What are Benzodiazepines?
Pronounced as /ben-zō-dī-ˈa-zə-ˌpēn/
Benzodiazepines are prescription drugs that are used to treat a variety of conditions, including anxiety disorders, panic attacks, and insomnia. Benzodiazepines work by acting on the central nervous system to produce a calming effect.
The term benzodiazepine can refer to several different types of medications, including diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin). There are generic and brand-name versions of benzodiazepines.
The core chemical structure of benzodiazepines is the combination of a benzene ring and a diazepine ring. Different types of benzodiazepines share the same core structure but can vary in terms of potency and duration of action.
Benzodiazepines are all considered to be Schedule IV controlled substances, which means they still have a drug abuse risk and can lead to dependence.
What Do Benzodiazepines Look Like?
Benzodiazepines come in tablet, capsule, and liquid form. Depending on the type of benzodiazepine, they can come in different shapes, sizes, and colors.
The look of individual benzodiazepines can also change depending on whether it's a name-brand or a generic version of the drug. For example, generic alprazolam will look different from the name-brand Xanax. Other drugs like Valium or Klonopin will also look different.
Other drugs in the benzodiazepine class can be taken intravenously or under the tongue. An example of a benzodiazepine taken intravenously is midazolam (Versed) while others are dissolved under the tongue such as Ativan.
What Are the Other Names of Benzodiazepines? Types of Benzodiazepines
With benzodiazepines being a class of drugs, there are different types available. Here are some of the types of benzodiazepines available in the United States:
Generic Name | Brand Name | Generic Name | Brand Name |
alprazolam | Niravam, Xanax, Xanax XR | diazepam | Valium |
chlordiazepoxide | Librax | estazolam | ProSom |
clobazam | Klonopin | flurazepam | Dalmane |
clorazepate | Tranxene | Lorazepam | Ativan |
midazolam | Versed | Oxazepam | Serax |
Temazepam | Restoril | Triazolam | Halcion |
Benzodiazepines are also known by different street names. Using street names for benzodiazepines as well as other substances is a common technique to disguise drug use. Some of the more common street names for benzodiazepines include "benzos," "downers," "tranx," and "roche."
Other benzodiazepines like Xanax and Valium have their own street names. Xanax is sometimes referred to as "Xans" or "Xannies" while Valium is known as "eggs" or "moggies."
It’s important to note that Benzodiazepines are prescription medications and should be taken under the supervision of a healthcare professional. Buying and taking benzodiazepines off the street or online can be dangerous.
What Are the Street Names?
The drug is known in the streets by different names, depending on the area or what it is mixed with.
Here are some street names:
- Bars
- Benzos
- Blue V
- Blue footballs
- Candy
- Downers
- Sleeping Pills
- Tranks
- Nerve pills
- Rohypnol
- Roofies
- Roofinol
- Rope
- Rophies
- Jellies
- Sleepers
- Moggies
- Eggs
- Rugby balls
- D5s
- D10s
- Roche
- Xans
- Xannies
What Are Benzodiazepines Used For?
Benzodiazepines are a type of medication that is used to treat a variety of mental health disorders, such as anxiety disorders, epileptic seizures, panic attacks, and insomnia. People suffering from depression may also be prescribed benzodiazepines.
Short-acting benzodiazepines are typically used to treat acute anxiety. The rapid onset and short duration of action make them ideal for treating anxiety that is experienced at the moment.
Long-acting benzodiazepines are typically used to treat chronic anxiety, such as generalized anxiety disorder or post-traumatic stress disorder. The slower onset and longer duration of action make them better suited for managing these conditions.
Whether the doctor will prescribe a long-acting or short-acting benzodiazepine depends on the individual's needs and medical history.
Benzodiazepines should only be used for short periods, usually no more than two to four weeks. Because of the adverse effects, long-term benzodiazepine use can lead to benzodiazepine dependence. However, benzodiazepines retain the potential to be effective medications and have helped treat many people with anxiety disorders.
