You must have come across drug abuse and addiction either through reading, media, internet surfing or even through conversing with a friend. 70% percent of drug addicts are addicted to benzodiazepines.
Benzodiazepines, locally known as ‘Benzos’, are classes of drugs used for treating anxiety disorders but are most times more effective in treating several other conditions, they are mostly found in tranquilizers.
Benzodiazepines works in the body by interacting with the neurotransmitter (gamma aminobutyric acid-A, GABA-A) in the brain.
Chemicals released by the nerves in order to communicate with other nearby nerves, Now scientist believes that excess activity of our nerves can be the lead cause of anxiety and other psychological disorders and benzodiazepines interacts with the GABA-A neurotransmitter in a way that suppresses the activity of the nerve, thereby slowing down the activity of the brain and spinal cord.
Benzos are very effective in the treatment of many mental illnesses and sleeping disorders, which is the reason it is commonly prescribed by pharmacists. However, if not properly used or illegally use, the manner in which this category of drugs affects the brain can swiftly result in addiction and dependence.
Conditions for Benzodiazepine Usage
Benzodiazepines are legally administered by Professional doctors and pharmacists to treat:
- Panic attacks
- Convulsions (seizures)
- General anesthetics (drugs or chemical agent that produces a local or general loss of sensation including pain and suppresses response to stimulation).
- Trouble sleeping (insomnia)
- Muscle spasms
- Nausea and vomiting
Examples of Benzodiazepines
Some common examples of drugs belonging to the group of benzodiazepines include.
- Rohypnol: Commonly known as ‘Roofie’, it is popularly prescribed as a method of treating sleep disorder. However, it was banned and branded unsafe in the U.S and many countries, after researches revealed the increase potency of its effect especially when mixed with alcohol and how it was used to aid sexual assaults. But it is still produced, sold in some countries and smuggled into countries where is has been banned.
The drug kicks within one hour of administration and it effects last about six hours in the blood.
- Valium: This is the common diazepam as we all call it. It is known to treat mental disorder, seizures and muscle spasms. Produced to be taken under strict medical supervision and guidelines, some users seem to ignore its prescription and overdose which leads to addiction as the body become more dependent on the drugs.
The effect of Valium kicks in about 15 minutes after administration and remains up to 100 hours in the blood stream.
- Xanax: These drugs kick in 30 minutes after administration and lasts for about 20 hours in the blood stream. It was once the most prescribed medication in the U.S as over 44 million prescription of xanax was written every year. The drug functions by inducing a calming sensation and causing drowsiness (feeling of sleep) making it highly addictive and one of the most commonly abused drugs. Example of xanax is alprazolam.
- Ativan: Lorazepam, is one of the most effective/powerful of all Benzodiazepines. It is administered and prescribed for depression, anxiety disorders and sometimes for panic attacks. Lasting up to 24 hours after administration, it is very addictive and the drugs carriers a very high dependence risk.
- Klonopin: Klonopins is the longest acting Benzos, about 50 hours after administration, taking longer time to take full effect on the patient and can also be the most potent when abused. The withdrawal symptoms of klonopin can be life threatening as its very severe. Example is clonazepam.
- Librium: Having similar effects to xanax and having same lasting period as valium, Librium is used to treat many anxiety disorders. The drug is considerably less potent than other Benzodiazepines making it less addiction prone. However, it is commonly used with other substance like alcohol and sedatives, to increase the level of intoxication. Example of Librium is chlordiazepoxide
- Halcion: This is one the fastest acting benzodiazepine as it is absorbed faster into the neurotransmitters than other Benzos, it lasts about 8 hours in the blood stream and kicks in 30 minutes after administration. The drug is used to combat insomnia (difficulty in sleeping) and anxiety.
Regarding Halcion, its biggest risk is patients and abusers are inclined to increase their dosage because the ‘highness’ effect goes away quickly which accelerates the formation of dependence. An example of halcion is triazolam.
Other considerable examples of benzodiazepines include Tranxene (clorazepate), Midazolam (versed), Oxazepam (Serax), Estazolam (Prosom), Temazepam (Restoril), Flurazepam (Dalmane) among others.
Benzodiazepine Misuse and Addiction
Some benzos are most commonly used for certain conditions, most are used interchangeably, and this can lead to misuse and drive the abuser deeper into addiction.
All benzos when misused or overdosed can cause physical dependence. Suddenly stopping the use of the drug after a period of constant administration may be associated with withdrawal symptoms which majorly includes.
- Feeling of loss of self worth
- Cramping, spasm or twitching of muscles
- Profuse sweating, in order to avoid these symptoms, benzos are tapered slowly.
Benzodiazepines if taken constantly, longer than its prescribed period of time (usually a few months) leads to addiction.
The dangers of benzodiazepine addiction are numerous, apart from the severe withdrawal symptom; overdosing on benzos can lead to shock and grant free passage to the emergency room or hospital admissions.
Prevention’s and management of Benzodiazepines
In emergency cases benzodiazepine overdose can be treated by rapidly injecting flumazenil (antidote for benzodiazepines) into the vein.
Any person who has been on any benzodiazepine for longer than 4 weeks is likely to experience withdrawal symptoms if the drug is ceased suddenly or unexpectedly. So medically, this is prevented by administering prescription limited to 1 to 2 weeks supply.
Patient consent in management of benzodiazepine misuse is vey essential as without this all attempt to combat the harmful use may be hindered.
If the patient is not ready to deal with this issue or is just considering changing, then the motivational interview techniques may be recommended. But if the reverse is the case, there are two possible approaches to the management of drug dependence:
- Benzodiazepine maintenance therapy
- Benzodiazepine withdrawal with the aim of abstinence
Any of the above choice of approach either by the doctor or patient depends on assessment of the risk of self harm and relapse.
High risk patients are managed with initial stabilization and maintenance therapy in specialist residential and low risk patients can be managed in general practices and may benefit most from attempting withdrawal.
Benzodiazepine are effective and yet dangerous medications when misused. This misuse can result in incredibly powerful addictions, which completely overtake the life of the user.
The misuse not only affect the user but also his friends, family and environment as well. But no hope is lost as with proper guidance and counseling, any addict can be restored.