Benzodiazepine Addiction Treatment: Symptoms & Risks

Written by Theresa Valenzky

& Medically Reviewed by Dr. Jessica Pyhtila, PharmD

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Benzo addiction can be dangerous, but recovery is possible with help.

Benzos are common drugs that can be addictive. When you are addicted to a benzo, the prospect of quitting can seem overwhelming. However, help is available to gently wean you off your benzo, avoiding withdrawal symptoms and setting you up for a benzo-free life. For this reason, it is vital to understand how benzo addiction works and the risks of both addiction and withdrawal.

What Are Benzodiazepines?

Benzodiazepines are central nervous system depressants that work similarly. Specifically, benzos act on the brain’s benzodiazepine receptors to enhance the activity of a brain chemical called gamma-aminobutyric acid (GABA). GABA is a major neurotransmitter that works to slow down the activity of the brain and central nervous system.

Most Prescribed Benzos

Tens of millions of benzo prescriptions are dispensed every year. Many different benzos exist, and as of 2020, the most recent year for which data is available, the most common benzos include:

  • Alprazolam (Xanax), with more than 16.7 million prescriptions
  • Clonazepam (Klonopin), with more than 14.7 million prescriptions
  • Lorazepam (Ativan), with more than 10.5 million prescriptions
  • Diazepam (Valium), with more than 4.9 million prescriptions
  • Temazepam (Restoril), with more than 2.1 million prescriptions

Benzodiazepine Side Effects

Benzodiazepine side effects can vary from person to person, but some side effects are more expected than others. These reactions can happen on any benzodiazepine and are due to the way the drug works in the brain. Side effects include:

  • Slowed breathing
  • Stopped breathing
  • Drowsiness
  • Confusion
  • Headache
  • Passing out
  • Nausea or vomiting
  • Diarrhea
  • Tremor

Why Are Benzodiazepines Addictive?

Benzodiazepines are addictive because they trigger the brain’s reward system. Specifically, benzodiazepines act on an area of the brain called the ventral tegmental area, where they cause a surge of the feel-good chemical dopamine. Over time, this can lead to compulsive use of the benzodiazepine to try to chase that feeling, paving the way to an addiction.

Benzodiazepine Addiction Statistics

Benzo addiction is unfortunately common. Most benzos are Schedule IV controlled substances, meaning that they are prescription drugs that have legitimate medical use but carry a risk of abuse, addiction, and dependence. However, some illicit synthetic benzos have no fair medical use and are, therefore, Schedule I controlled substances, including:

  • Etizolam
  • Flualprazolam
  • Clonazolam
  • Flubromazolam
  • Diclazepam

Even among prescription benzos, abuse can occur. In 2021 alone, about 3.9 million Americans misused prescription benzos, with people aged 18 to 25 being at the highest risk and multiracial and white people being at higher risk than other races.

Benzodiazepine Addiction Signs

When a person begins to develop a benzodiazepine addiction, signs and symptoms often become evident to friends, colleagues, and loved ones. The presence of at least two of the following characteristics within 12 months can mean that the person has developed a benzo use disorder:

  • Taking more benzos than intended or for a longer time than planned.
  • Unsuccessful attempts to cut back on benzo use.
  • Spending a lot of time seeking, taking, or recovering from benzos.
  • Cravings for benzos.
  • Problems keeping up with life obligations because of benzo use.
  • Interpersonal problems linked to benzo use.
  • Giving up other activities because of benzo use.
  • Taking benzos even when it is physically dangerous to do so.
  • Remaining on benzos even though you know that they are harmful to you.
  • Needing more benzos to achieve the same effects you got at first.
  • Withdrawal symptoms when you try to stop taking benzos.

Benzodiazepine Withdrawal Symptoms

Benzo withdrawal can be extremely dangerous, and should only be attempted under a doctor’s care. Experts recommend slowly decreasing your benzo dose over time instead of stopping the drug cold turkey for this reason. Benzo withdrawal symptoms can include:

  • Sweating 
  • Rapid pulse
  • Hand tremor
  • Trouble sleeping
  • Nausea or vomiting
  • Hallucinations or illusions
  • Agitation
  • Anxiety
  • Seizures

Benzo withdrawal symptoms can start within a few hours to days after the last use of the substance and often wax and wane over time, getting better and then worsening again. The duration of withdrawal often depends on the benzo that has been used:

Short-acting benzoLong-acting benzo
Benzo examplesAlprazolam (Xanax)Lorazepam (Ativan)Oxazepam (Serax)Temazepam (Restoril)Clonazepam (Klonopin)Diazepam (Valium)Chlordiazepoxide (Librium)
Onset of withdrawal6 to 8 hours after the last doseOne day to one week after the last dose
Peak withdrawal symptomsSecond day after the last doseSecond week after the last dose
Withdrawal resolvesFourth or fifth day after the last doseSeveral months after the last dose

Benzodiazepine Overdose Signs and Symptoms

Benzodiazepine overdoses increased by more than 23% between 2019 and 2020. Although any benzo overdose is problematic, mixing the drug with other central nervous system depressants like opioids or alcohol increases the risk of dangerous signs and symptoms.

When taken without other substances, a benzodiazepine overdose is rarely fatal but can produce symptoms like: 

  • Slurred speech
  • Movement problems
  • Mental status changes
  • Severe drowsiness

However, when mixed with other depressants, the risk of a potentially fatal overdose increases.

Risks of Mixing Benzos with Other Substances

Benzos can be dangerous on their own, but mixing them with other substances can be deadly. This is especially true when benzos are mixed with other central nervous system depressants like opioids or alcohol. Because they are all depressants, mixing benzos with either of these substances can cause side effects like:

  • Dizziness 
  • Lightheadedness
  • Extreme sleepiness
  • Slowed breathing
  • Problems breathing
  • Coma
  • Death

Mixing Benzos with Alcohol

The FDA warns against mixing benzos with alcohol due to the increased risk of severe side effects, which can be deadly in some cases. Nonetheless, people who struggle with drinking often struggle with benzos as well. One study showed that 7.5% of people who have unhealthy drinking habits also use benzos despite the FDA warning.

Mixing Benzos with Opioids

Mixing benzos with opioids can be fatal. For this reason, the FDA requires a Boxed Warning on all benzodiazepines and opioids, warning of the risk of taking them together. Despite this warning, some people continue to take the drugs together: in 2019 alone, 18.7% of benzodiazepine overdoses involved the person also taking an opioid. 

Benzodiazepine Addiction Treatment Options

If you or a loved one struggle with benzos, addiction treatment options and help are available. It is crucial to always get medical advice before stopping a benzo to prevent severe withdrawal complications like seizures. Our benzo addiction experts at The Recovery Village Indianapolis are here every step of the way to help safely wean you off benzos and put you on the road to a full recovery. Don’t wait: contact us today to see how we can help.


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