Let's further discuss some of the conditions that benzodiazepines can treat and the potential side effects of these medications.
Anxiety Disorders
Anxiety is a feeling of fear and worry, often accompanied by physical symptoms such as sweating, shaking, and difficulty concentrating. Numerous controlled trials proved that benzodiazepines can help reduce the severe anxiety symptoms associated with generalized anxiety disorder.
Seizure Disorders
Benzodiazepines can be prescribed to help control epileptic seizures. Benzodiazepines like Ativan, Klonopin, and Valium can help reduce the frequency of seizures and overall help with seizure disorders.
Panic Disorder
Benzodiazepine drugs are also used to treat panic attacks which are sudden and intense periods of fear that can last for several minutes or hours. The sedative effect of benzodiazepines can help to calm the person and provide relief from a panic disorder. While some doctors prefer to prescribe selective serotonin reuptake inhibitors or SSRIs, there are still many who prescribe benzodiazepines as a primary treatment for panic disorder.
Insomnia and Abnormal Sleep Patterns
As a muscle relaxant, benzodiazepines can be prescribed to treat insomnia, as well as other sleep disorders. Taking benzodiazepines work by calming the body and mind so that you can fall asleep more quickly and stay asleep longer.
Alcohol Withdrawal
Alcohol withdrawal symptoms can be extremely uncomfortable and can even be life-threatening. Taking benzodiazepines may be useful to help people who have become dependent on alcohol to detoxify from this substance. The use of benzodiazepines can reduce the intensity of alcohol withdrawal symptoms and make the detoxification process easier.
Restless Leg Syndrome
Restless Leg Syndrome (RLS) is a neurological disorder that causes an uncomfortable sensation in the legs when lying down or sitting. Benzodiazepine use can help relieve symptoms of RLS, such as excessive leg movement.
How Do Benzodiazepines Work?
Benzodiazepines work by calming the central nervous system and increasing levels of the inhibitory neurotransmitter gamma-Aminobutyric acid (GABA).
GABA is an inhibitory neurotransmitter, which means that it helps to decrease neuron activity in the brain. GABA A receptors that bind benzodiazepines are called benzodiazepine receptors (BzR).
By enhancing the effects of GABA, benzodiazepines help to calm down the nervous system and reduce symptoms of anxiety or panic attacks.
This action makes these drugs effective at treating a wide range of conditions from anxiety to seizures. The effects of benzodiazepines also help people to fall asleep more easily and stay asleep for longer periods.
How Strong Are Benzodiazepines Compared to Other Drugs?
Benzodiazepines are prescription drugs that are sedative-hypnotics. This means that like other drugs classified as sedative hypnotics, they are relatively strong medications that can cause drowsiness and sedation.
While benzodiazepines are classified as Schedule IV drugs, meaning they have a lower potential for abuse than Schedule II or III drugs, they are still powerful medications.
Initially, it was thought that the use of benzodiazepines on a long-term basis was safe, however, more recent research suggests that long-term use of these medications can lead to an increased risk for drug abuse. Repeated use of benzodiazepine can be habit-forming and this could lead to benzodiazepine dependence.
For this reason, taking benzodiazepines or other sedative hypnotics as prescribed by your doctor is very important.
How Long Do Benzodiazepines Stay in Your System, Blood, Urine, Saliva, Hair?
If you're undergoing a drug test, you might be wondering how long benzodiazepines stay in your system. Benzodiazepines are detectable in drug tests and can stay in your system from a few days to a few weeks. The duration will depend on many factors such as the type of benzodiazepine used, the dose, and the frequency of benzodiazepine use.
It will also depend on the type of drug test. Below are some estimates of how long benzodiazepine stays in your system.
- Blood test: 2-3 days
- Urine test: 2-28 days
- Saliva test: up to 3 days
- Hair test: up to 90 days
It's also important to note that mothers who breastfeed while taking benzodiazepines can pass the drug to their infants through breast milk. Benzodiazepine use by pregnant women is not recommended as it can cause withdrawal symptoms in newborns.
