Benzodiazepines drugs are most often prescribed to treat mood disorders, panic disorders, and anxiety disorders, including generalized anxiety disorder (GAD). Xanax, Valium, and Klonopin are some of the most well known benzodiazepine drugs, often referred to as benzos.
They are prescribed frequently by doctors, yet if taken without the specific guidelines given by a healthcare professional, benzos can be potentially dangerous.
Benzodiazepine addiction can happen to anyone, regardless of whether the drug is taken as a prescribed medicine or not, and physical dependence can develop in as little as four weeks.
After continued use, the body becomes used to the presence of benzos, and people can feel like they can not function without them. The body builds up a resistance to the drug, meaning a higher dose is needed to acquire the desired effect.
Why You Need to Know the Signs
Prescription drug abuse is on the rise in the US, claiming the lives of tens of thousands of people each year, with 12,290 people dying from an overdose involving benzodiazepines in 2020.
Knowing the signs of benzodiazepine abuse early can increase the risk of early substance abuse intervention, lowering the risk of a person becoming physically dependent or addicted to the drug. Benzodiazepines are one of the most commonly abused prescription drugs in the United States, with around 4.8 million people reported misusing benzodiazepine drugs in the past 12 months.
List of Benzodiazepine Medications
- alprazolam (Xanax)
- chlordiazepoxide (Librium)
- clonazepam (Klonopin)
- clorazepate (Tranxene)
- diazepam (Valium)
- estazolam (Prosom)
- flurazepam (Dalmane)
- lorazepam (Ativan)
- midazolam (Versed)
- oxazepam (Serax)
- temazepam (Restoril)
- triazolam (Halcion)
- quazepam (Doral)
The Tell-Tale Signs
Whether you already know a person has been prescribed benzodiazepines and you are worried that they are abusing their prescription pills, or you suspect they may have acquired the benzo medication illegally, there are physical and behavioral signs to look out for. Benzodiazepine dependence can progress quickly, so it is important to take action as soon as you suspect a person is abusing the drug.
Detoxing from benzodiazepines is much more painful and challenging once a person is addicted and physically dependent on the drug, making relapse more likely.
Benzodiazepines are prescribed for their calming effects, and while different side effects may occur depending on the type of benzodiazepine, the dose, and the individual, behavioral changes will often include a reduction in energy and increase in apathy or lethargy. Other behavioral signs of benzo abuse include:
- Mental confusion
- Being increasingly secretive about day-to-day things such as their schedule or lying to hide the substance abuse
- Reduced effort to maintain good personal hygiene
- Engaging in uncharacteristic ways in order to obtain more benzos, such as borrowing money, stealing, or maxing out credit cards.
- Withdrawal from friends, family, and obligations such as work or study
- Sudden feelings of annoyance or irritability (generally caused by the onset of withdrawal symptoms when the drug begins to leave a person’s system)
- Major behavioral changes, such as extreme drowsiness or lack of interest
- Manic-type moods
- Unwillingness to do tasks which require extended attention
- Impaired cognition and memory
Mental Health Symptoms
Chronic benzo abuse can actually cause symptoms that mimic many of the reasons or symptoms for using them in the first place, including:
Moreover, long term use can result in benzodiazepine dependance which causes withdrawal symptoms to appear when benzodiazepine begins to leave their system. In extreme cases, people can even begin to experience these withdrawal symptoms in between doses. These symptoms include:
- Panic attacks
- Persistent headaches
- Difficulty focusing, concentrating, and remembering
- Drug cravings
Benzodiazepines abuse can cause a variety of long and short term physical side effects including:
- Difficulty sleeping
- Hand tremors
- Extreme drowsiness
- Physical tension
- Persistent headaches
- Heart palpitations
- Nausea, vomiting, and diarrhea
- Hypersensitivity to light and sound
- Muscle pain and stiffness
- Drug cravings
- Slurred speech
- Loss of appetite
- Poor coordination
- Respiratory depression
Long term benzodiazepine addiction also increases the risk of developing dementia, an illness affecting the brain that causes gradual memory loss and problems with language and motor skills in the long term. These are all noticeable physical effects of benzodiazepine abuse to look out for; however, two very serious effects of benzo abuse are often invisible. Benzodiazepines are central nervous system depressants, so they lower heart rate, core body temperature, blood pressure, and respiration. If these vital life functions get too low, a person is at risk of an overdose.
Is Your Loved One Self-Medicating?
Physical and mental health problems or illnesses can sometimes be difficult to diagnose, and some people turn to self-medication to deal with the issues that they are faced with. In other cases, problems may seem too large to deal with, and masking the problem with drugs or alcohol seems easier or even safer, especially in the face of confronting past traumatic experiences which are causing mental health problems.
Self-medication is the practice of using substances to alleviate pain or symptoms without a prescription from a doctor.
Prescription drugs can be a common choice for self-medication as they seem safer and are more readily available. Approximately half of people who abuse prescription drugs in the past year said that they obtained them from a friend or relative for free.
It is common for people to begin by obtaining prescription drugs in this way and then gradually begin obtaining them in other ways including paying a drug dealer or going to multiple doctors to get a prescription. Self-medication may seem relatively harmless at first, but is likely to lead to more serious drug abuse. In fact, about 80% of people who use heroin initially misused prescription drugs.
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Are They ‘Doctor Shopping’?
Doctor shopping is the practice of obtaining prescriptions from multiple doctors and then going to different pharmacies to pick up the medication. Benzodiazepines are the second most common controlled substance that people obtain by ‘doctor shopping’.
People generally begin doctor shopping because they have become dependent on a controlled substance, and as their tolerance has increased, they are looking for ways of obtaining more for their own consumption. It is often the case that a person was prescribed the medication legitimately at some point, but either their prescription has finished or they require a higher quantity to feel the effects as a result of increased tolerance.
Some people also engage in doctor shopping with the goal of selling the drugs. Prescription medications are in extremely high demand – benzodiazepines are prescribed at 66 million doctors’ appointments a year. If you suspect a person may be doctor shopping, the telltale signs are:
- An individual is taking too much medication or finishing prescriptions early
- The person is visiting multiple doctors for various reasons
- They say that their prescription drugs were misplaced
- Paying for prescriptions with cash
- An individual crosses state lines to visit doctors
Signs of Abuse Related to Specific Medications
Benzodiazepines can be abused in a number of ways, bringing different signs to look out for. Benzodiazepines are most commonly abused orally. However, cases of people snorting, injecting, and smoking crushed up Xanax, Valium, and Klonopin pills have also been reported.
There have been reports of people smoking Xanax by crushing up a Xanax pill, mixing the powder with tobacco or marijuana, and rolling a cigarette with the contents. Others have reported using an e-cigarette or putting the Xanax powder on top of foil, in a method similar to how individuals smoke heroin or fentanyl. Finding smoking paraphernalia, smelling smoke, finding crushed up pills, and seeing mouth burns on a person could all be signs of this form of abuse.
Klonopin is often abused in combination with other substances to mask some effects or amplify others. Some people take stimulants such as cocaine to counteract Klonopin’s sedative effects. Others may consume alcohol to enhance Klonopin’s calming effects.
Some users may snort Valium or other benzos in an attempt to intensify their high. Signs of this form of abuse include frequent nosebleeds, finding blue powder from crushed up pills, as well as other paraphernalia such as empty pill bottles, straws, rolled up bank notes, or razors.