Benzodiazepine Dependence: Causes, Symptoms and Prevention

Benzodiazepines are substances with depressant qualities that help in inducing sleep and relaxing muscles. Benzodiazepines are used to treat insomnia and help people to sleep better, but the misuse, abuse, and long-term use of benzodiazepines can cause Benzodiazepines dependence.

Benzodiazepine dependence is a type of substance use disorder that one can develop after consistent long-term use of a benzodiazepine. At this point, when the individual tries stopping the use of benzodiazepine, he or she experiences what we call ‘withdrawal symptoms.’

Withdrawal symptoms are awful symptoms you experience when you stop supplying your body with doses of substances that it was dependent on for enhanced functioning.

Benzodiazepine dependence is known to develop when the substance is used for so long, including low therapeutic doses.

What is benzodiazepine dependence?

Benzodiazepine dependence is a medical condition developed over time due to the long-term use of the substance, benzodiazepine.

Drug dependence, in general, is characterized by drug tolerance (which is the individual’s system adjusting to accommodate more doses of the substance, making the previous dosage less effective.

However, this can lead to overdose and cause death, drug-seeking behaviors, maladaptive substance use patterns, continuous use despite the unpleasant symptom, harmful side effects, and withdrawal symptoms.

This condition is associated with the constant use of the substance because the person needs to avoid the withdrawal syndromes that comes with the abrupt discontinuation of the drug, and the individual feels the need to have the pleasurable effects from the substance. Benzodiazepine dependence includes psychological and physical dependence.

The physical dependence is also known as addiction, which includes the misusing or abnormal craving of the substance.

This is because the user desire to feel the euphoric effects that come with the use of benzodiazepines and less because the individual takes the substance to suppress the withdrawal symptoms.

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While the psychological dependence is manifested when the user continues the intake of the drug to relieve withdrawal syndrome.

Mechanisms of developing benzodiazepines dependence

Dependence usually occurs due to increased GABA activity inhibition, which is a result of benzodiazepines’ influence on the body causing it to develop tolerance to the effects of drugs.

Tolerance develops as a result of neuroadaptations, which leads to decreased GABA activity and increased excitability of the glutamate system. The adjustments that your body makes are as a result of the body attempting to overpower the central nervous system efforts.

The CNS efforts involve the depressant effects of the psychoactive substances to restore and maintain homeostasis. When the use of benzodiazepines is stopped abruptly, the neuroadaptations are unwraps, causing the nervous system to be overexcited, hence, the manifestations of withdrawal symptoms.

Buildup of tolerance

If a user, over time, begins to up their dose of benzodiazepines to get the same effect that the previous small doses used to give before, then drug tolerance is said to have built up.

Symptoms of benzodiazepine dependence

Some signs and symptoms suggest that you may have benzodiazepines dependence if you have been using benzodiazepines for a while or for a long time.

This may include attempting to reduce or quit benzodiazepine use, benzodiazepine tolerance, inability to cope without benzodiazepine use, and withdrawal symptoms. Withdrawal symptoms are reactions of the body to the immediate stoppage of benzodiazepines use.

Some withdrawal symptoms that may you are likely to experience includes:

  • Anxiety
  • Depression
  • Depersonalization
  • Derealisation
  • Sleep disturbance
  • Hypersensitivity to touch and pain
  • Tremor
  • Shakiness
  • Muscular aches
  • Pains
  • Twitches
  • Headache

Benzodiazepine dependence and withdrawal syndrome have been linked to suicide and other self-harming behavioral patterns, especially in adolescents and young adults.

Causes of Benzodiazepine dependence

Benzodiazepines are depressants that have anticonvulsant, sleep-inducing, and muscle-relaxing effects on the user.

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The user applies benzodiazepines for the desired calming effects, but using this substance for so long can make you develop a tolerance for the medication. You can also achieve this by merely misusing and abusing the drug.

Benzodiazepine tolerance occurs when your body adjusts to accommodate a particular dosage in the body system, making the previous dosage have little or no effects on the individual, causing the person to take more than usual to get the desired effects.

