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Definition

What is Benzodiazepine abuse?

Benzodiazepines are a type of medication known as tranquilizers. Familiar names include Valium and Xanax. They are some of the most commonly prescribed medications in the United States. When people without prescriptions obtain and take these drugs for their sedating effects, use turns into abuse.

Doctors may prescribe a benzodiazepine for the following legitimate medical conditions:

  • Anxiety
  • Insomnia
  • Alcohol withdrawal
  • Seizure control
  • Muscle relaxation
  • Inducing amnesia for uncomfortable procedures
  • Given before an anesthetic (such as before surgery)

Benzodiazepines act on the central nervous system, produce sedation and muscle relaxation, and lower anxiety levels.

Although more than 2,000 different benzodiazepines have been produced, only about 15 are currently FDA-approved in the United States. They are usually classified by how long their effects last.

  • Ultra-short acting – Midazolam (Versed), triazolam (Halcion)
  • Short-acting – Alprazolam (Xanax), lorazepam (Ativan)
  • Long-acting – Chlordiazepoxide (Librium), diazepam (Valium)

Benzodiazepines are commonly abused. This abuse is partially related to the toxic effects that they produce and also to their widespread availability. They can be chronically abused or, as seen more commonly in hospital emergency departments, intentionally or accidentally taken in overdose. Death and serious illness rarely result from benzodiazepine abuse alone; however, they are frequently taken with either alcohol or other medications. The combination of benzodiazepines and alcohol can be dangerous — and even lethal.

Benzodiazepines have also been used as a “date rape” drug because they can markedly impair and even abolish functions that normally allow a person to resist or even want to resist sexual aggression or assault. In recent years, the detection and conviction of people involved in this has increased dramatically. The drug is usually added to alcohol-containing drinks or even soft drinks in powder or liquid forms and can be hard to taste.

How common is Benzodiazepine abuse?

Benzodiazepine abuse is common. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Benzodiazepine abuse?

The common symptoms of Benzodiazepine abuse are:

  • Drowsiness.
  • Dizziness.
  • Double vision.
  • Slurred speech.
  • Muscle weakness.
  • Slowed reaction time.
  • Incoordination.
  • Poor concentration and memory.
  • Confusion.
  • Stupor.

The appearance of withdrawal symptoms upon cessation of use is a clear sign that the user has developed a dependence on the drug. Benzo withdrawal symptoms include:

  • Anxiety.
  • Depression.
  • Insomnia.
  • Increased heart rate and blood pressure.
  • Excessive sweating.
  • Hand tremors.
  • Hallucinations.
  • Seizures.

Depression, anxiety, and insomnia may occur for extended periods of time (for several months) following acute withdrawal from benzodiazepines and may contribute to relapse in recovering addicts.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Benzodiazepine abuse?

Although some people may have a genetic tendency to become addicted to drugs, there is little doubt that environmental factors also play a significant role. Some of the more common environmental influences are low socioeconomic status, unemployment, and peer pressure.

Risk factors

What increases my risk for Benzodiazepine abuse?

Some biological risk factors for benzodiazepine abuse include female gender and elderly age group. A noteworthy statistic about benzodiazepine abuse is that women are more likely than men to be prescribed and therefore exposed to a benzodiazepine compared to men. Being of the elderly age group is also a risk factor for the abuse of benzodiazepines since physicians may inappropriately prescribe benzodiazepines for elderly individuals with depressive symptoms.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Benzodiazepine abuse diagnosed?

The diagnosis is based on findings from your medical history, examination, and any lab tests performed.

In acute ingestions, diagnosis is often obvious because you or your family can tell the doctor exactly what was taken.

The diagnosis of chronic drug abuse can be much more difficult, because an abuser and his or her family often try to cover up or hide what is going on.

The emergency department work-up of any possible toxic drug overdose consists of an initial evaluation. Doctors will assess how well you are breathing. The rest of the work-up depends on you and your symptoms. The physician will ask about many of the signs and symptoms. Unless you are willing to admit that you are abusing benzodiazepines or family members are present to help with the history, it is easy for you to cover up drug abuse.

Monitoring and testing

In the emergency department, you will usually be placed on a monitor evaluating heart rate, blood pressure, and pulse oximetry (a measure of how much oxygen is in your bloodstream). An IV line will be started. Oxygen is given if you are short of breath or have a reduced level of consciousness.

Urine drug screens are sometimes performed. These lab tests can detect many of the commonly abused drugs, including benzodiazepines (but may not be able to discover them all). The urine drug screens do not, however, reveal a specific level or amount of the drug taken. Urine is also usually tested for pregnancy in all females of childbearing age.

Blood samples, ECGs, and chest x-rays may be obtained if there is concern that you may have taken other dangerous drugs.

How is Benzodiazepine abuse treated?

Acute toxicity: The treatment required usually depends on what drugs were taken and how much. Often, you need only a period of evaluation in a hospital emergency department.

If the drugs were taken within the previous 1-2 hours, the doctor may consider gastric lavage. With this procedure, a large tube is placed directly into your stomach through the mouth or nose. Large volumes of water can then be pushed into the stomach in an attempt to wash out the pill fragments. This is not used often and only if you are known to have swallowed other potentially more lethal medications.

A single dose of activated charcoal is recommended for people who come to the emergency department within 4 hours of taking drugs. This acts to prevent absorption of the medication. It is a black powder that is mixed with water and given to you to drink. Side effects can include nausea, vomiting, and abdominal cramps.

There is an antidote to counteract the toxic effects of benzodiazepines called flumazenil (or Romazicon). This reverses the sedative effect of benzodiazepines. It is, however, usually reserved for severe poisoning, because it can cause withdrawal and seizures in people who are chronic benzodiazepine abusers, and also may require repeated administrations, with careful monitoring, due to its fairly short duration of action.

Chronic abuse: The treatment of chronic abuse can usually be done at home with the help of your doctor or in specific drug rehabilitation centers. The first step consists of gradual reduction of benzodiazepines to prevent withdrawal and seizures. This is often much easier than the prolonged recovery phase in which the person attempts to stay drug-free. In addition to the medical care, someone abusing these drugs often requires social support and help in finding housing and employment. The involvement of family and friends can be very helpful in this difficult stage.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Benzodiazepine abuse?

If you have any questions, you could call your doctor, but if you are in doubt whether someone needs immediate medical attention, you should go directly to a hospital emergency department.

If you are concerned that you or someone else has taken an overdose, it is very important that you seek medical help immediately. You should go to the nearest emergency department or call emergency for help. After someone takes an overdose, the effects may not become immediately obvious.

It will assist the doctors if you bring the pill containers with you because it helps them determine the number and type of pills taken.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: November 3, 2017 | Last Modified: November 3, 2017

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