Half-life of Benzodiazepines
Generic Name | Brand Name | Half-life (hours) |
Alprazolam | Xanax, Xanax XR | Short-effect: 6-26h |
Chlordiazepoxide | Librax | Long-effect: 30-100h |
Clobazam | Onfi | Long- effect: 71-82h |
Clonazepam | Klonopin | Long- effect: 20-50h |
Clorazepate | Tranxene | Long- effect: 20-100h |
Diazepam | Valium | Long- effect: 20-100h |
Estazolam | ProSom | Medium- effect: 10-24h |
Flurazepam | Dalmane | Long-effect: 40-100h |
Lorazepam | Ativan | Medium-effect: 10-20h |
Midazolam | Versed | Short-effect: 2.5h |
Oxazepam | Serax | Short-effect: 5-15h |
Temazepam | Restoril | Medium-effect: 10-20h |
Triazolam | Halcion | Short-effect: 2-5h |
How Does Benzodiazepine Affect the Brain and the Body?
The side effects of benzodiazepines on the brain and body can be serious. Benzodiazepine use can slow down your reactions, impair judgment, and cause confusion, impaired memory, drowsiness, and even coma.
Like other medications, the adverse effects of benzodiazepines can also manifest after using the drug for a long time. Long-term use of benzodiazepines can also cause an increased risk of cognitive decline. Cognitive decline or cognitive impairment is an inability to think, reason, or remember properly (memory impairment).
Aside from the intended effect on the brain, mood, and muscle, here are other short-term and long-term effects:
Short-term effects:
- Diarrhea
- Drowsiness
- Dry mouth
- Depression
- Constipation
- Confusion
- Sexual dysfunction
- Disturbed motor skills
- Muscle weakness
Long-term effects:
- Decreased sexual desire
- Depression
- Mental impairment
- Numbness
- Extreme anxiety
- Agoraphobia
How Does One Get Addicted to Benzodiazepines?
Benzodiazepine addiction can happen to anyone. Benzodiazepines are easy to get addicted to and misuse of these drugs can lead to dependence or abuse.
Benzodiazepine abuse can lead to tolerance where you need higher doses of these drugs to get the same effect. Dosage escalation without the proper medical advice can be the start of dependence.
Taking benzodiazepine can lead to physical and psychological dependence on the drug. Physical dependence is when you experience physical withdrawal symptoms such as nausea, vomiting, muscle aches, and tremors if you stop taking the drugs suddenly. These withdrawal symptoms can be severe and can be life-threatening in some cases.
Psychological dependence is when you experience cravings for the drugs even if you don’t need them. Benzodiazepine addiction can also cause changes to your behavior as well as depression, anxiety, paranoia, and agitation.
When this happens, there is an increased risk of substance abuse. It is not uncommon for many users to develop substance use disorders involving drugs like benzodiazepines.
Drug abuse can develop rapidly as a consequence of prolonged and excessive use of benzodiazepines. Some users do not seek medical treatment while others continue using because they cannot withstand the withdrawal effects caused by stopping the drugs. There are also patients prescribed long acting benzodiazepines that abuse the medications.
What Causes Benzodiazepine Overdose?
Benzodiazepine abuse can result in an overdose. People who abuse benzodiazepines do so often in combination with other substances or drugs. Many Xanax users, for instance, would take it with other drugs like opioids to heighten the effects.
Additionally, combining benzodiazepines with other substances like alcohol can be particularly dangerous and result in toxic effects. The drug interactions result in an increased risk of a drug overdose.
As mentioned, benzodiazepine overdose can also happen when a person unknowingly takes a fake benzodiazepine that is mixed with fentanyl. Fentanyl has been found in many counterfeit Benzodiazepines, and its effects can be dangerous and even life-threatening.
