What are benzodiazepines?
There are a wide variety of benzodiazepines, which differ in the balance of effects they have, and how long they last. The most well-known types include diazepam (Valium), temazepam, nitrazepam and others, usually with names ending in –pam or -lam. Flunitrazepam (Rohypnol) is a benzodiazepine but due to suggestions that it has been used as a ‘date rape drug’, it is now illegal in some European countries, outside of medical use.
What are the different forms of benzodiazepines
Not all benzodiazepines used recreationally are diverted pharmaceutical products. Illicitly manufactured benzodiazepine tablets are frequently being encountered due to availability from the internet. These may resemble pharmaceutical preparations but are as unreliable as any other drugs on the unregulated market. The content of these preparations will vary and may not contain the drug expected.
How do benzodiazepines work as drugs in the body and brain?
Do benzodiazepines have any medical uses?
Benzodiazepines relax muscles and have anticonvulsant effects. They are useful in treating the withdrawal effects of alcohol, where they work to ease the agitation as well as preventing seizures, muscle spasms and shaking.
Benzodiazepines are also used longterm, although there are greater risks from long-term use.
What are the effects of benzodiazepines?
Very occasionally benzodiazepines can have paradoxical effects. For instance, some people have become aggressive or violent when taking benzodiazepines. This is thought to be due to the disinhibiting effects of the drug.
What are the risks of benzodiazepines? Can they be avoided or reduced?
The danger of severe harm and death is very much greater if a benzodiazepine is taken with other sedative drugs such as alcohol, heroin or GHB. In these combinations, breathing can be depressed and stopped.
Emergency medical assistance should be sought when someone becomes unresponsive after taking drugs.
Benzodiazepines decrease control and impair judgment, making the risk of accidents much higher. This means activities like driving under the influence of benzodiazepines is potentially very dangerous.
Are there health conditions that make benzodiazepines more dangerous?
Mixing benzodiazepines with other drugs
How addictive are benzodiazepines?
People who become dependent on benzodiazepines may become tolerant to the drug’s effects and experience withdrawal symptoms without it. Users may crave the drug and feel unable to cope without it. The longer the drugs are taken, the higher and more regular the dose and the stronger the benzodiazepines, the higher the risk of dependence.
What are the harms of benzodiazepine addiction and withdrawal?
period of sustained dependence on any drug can be debilitating and prevent people from working and leading an active life. It may also cause mental and physical harm and benzodiazepine withdrawal can be very unpleasant.
Long term use of benzodiazepines is often accompanied with the use of other drugs, such as alcohol and opioids. This is because some users may feel that benzodiazepines enhance the effects of a drug, or lessen the effects of drug withdrawal/comedown, or both. Those who solely use benzodiazepines outside of medical use often do so after becoming dependent on them after being prescribed them for a medical condition.
Acute withdrawal effects for some benzodiazepines can be severe, although for many they will be milder. Acute withdrawal effects include anxiety, increased heart rate and blood pressure, shaking, insomnia and sensitivity to sound/light. Very severe withdrawal can cause symptoms that require intensive care, such as seizures. Someone who has been taking a benzodiazepine regularly for a sustained period should stop under the supervision and guidance of a doctor. Abruptly stopping use can be harmful so it is often better to taper use gradually before stopping entirely, and to do this safely professional advice is recommended.
Potential effects of long term benzodiazepine use include anxiety, depression and insomnia. These effects may last for months, depending on how dependent a person was on the drug, the drug used, the length of time used, untreated on-going psychiatric conditions, as well as other personal factors such as why the drug was initially prescribed or used illicitly.
What are the long term effects of benzodiazepines on health and wellbeing?
There is some evidence suggesting that long-term benzodiazepine may increase the risk of dementia. However, other experts think that the evidence of this is not yet convincing.
Benzodiazepine harm reduction advice
How much are you taking, how often?
The occasional medical or recreational use of benzodiazepines has a relatively low risk of harm. However, benzodiazepine dependence and withdrawal can develop after a few weeks of use and can cause considerable harm to quality of life and health. If you develop tolerance to any of the effects of a benzodiazepine, this should be taken as a warning sign that the drug may be harmfully affecting your body and brain.
Are you taking them with anything else? Mixing drugs is risky.
Drug effects are unpredictable, but mixing drugs makes the effects on your body and mind even harder to control. Deaths involving benzodiazepines generally involve other drugs too. It is particularly dangerous to combine a benzodiazepine with another drug that can depress breathing such as alcohol, heroin (or any opioid) or GHB. Additionally, if someone is taking antidepressants or even antihistamines, these may increase the effect of the benzodiazepines. Grapefruit juice can do the same with a few types of benzodiazepine. You should check whether this is possible if taking a benzodiazepine.