October 15, 2020
What is a benzodiazepine?
Benzodiazepines or benzos are drugs whose structure contains a benzene ring and a diazepine ring. They are also a part of the sedatives and anxiolytics due to their central nervous system depression and anxiety-relieving effects. The most common examples include diazepam, clonazepam, lorazepam, bromazepam, xanax (alprazolam), rohypnol, chlordiazepoxide.
Benzodiazepines are prescribed once or briefly in situations of acute unbearable stress. There is a misconception that benzodiazepines are beneficial to people with mental and psychological problems such as panic attacks, depression, anxiety and other disorders when taken appropriately according to prescription. This is because benzodiazepines work by improving the action of GABA, thereby making the neurons less excitable. However, after several weeks of consuming (if used for more than 21 days), they may cause an addiction, and a person may develop benzodiazepine dependence.
From this article, you will learn everything you need to know about benzodiazepine addiction, what are its manifestations, how it can be treated, and what are the expected outcomes of detoxification from benzodiazepine.
Addiction to benzos occurs rather quickly. After two to four weeks of daily use, the body is accustomed to its effects that create a feeling of protection, safety, and stability. This is the genesis of benzo addiction, and at a point, the body will begin to tolerate the previous dosage and will seek higher doses to maintain those feelings. This will precipitate dependence and kick off the series of cycles. Eventually, the sequence culminates in benzodiazepine dependence and subsequent benzodiazepine addiction.
Not long after using benzodiazepines, a person becomes agitated, paranoid, aggressive, and depressed. In the absence of the substance, there is a barely tolerable withdrawal symptom characterized by:
- slurred speech
- blurred vision
- increased salivation
- swelling of arms and feet
- and sometimes even convulsion.
Also, benzodiazepines negatively affect the entire physical and psychological state of the body, especially memory. They can lead to so-called anterograde amnesia when a person does not remember specific situations, conversations, events for some time.
Suddenly, the benzodiazepines which gave inner peace and an illusion of life turn against the user who is insecure, scared, and unable to function normally in any field.
Thus benzodiazepines can cause strong physical and psychological addiction. They are often used by patients who are already addicted to some other drug substances like opioid drugs, antidepressants, and/ or alcohol, and these combinations are especially dangerous.
How are benzodiazepines addictive?
Studies suggest that benzodiazepine addiction follows the same pathway as that of opioids and cannabinoids. The addiction is due to the increased activity of the dopaminergic neurons, which mediates via the alpha-3 subtype of the GABA receptors, which also explain the rewarding effect on users of benzodiazepines. Though not recommended as the first line and long term treatment of anxiety and depression, the benzos are often prescribed due to the quick onset of action.
Symptoms of benzodiazepine abuse
Although benzoic drugs are sedatives, they are very addictive. Benzodiazepine abuse and addictions can come in a wide array of symptoms. These include drowsiness, behavioral changes, mood swings, weakness, motor incoordination, and lethargy. These are widely known as the signs of benzo dependence, and the abusers also have an increased risk of suicidal thoughts.
The withdrawal symptoms usually set in when a patient tries to abruptly stop the drugs or cut down the dosage without appropriate monitoring by a physician. These symptoms and consequences of benzodiazepine use disorder (BUD) are manifested as:
- The person avoids friends, family, and obligations to use the drug.
- The person ensures an adequate supply is maintained at home so they don’t go out of stock.
- A benzo addict can go any length to pay for the drug, such as borrowing money, stealing, draining bank accounts, or maxing out credit cards.
- The person engages in risky activities such as driving after using the drug.
- The person spends an increasing amount of time and energy on different facets of drug abuse.
- Reduced effort at maintaining hygiene or grooming.
- The person is uncharacteristically secretive about their daily schedule and/or tells lies to protect the substance abuse.
- Shifts in mood or personality are experienced.
Treatment of benzodiazepine dependence
The ideal goal of management is to discover the cause of the addictive disorder based on an all-encompassing analysis and approach the whole treatment process accordingly. Hospital treatment usually lasts 10–14 days to successfully resolve an addiction problem and stabilize the patient’s condition. It is divided into three stages.
Diagnosis is the first and a significant phase of treatment during which the patient’s physical and psychological state is assessed. This is the initial stage that is followed by forming an individual approach to the patient. This refers to a combination of special medical methods aimed at painless detoxification of the body for protecting the damaged organs and the patient’s health at the same time.
The standard diagnostic examination for physical condition assessment includes:
- Urine analysis
- Tests for hepatitis B and C, HIV infection
- General blood analysis
- Blood biochemical testing
- An internist examination
The standard diagnostic examination for assessing the psychological condition involves psychodiagnostic. These are psychological tests used to determine the level of addiction, the consequences of using substances on mental health, detecting the signs of psychological disorders, the presence of depression, the degree of motivation for healing, and self-criticality preservation of voluntary mechanisms.
Having made the diagnosis, the team of doctors develops a treatment plan. If deviations are found in the results, additional tests are carried out, and therapy is prescribed for the accompanying diseases.
Depending on the problem, it is possible to do additional tests, including MRT, EEG, ultrasound, X-ray, endoscopy, medicine, and drug concentration analysis, cardiac examination, neurological examination, endocrinological examination.
The detoxification process starts immediately and involves the daily administration of infusion and medications within the first few days. Pharmacotherapy (psycho-stabilizers and abstinence therapy) helps shut off changes in the brain that occur due to the absence of benzodiazepines. The symptoms of the crisis disappear, and their effect is reduced to a minimum. Withdrawal symptoms are also eliminated and benzodiazepines are cleared from the body. Regular tests are carried out mandatorily until the body is thoroughly cleansed of the sedative.
During detoxification, a patient is under constant medical supervision. Also, it is imperative that:
- The detox is fast.
- The patient does not feel pain.
- The patient’s sleep and appetite return to normal.
- The patient’s mood becomes stable.
- There is no more anxiety or depression.
- Detoxification gives the patient the ability to live and function in the future without tablets.
Evaluation of results
At the end of treatment, outcomes are evaluated. Urine tests are negative for benzodiazepine, and the physical and psychological state of the patient is stable. Preparation for discharge is done, and the patient and his family are given instructions to follow afterward. In a conversation with a patient, doctors plan their further activity and advise on successful rehabilitation and resocialization in a bid to return to normal life.
After the treatment, when no risk of the crisis is estimated, and the benzodiazepine test is negative, the phase of neurometabolic change is approached. This is the phase of regenerating what benzodiazepines have damaged.
Is there a chance to end an addiction?
Being addicted to benzodiazepines or having someone close to you struggle with addiction could be a very dark situation. But quick recovery is possible if properly managed. Most of those who seek a solution to the problem are able to get rid of bad habits, restore health, and become full-fledged members of society.