Benzodiazepines

Benzodiazepines (or benzos) are depressant drugs which slow down the messages between the brain and the body. Benzos include a group of nervous system depressants prescribed for the short term treatment of stress, anxiety or insomnia. They are also known as ‘minor tranquillisers’ and sedatives (or sleeping pills).

Benzodiazepines are available on prescription in Australia and should only be used under a doctor’s supervision. They can be highly addictive and can cause overdose, particularly when used with alcohol or other drugs, and should not be used long term.

What are benzodiazepines?

Benzodiazepines are medicines that are only available on prescription from a doctor. They are usually a short-term treatment to help calm the nervous system and promote sleep.

Benzodiazepines may be prescribed to:

• treat the symptoms of anxiety disorders
• relieve insomnia
• help with treatment of symptoms experienced by cancer patients
• control epilepsy
• help relax muscles during certain medical procedures (such as endoscopy)
• treat alcohol withdrawal.

Types of benzodiazepines

There are three types of benzodiazepines – long-acting, intermediate and short-acting. Short-acting medications tend to be more addictive and have a stronger withdrawal and ‘come down’ effect. They are made by different companies and sold under various brand names.

Pharmaceutical names

How benzodiazepines work

Benzodiazepines are central nervous system depressants, which means they slow down the messages between the brain and the body. They only treat symptoms of anxiety or insomnia, and do not solve the underlying causes of these conditions.

Benzodiazepines can be highly addictive, whether they are taken under medical supervision or used recreationally.

Benzodiazepines are a small part of treatment

It is generally recommended that benzodiazepines only be used for a short term – just days or weeks at a time.

They are a small part of overall treatment for stress, anxiety or insomnia and used with other treatments that provide longer term solutions, including:

• psychological therapies - such as cognitive behaviour therapy (CBT)
• techniques to lower stress levels (such as relaxation or breathing exercises)
• techniques to build self-esteem
• lifestyle changes (such as eating healthily or incorporating physical activity into your day)
• structured problem solving.

Recreational use of benzodiazepines

Some people take benzodiazepines illegally for recreational use. They may use them to feel a sense of euphoria (or high) or use them after taking stimulants (cocaine, amphetamines, ecstasy) to help with the ‘come down’.

Benzodiazepines can be dangerous when mixed with other drugs (including alcohol) and can put you at risk of overdose or harm.

Some people may give them to others intentionally or without their consent (such as spiking their drink).

In Victoria, it is against the law to use benzodiazepines without a prescription or to give or sell them to someone else.

How benzodiazepines affect the body

The effects of benzodiazepines depend on the strength of the dose, the physical make-up of the person taking them and their state of mind.

Common effects of benzodiazepines include:

• relief from anxiety
• euphoria
• confusion
• headache
• dry mouth
• blurred vision
• nausea
• impaired coordination
• muscle relaxation
• sleepiness
• a sense of being disconnected or detached from reality
• dizziness
• diarrhoea or constipation
• loss of inhibitions.

Long-term effects of benzodiazepines

Using benzodiazepines on a regular basis can lead to significant health problems, including:

• impaired thinking or memory loss
• anxiety and depression
• irritability, paranoia and aggression
• personality change
• weakness, lethargy and lack of motivation
• drowsiness, sleepiness and fatigue
• difficulty sleeping or disturbing dreams
• headaches
• nausea
• skin rashes and weight gain
• addiction
• withdrawal symptoms.

Benzodiazepines and pregnancy

There is a risk that benzodiazepines can be harmful to babies. If you are pregnant or breastfeeding, it is best to avoid them. Be guided by your doctor and health team.

Store benzodiazepines securely

As benzodiazepines can be highly addictive, they should only be used under medical supervision.

If you are prescribed benzodiazepines, store them safely and securely and never allow others to use them.

Benzodiazepine overdose

Overdoses are usually characterised by slow, shallow breathing which may lead to unconsciousness, coma and potentially death.

This is more common if benzodiazepines are combined with other drugs such as alcohol, painkillers, certain types of antidepressants or antihistamines, and opioids like heroin.

Always check with your GP or pharmacist if you can safely use benzodiazepines with other medications. Overdose symptoms include:

• over-sedation or sleep
• nausea, slurred speech
• problems thinking, concentrating and with memory
• jitteriness and excitability
• mood swings and aggression
• slow, shallow breathing
• unconsciousness or coma
• death (more likely when taken with another drug such as alcohol).

If you suspect an overdose, call triple zero (000) for an ambulance immediately. Ambulance officers don’t need to involve the police.

Benzodiazepine dependence and tolerance

Taking benzodiazepines regularly may not only lead to physical dependence (addiction), but can also lead to psychological dependence where people may feel they need the drug to cope with daily life.

After only a short amount of time, a person can develop a tolerance, which means they need to take larger and larger doses to achieve the same effect. Some people may begin to experience tolerance after only a few days. Over time, the body comes to depend on benzodiazepines to function.

Withdrawal from benzodiazepines

Withdrawal symptoms vary from person to person and are different depending on the type of benzodiazepine being taken.

Always withdraw from benzodiazepines slowly, over a period of time, under medical supervision.

Someone who suddenly stops taking benzodiazepines after a prolonged period of use can put themselves at risk of serious withdrawal symptoms, such as seizures.

Symptoms can last from a few weeks to a year and may include:

• headaches
• aching or twitching muscles
• dizziness and tremors
• nausea, vomiting and stomach pains
• bizarre dreams, difficulty sleeping and fatigue
• poor concentration
• anxiety and irritability
• altered perception and heightening of senses
• delusions, hallucinations and paranoia
• seizures.

Treating benzodiazepine dependence

Treatment options for drug dependence may include detoxification, individual counselling and group therapy.

See your doctor for information and referral, or contact an alcohol and drug service – call DrugInfo on 1300 85 85 84 to find the appropriate referral for you.

Where to get help

• If an overdose is suspected, call triple zero (000) for an ambulance immediately
• Your GP (doctor)
• Alcohol and Drug Foundation (ADF) Path2help – resources to assist people looking for ways to support their loved ones who use alcohol and/or other drugs
• Alcohol and other drug services
• Reconnexion – support and information for tranquilliser dependency Tel. (03) 9809 8200 or 1300 273 266 Mon to Fri 9 am to 5 pm
• DrugInfo Tel. 1300 85 85 84 –information and referral services for anyone seeking help for alcohol or drug use
• DirectLine Tel. 1800 888 236 – for 24-hour confidential drug and alcohol telephone counselling, information and referral
• Counselling Online – for online counselling and referral
• Your community health service
• Youth Drug and Alcohol Advice service (YoDAA), Victoria Tel. (03) 9415 8881 (9am to 5pm, Monday to Friday)
• Family Drug Help Tel. 1300 660 068 – for information and support for people concerned about a relative or friend using drugs