In fact, U.S. health authority officials report that many patients that overdose on drugs in emergency department centers have been found to have taken counterfeit Benzodiazepines mixed with fentanyl and other drugs.
What Are the Signs of an Overdose?
Acute toxicity or overdose involving benzodiazepines can be life-threatening. Signs and symptoms of Benzodiazepine overdose include confusion, impaired coordination, slowed breathing, loss of consciousness, coma, and death.
Other signs of Benzodiazepine overdose may include drowsiness, slurred speech, nausea and vomiting, abdominal pain, tremors, or seizures. Calling the emergency department immediately if you notice any of these signs.
Here are some of the visible signs and symptoms when a person overdoses on these prescription drugs.
- Drowsiness
- Blurry vision
- Fatigue
- High-level irritability
- Uncoordinated muscle movements
- Loss of appetite
- Headache
- Dry mouth
- Decreased sexual pleasure
How Do You Treat Benzodiazepine Overdose?
If you know someone who has overdosed on benzodiazepines, it is important to seek medical help right away. Look for the signs of overdose like respiratory depression or loss of consciousness and quickly seek help from the emergency department of the nearest hospital.
Benzodiazepine overdose or acute toxicity can be treated with the drug flumazenil, which reverses the toxic effects of Benzodiazepines and helps reduce the risk of overdose-related complications caused by these drugs.
What Are the Withdrawal Symptoms from Benzodiazepine?
Abrupt discontinuation of benzodiazepines can result in withdrawal symptoms. These symptoms may include headaches, nausea, insomnia, muscle pain, depressive symptoms, rebound insomnia, and
It is important to note that drugs like benzodiazepines should never be stopped abruptly. Stopping benzodiazepines without medical supervision can result in serious withdrawal symptoms and even be life-threatening.
Benzodiazepines should only be stopped after a gradual dose reduction of the drugs used. This involves tapering the dose or taking low doses of Benzodiazepine drugs over some time with close monitoring from a medical professional.
Withdrawal symptoms may include:
- Delusions
- Confusion
- Depression
- Hallucinations
- Abdominal cramps
- Increased light sensitivity
- Muscle spasms
- Vomiting
- Agitation
- Excessive sweating
- Seizures
- Convulsions
- Increased heartbeat
How Can You Treat Benzodiazepine Addiction?
It is also important to seek professional treatment for Benzodiazepine abuse. Drugs such as benzodiazepines can be very addictive and they can cause serious health problems when abused.
If you or someone you know is struggling with Benzodiazepine addiction or addiction to other drugs, it’s important to get help right away. Benzodiazepine addiction can be treated with a combination of counseling and medication-assisted treatment (MAT).
- Consult your medical personnel or clinician for a comprehensive guideline in order to recover from drug dependence.
- Below are some of the drug medications to treat substance addiction:
o Klonopin (Clonazepam): Minimize symptoms for short-acting substances. It is used to cure seizures, panic attacks, and anxiety. Intake should be controlled.
o Phenobarbital: This drug is under the class known as “barbiturates”. It is used to minimize seizures and anxiety.
o Buspirone (Buspar): It is an anxiolytic drug for it stimulates the production of serotonin in the brain.
o Tegretol (Carbamazepine): This calms the brain and reduces anxiety.
o Tofranil (Imipramine): This drug is under the tricyclic antidepressant group. It is used to cure depression and anxiety as a result of the addiction. - Reward System: A contingency management plan where sets of rewards will be given to the patients who avoid using these substances.
- Cognitive Behavioral Therapy (CBT): A treatment process seeking to determine the variables causing drug abuse, risk reduction methods, and enhancing coping mechanism.
- Recovery Group: A community-based plan which allows the patient to meet other victims and have a sharing about their experiences and success.
Professional addiction treatment centers are the best way to get help with Benzodiazepine addiction. You can consult with a professional on whether you need short term treatment or a more comprehensive residential treatment. They can also help you find the best Benzodiazepine addiction treatment program for your needs.