently they are also used recreationally by people as well as being applied to alleviate medical problems. Some people who have been prescribed them for long periods develop dependence and find withdrawal difficult.

Patterns of Use

Until the 1960s and 70s, the main group of drugs for helping with stress were barbiturates. They are quite harmful and risky drugs especially when mixed with alcohol where there is a danger of overdose.  The medical industry developed benzodiazepines (benzos) as a safer alternative and gradually they have replaced barbiturates.

Although they have helped millions of people with their anxiety and sleep, they have also caused many people to become dependent on them. There are more women than men (about 2:1) taking prescribed benzos, often on repeat prescriptions. Doctors are given guidance on responsible prescribing to prevent abuse yet the number of prescriptions is still large. Last year there were over 11 million prescriptions and there are estimated to be 1.3 million long-term users of benzodiazepines in Britain.

Benzos are also sometimes taken as ‘downers’ by users of stimulants often after a long session on cocaine, ecstasy or mephedrone. About 50,000 people take tranquilisers without prescription each year (this is not legal). They are sold cheaply - often for less than a pound each and are also available from internet sites.

Appearance and Effects

There are a wide range of benzodiazepines to help with differing mental ailments, from stress, anxiety, depression and sleep disorders. They are also sometimes used to treat alcohol dependence, particularly withdrawal. There is also a wide variety in shape, size and colour of the benzodiazepine pills.

The most popular are alprazolam (Xanax), chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan) and temazepam (colloquially known as “temmies”). Generally they cause drowsiness and encourage sleep, working in the opposite way to stimulants. Some like Valium start working in less than an hour, others work longer and slower in order to stabilise the person’s emotional state.

Users feel calmer and experience a lift in optimism and outlook which can last for several hours. It can also cause short-term memory loss. Mixing alcohol and benzos can make you pass out with little warning. The drowsy effects mean driving on benzos would be unsafe and illegal.

Harms
The harms of benzos centre round their addictive properties which are both psychological and physical. Signs of dependence can show after a few weeks: increased tolerance and using benzos as an emotional crutch. Withdrawal can lead to fatigue, loss of confidence and concentration. Physical problems may include, muscle pain, sweating, nausea and insomnia.

 A period of sustained dependence can be very debilitating and prevent people from working and leading an active life. The impact can be felt through the whole family. Passing out on drugs like Valium, particularly after drinking alcohol can leave you vulnerable to personal injury. Taking benzos as a ‘downer’ to counteract the effects of other stimulants is not just a simple antidote but puts more strain on your body if you become dependent on them.

It is possible to overdose on benzos but death is rare unless intentional. These drugs appear on a high proportion of the death certificates of polydrug users who have taken a variety of drugs. Because benzos have a strong sedative effect, they can be used to render people unconscious. Rohypnol (flunitrazepam) mixed in alcoholic drinks has been used to sedate victims prior to sexual assaults. It works in about half an hour and last 4-6 hours. Anyone using a drug on someone for these purposes is committing a very serious criminal offence.

The Law
Benzodiazepines are class C drugs. It is an offence to possess the drug without a prescription although convictions for small amounts are rare. You more likely to be arrested if the pill is mistaken by the officer for another controlled drug such as ecstasy. Dealing in benzodiazepines is not common but could attract a custodial sentence.