However, this can result in overdose as the individual takes more than the body can handle to get the desired outcomes from the drug, and can eventually lead to death.

Once tolerance is developed, the individual begins to take more doses of benzodiazepines into their system, making them experience withdrawal symptoms when they abruptly cease the intake of benzodiazepines into their system.

Withdrawal symptoms are unpleasant effects that you experience when you stop taking medication that you are dependent on.

These reactions occur when you don’t get the drugs because your system depends on the pills to function, and the only way you think you would get relief is by taking the drugs. This makes the users more dependent on the medication.

Risk factors

Factors that contribute to the development of benzodiazepine dependence include:

  • Accessibility to benzodiazepines: When an individual has easy access to benzodiazepines, he or she is most likely to try it out and have a taste. Without strict adherence to a doctor’s prescription, this can actively cause benzodiazepine addiction and dependence.
  • Other medical condition: Other medical issues that would push a person to do benzodiazepines to get better sleep patterns or relax their nerves include health complications such as insomnia, phobias, anxiety, and more. These conditions may cause a person to take benzodiazepines outside their doctor’s knowledge to control and manage one’s health. This will lead to physical and psychological benzodiazepine dependence.
  • Stressful lifestyle: A life of stress always has harmful effects on the well-being of an individual. Therefore, you are required to adopt strategies to cope with stress. However, most people see doing drugs as an easy way of relaxing and basking in the pleasure of euphoria. So they abuse psychoactive substances in which benzodiazepines are inclusive, which can lead to its dependence.
  • Cross tolerance: The use of benzodiazepines causes disorders similar to other sedatives, especially tolerance for a particular drug is developed, and the body can accommodate more doses. For instance, an individual with a drug problem is likely also to have drug tolerance for benzodiazepines.

Diagnosis of benzodiazepines dependence

The following procedures may be used to diagnose benzodiazepines dependence:

  • Interrogation: The information on how much and how long the user has been on benzodiazepines use is the first step in diagnosing the substance use disorder.
  • Physical examination: Physical examination has to do with what meets the eye, and the individual is examined physically. At the same time, observations made are taken down, and other medical tests are done to narrow down the health condition.
  • Blood tests: Blood samples may be collected to confirm the presence of benzodiazepine in the bloodstream. An individual may be diagnosed with benzodiazepines use disorder if he or she shows three or more of the fore-mentioned symptoms within the same year period.

Effects of benzodiazepines dependence

Benzodiazepines dependence has an adverse impact on the user, and the following are the possible effects of benzodiazepines dependence:

Mental health

The user’s mental health can be severely affected as a result of the long-term use of benzodiazepines. The following are psychological withdrawal symptoms:

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  • Paranoia
  • Intense cravings
  • Depression
  • Fatigue
  • Aggression
  • Anxiety

Negative lifestyle changes

When you have benzodiazepine use disorder, you may find yourself changing your lifestyle to suit your addiction and dependence. You will love the medication more than you love yourself.

You will find yourself going out of your way to having a taste of the medicine. Affected individuals can change their social, recreational, and work lifestyle just to have a taste of benzodiazepine.

Treatment

Benzodiazepines are psychoactive substances that are highly addictive, and long-term use can cause benzodiazepines dependence, and this can be adversely severe, adversely affecting the physical, psychological and social health of the individual.

Treatment should be strictly administered to help the sufferer free from this condition. This use disorder is a severe health condition that should be treated as soon as possible. The treatment options available may include the following:

Hospitalization

Within a hospital setting under the supervision of professionals in the medical field, it is much easier to handle withdrawal symptoms of benzodiazepines use.

Within this setting, suicidal tendencies and attempts, aggressive behaviors, and self-harm behavioral patterns are best controlled compared to doing it all alone or without professional help.

Therapy

The therapeutic approach is considered to be the most effective approach in treating many psychological health problems, including phobias, addiction, and dependence. CBT can be applied under this approach.

Cognitive-behavioral therapy

Cognitive-behavioral therapy can be used in the treatment of so many psychological issues, including insomnia, addiction, and dependency. According to research, people who have insomnia are likely to use benzodiazepines if they have access to them.

