Benzodiazepine Abuse

GENERAL INFORMATION:

What are benzodiazepines? Benzodiazepines (ben-zo-die-AH-zuh-peens) belong to the group of medicines called central nervous system (CNS) depressants. These medicines slow down the nervous system in your body. Benzodiazepines may be used to help keep you from being anxious or nervous, control seizures, or decrease memory of a procedure or treatment. They may also be used to decrease vomiting (throwing up) caused by medicines (such as cancer treatments), control tremors (shaking), or relax muscles. The benzodiazepine that was prescribed (ordered) for you was meant to be used for a specific purpose.

Why do caregivers prescribe a benzodiazepine?

• To treat anxiety, panic attacks, or if you need help going to sleep or staying asleep.
  
  
• To keep you from having seizures (convulsions), or to stop seizures. They may also be prescribed if you have a problem controlling jerking muscles.
  
  
• Given before surgery or other medical or dental procedures to decrease fears you may have about the surgery.
  
  
• To help you relax during certain medical procedures
  
  
• To help you cope if you are withdrawing from another substance, such as alcohol or cocaine.

What is benzodiazepine abuse?

• Benzodiazepines are generally safe if you take them exactly as your caregiver has told you to, and you do not use other medicines or substances at the same time. One or more of the following situations within a one-year period may mean that you are abusing a benzodiazepine:
  
  
  • Does your use of this medicine stop you from doing your regular work, home, or school duties? Do you miss work or school, or get there late? Is your performance at these activities dropping or poor? Do you neglect your home or children?
    
    
  • Do you use this medicine when it is dangerous to use it? Do you drive a car or operate a machine when you are high or sleepy after using this medicine?
    
    
  • Do you have legal problems because of your use of this medicine? Do you get traffic tickets, have vehicle accidents, or have arguments with people that may end with the police being called?
    
    
  • Do you keep using this medicine even when you argue with your family and friends about your use?
  
  
• Benzodiazepines should never be taken with certain other medicines or substances. Benzodiazepines taken at the same time as alcohol (wine, beer, mixed drinks, liquor), methadone, LSD, marijuana, or cocaine may kill you.

How do benzodiazepines affect older adults? Caregivers may prescribe a benzodiazepine to help an older adult sleep, because they are nervous or anxious, or because they have upsetting mood changes. Older adults may abuse the medicine by taking more medicine than the caregiver prescribed, or drinking alcohol while taking the medicine. Because benzodiazepines can cause sleepiness, older adults are at higher risk of falling or getting in car accidents when they use the medicine. Older adults may also have new problems with memory and understanding after using benzodiazepines.

How do benzodiazepines affect younger people? Younger people may take benzodiazepines for the relaxing effect. They may also take a benzodiazepine to decrease withdrawal symptoms caused by another drug or substance. Sometimes young people take benzodiazepines to enhance the effects of another drug or substance.

Are benzodiazepines always "downers"? No. Benzodiazepines may have the opposite effect when used by children, older adults, and people with developmental disabilities. The following are effects a benzodiazepine may have on certain people:

• Aggression. You may be less tolerant than usual. You may anger quickly and yell or even hit people for no reason.
  
  
• Hostility. You may become very unfriendly.
  
  
• Impulsivity. You may do things without thinking about the effects of your action.
  
  
• Increased excitement. You may become more anxious or nervous.
  
  
• Irritability. You may grumble or be unhappy for no reason.

How do I know if I am dependent on benzodiazepines? If you use benzodiazepines every day, or two or three times a day for weeks or months, you may become dependent on a benzodiazepine. When you are dependent on a benzodiazepine you feel normal while you are taking it. It is important to realize that you are dependent on the medicine. Do not suddenly stop using benzodiazepines. The amount of medicine, and the frequency that use it must be decreased over time. Withdrawal symptoms may not begin for hours or days after decreasing use of the medicine. If you have been taking a benzodiazepine for a long time or you are taking a high dose, withdrawal symptoms may be severe (very bad).

What are the signs and symptoms of withdrawal?

• The length of time after decreasing your use of the drug, and the time that signs and symptoms of withdrawal begin depends on several factors. These include which benzodiazepine you were using, how long you have been using it, and the amount of medicine you were using. Signs and symptoms may begin within hours after decreasing your use of the medicine, and may continue for up to a week. Signs and symptoms may also begin over a week after decreasing your use of the medicine, and may continue for a month or longer.
  
  
• Signs and symptoms of withdrawal are two or more of the following, that begin hours to days after decreasing use of, or stopping the medicine:
  
  
  • Feeling nauseated (sick to your stomach) or vomiting (throwing up).
    
    
  • Increased sweating, and having a fast heartbeat.
    
    
  • Seeing, feeling, or hearing things that are not there. These are called hallucinations.
    
    
  • Shaky hands.
    
    
  • Trouble falling or staying asleep.
    
    
  • You may do things over and over that have no meaning, such as pacing or wringing your hands.
    
    
  • You may feel very nervous.
    
    
  • You may have a seizure (convulsion).
  
  
• These symptoms may be very uncomfortable for you. They may also keep you from doing your normal daily activities.

What may happen if I take too much of a benzodiazepine? Taking too much of a benzodiazepine is called benzodiazepine intoxication. Signs and symptoms are the following:

• You may behave in a way you do not usually behave, or you may do upsetting things to other people. You may talk or act in ways that make people back away from you or make them want to get away from you. You may have quick mood changes. You may go to sleep.
  
  
• You may also have one or more of the following signs and symptoms:
  
  
  • Being unable to control your eye movements.
    
    
  • Being unable to focus on one thing.
    
    
  • Others may have trouble trying to wake you up from sleeping.
    
    
  • Slurred speech.
    
    
  • Trouble picking up, holding or using a familiar item.
    
    
  • Trouble walking.

What happens to a woman if she uses benzodiazepines while pregnant or breast feeding?

• Benzodiazepines should not be used while you are pregnant. These medicines pass to your baby through your placenta (afterbirth). Your placenta is attached to your uterus (womb) and provides food and oxygen to your baby through the umbilical cord. Your use of benzodiazepines while pregnant may cause your baby to become dependent on the medicine. When the baby is born, it will have signs and symptoms of withdrawal, which can be very harmful, and your baby may even die.
  
  
• Benzodiazepines should not be used while you are breast feeding. The medicine is in the breast milk of a woman using benzodiazepines. If you use benzodiazepines and breast feed your baby, your baby is also using the medicine. Use of this medicine in babies is very harmful, and your baby may develop life-long medical problems, and may even die.

What should I do to stop using benzodiazepines?

• Talk to your caregiver. If you take benzodiazepines on a regular basis, do not suddenly stop taking them. Your caregiver should help you by giving you a schedule to follow which will lower the dose or the number of times a day you use the medicine. Your caregiver may keep you on the same benzodiazepine or change your medicine. You may be treated as an inpatient in a hospital or as an outpatient, at home.
  
  
• Tell your caregiver exactly how much benzodiazepine medicine you are using. Your caregiver needs to know if you are using any other medicines, drinking alcohol, or taking illegal (street) drugs or substances. If you are using other substances while using benzodiazepines, caregivers need to know how much, and how often you are using them. Tell caregivers the truth about your drug use. Doing this will help caregivers put together the best treatment plan for you.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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