The use of benzodiazepines is effective in inducing sleep, but long term use can be detrimental to the well-being of the individual.

According to studies, CBT is a healthy and productive way of creating better sleep patterns. Individuals with insomnia going through CBT are likely to abuse benzodiazepines.

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CBT can be used in treating drug use disorders, and the study says that it is a relatively safer and effective way of treating substance use disorders.

CBT, group therapy, one-on-one counseling, and family therapy can help you achieve the following aim:

  • Identify the feelings accompanying benzodiazepines use
  • Fix relationships with family and friends
  • Replace benzodiazepines use with favorite hobbies
  • Makeup and adopt strategies in preventing the use of benzodiazepines
  • Map out and adopt coping strategies to help with the withdrawal syndrome
  • Getting support from others with similar issues with you
  • Medication

Flumazenil can be administered through injection to reverse the effect of benzodiazepine dependency. This is known as the safest method of treating benzodiazepine dependence, as it is regarded as the most effective way of treatment.

However, the use of flumazenil can cause seizures. Some doctors may prescribe flumazenil to help with the drug craving and relieve symptoms of benzodiazepine dependency. In summary, it enables you to get your life back together again.

Sending letters to patients

Sending letters to patients in a bid to create awareness about the adverse effects of benzodiazepines dependence and long-term intake of benzodiazepines.

These letters may also include recommended dosage reduction. According to statistical studies, this approach has been successful in the decline of benzodiazepine dependence cases.

Complications linked to benzodiazepines dependence

Without adequate professional intervention to control benzodiazepines dependence, the following are complications that may arise:

  • Overdose: Built-up tolerance for the psychoactive substance may make a person take more than they would take before to get the usual effects. This can lead to a continuous increase in the amount of drug taken into the system, which may eventually cause the person to take more than their system can handle.
  • Brain damage: Psychoactive drugs, including benzodiazepines, are known to cause brain damage, which may lead to memory issues, seizures, and stroke.
  • Death: This is very likely to follow after an overdose.

The long-term outlook of benzodiazepines dependence can be challenging to control. Relapse after treatment is prevalent.

However, active participation in treatment programs while involved in a one-on-one session may reduce the risks of relapsing and promote recovery.

Prevention

Have you ever heard of the quote ‘prevention is better than cure?’ Preventing benzodiazepines dependence is a whole lot better and more comfortable than treating it. Accompanying benzodiazepines dependency are severe effects that may affect the sufferer’s health so severely.

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Education has always been a tool used in bettering people’s lives in general. Drug education programs may be used to create awareness and enlighten people on the dangers of long-term use of benzodiazepines and how to prevent it.

This approach successfully reduces the rate of people abusing benzodiazepines and drugs in general. According to studies, teenagers are most likely to abuse drugs, especially benzodiazepines. This is mostly because of peer pressure and their need to experiment.

Drug education will give them the power to say “no” to benzodiazepines and drugs in general. This invariably flattens the curve of benzodiazepines use disorder cases.

Family support and therapy can help go a long way to save a person from abusing benzodiazepines. Individuals suffering from emotional and mental disorders are most likely to abuse drugs, including benzodiazepines.

Therefore, supporting such persons will make them see that drug abuse isn’t an answer or the escape they needed.

However, there is no evidence to prove that any of these prevent benzodiazepines use and use disorders in everyone; it is just a suggestion.

Notwithstanding, applying the following will surely help you avoid becoming dependent on benzodiazepines and other psychoactive medications:

  • Avoid long-term use of benzodiazepines
  • Use benzodiazepines strictly based on doctor’s prescription
  • Always contact your doctor whenever you experience any discomforting symptoms

Have you ever had to deal with benzodiazepine dependence? How were you able to manage the condition? Kindly tell us about your experience in the comments section below.

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Oluwafemi Michael
Oluwafemi Michael is an online Mental Health Therapist, Advocate for Mental Health Awareness, a programmer, and also a content creator from Edo state, Akoko-Edo LG.

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