A Closer Look At Benzodiazepines: An Unassuming Killer
Benzodiazepines have been around since the late 1950s, and they were marketed as being an alternative to barbiturates and as minor tranquilizers.
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When they’re prescribed for short term usage, they can be very useful for the treatment of insomnia, anxiety, seizures and after surgeries. However, when people take them for more than two to four weeks, they can become dependent on them, which can often lead to addiction.
One of the most surprising things about using prescription drugs like benzos is the fact that many people get hooked on them accidentally. Even when they follow their doctor’s directions to the letter, they can still develop a serious problem. And when they try to quit, they are assaulted by a range of uncomfortable – and sometimes deadly – withdrawal symptoms.
Plus, benzodiazepines are increasingly becoming a popular recreational drug as well. Abusers often take high doses alongside alcohol, heroin, cocaine, and other prescription drugs as well.
In order to understand how dangerous this addiction is, it’s important to look at what medications fall into this class, and what you can look for to determine whether you or someone you love is abusing benzodiazepines or has become addicted to them.
On top of that, it’s also helpful to know what to expect in terms of treatment for this dangerous addiction.
What Are Benzodiazepines?
Benzodiazepines, also referred to simply as benzos, is a class of drug that’s used to essentially slow down the brain’s activity. It does so by interacting with special chemicals to reduce the brain’s electrical activity. Due to this slowing effect, these drugs are classified as sedative-hypnotics.
These drugs can come in handy for a number of different conditions. Most notably, disorders that involve increased activity in the brain can be treated with benzos. These conditions include:
- Insomnia
- Anxiety disorders
- Panic attacks
- Epilepsy
- Alcohol withdrawal
Benzos are available by prescription only. That means that they can only be obtained through a licensed physician or psychiatrist. However, many benzodiazepine abusers also get their fix through illegal means. This might include buying them on the streets from drug dealers or taking them from friends or family members that have a legitimate prescription.
In fact, one study found that the overwhelming majority of prescription drug abusers obtain these drugs from people with a proper prescription. They may buy extras off of them, take unused doses, or even steal them.
Benzodiazepines are also referred to on the street as “Benzos,” and they can be very dangerous with prolonged usage. Even though doctors have recently tried to prescribe alternate drugs to their patients because of the risks involved with this classification, there are some who still heavily prescribe them. They are:
- Valium (generic name: diazepam)
- Ativan (generic name: lorazepam)
- Xanax (generic name: alprazolam)
- Klonopin/Rivotril (generic name: clonazepam)
- Restoril (generic name: temazepam)
- Rohypnol (generic name: flunitrazepam)
- Dalmane (generic name: flurazepam)
It is so easy to become dependent upon benzos because they actually do work really well for their intended purpose. However, it’s easy to develop a tolerance after only a short time of using them, which can lead to using increasing amounts as time goes on.
We know that benzos can be especially helpful for certain conditions that involve increased electrical activity in the brain. But how do they help? What do they do on a cellular level?
Well, to understand how these drugs work in the brain, it helps to know a bit about how the brain works in general. Everything we do – all of our actions, emotions, thoughts, and instincts – are driven by electrical activity in specialized brain cells called neurons. Every action and everything we experience matches up with a particular pattern of electrical activity in these neurons, of which the brain has 100 billion.
Whether or not these neurons light up with electrical activity is controlled by the amount of excitatory and inhibitory chemicals they’re exposed to. If the excitatory chemicals outnumber the inhibitory ones, the neuron lights up and transfers an electrical pulse to other neurons. If the inhibitory ones win, then the neuron stays inactive.
GABA (or gamma-aminobutyric acid) is one of the brain’s main inhibitory chemicals. Benzos like Xanax and Ativan interact directly with this chemical and make it much stronger. And as a result, many of the brain’s neurons become far less likely to fire off electrical signals.
The levels of these chemicals (called neurotransmitters) go up and down constantly throughout the day. However, in individuals with certain mental disorders (insomnia, anxiety, panic attacks, etc.) the excitatory neurotransmitters are always beating out the inhibitory ones. Benzos, then, can help return the brain’s neurotransmitters to their proper levels by increasing the strength of the inhibitory chemicals.
When benzodiazepines are taken in the long-term, though, the body eventually adjusts to them. It does so by increasing the potency of the natural excitatory neurotransmitters in the brain. As a result, patients commonly must increase their dosage to get the same beneficial effects.
And over time, they can develop a physical dependency that may lay the groundwork for addiction.
While drugs like Xanax and Ativan may seem new, the truth is that benzodiazepines have actually been around for quite some time.
According to the Center for Substance Abuse Research (CESAR), they were first discovered in the 1930s by Leo Sternbach, a chemist working for the Hoffman-LaRoche Company. It wasn’t until 1957 that benzos were first introduced to the public, however, when the company released Librium, an anti-anxiety medication.
Benzodiazepines were first lauded as a safer alternative to barbiturates, another central nervous system (CNS) depressant. Physicians and medication prescribers found that benzos had a beneficial effect on disorders like anxiety without the dangerous respiratory depression caused by the more outdated barbiturates.
However, as these drugs became more widely prescribed in the 1980s, experts began voicing concerns about the addictive potential of these drugs. These concerns were particularly geared towards elderly patients, who often experienced more severe side effects of the drugs.
As a result, legislation was passed to categorize these drugs as potentially harmful. But even still, benzodiazepines like Xanax are still one of the most widely prescribed drugs in the U.S. today.
As with so many other drugs, benzodiazepines have claimed the lives of a number of celebrities in recent years. Here are just a few of the most notable.
- Amy Winehouse
- Brittany Murphy
- Adam Goldstein
- Michael Jackson
- Heath Ledger
- Anna Nicole Smith
- Whitney Houston
- Mike Starr
For many benzo abusers, getting high on these drugs is mostly about the calming sensation that they provide. An especially strong sense of wellbeing, a release of stress, and a relief from worries and cares are often cited as the main benefits of a benzodiazepine high.
According to one user, StaySedated, from the drug forum Bluelight:
depending on dose, benzos at lower doses produce relaxation, stress/anxiety relief, feeling content with one's self and/or increased self-confidence, sedation, and drowsiness. lower doses generally feel similar to one or two alcoholic drinks.
as dose increases, a drunk like intoxication sets in and effects can include: lowered to loss of inhibitions, euphoria, slurred speech, poor or loss of coordination, impaired or loss of judgement, aggression, talkative or increased social mood, heavy sedation and drowsiness, excitation, and other alcohol like intoxication effects.
However, this is also often accompanied by drowsiness, fatigue, and a lack of coordination.
Many people also tend to combine benzos with other drugs in order to intensify the effects. When mixed with other CNS depressants like alcohol or opioids, the effects can be even more calming. That being said, mixing this drug with others can also increase the likelihood of a dangerous and potentially fatal overdose.
Benzodiazepines and opioids, for example, are both commonly abused together. According to the National Institute on Drug Abuse (NIDA), “More than 30 percent of overdoses involving opioids also involve benzodiazepines.”
That’s because both of these drugs are powerful respiratory depressants, meaning they slow down breathing. And when they’re combined in high doses, the body becomes unable to maintain healthy breathing levels and, eventually, can die as a result.
The Difference Between Benzodiazepine Dependency, Abuse, & Addiction
Unfortunately, there’s a lot of misunderstanding when it comes to defining a person’s relationship to a drug. Are they addicted or just physically dependent? Is any drug use considered abuse? And how do you know when someone truly is addicted anyway?

In order to answer these questions, it’s important to know the difference between three key terms: dependence, abuse, and addiction.
Physical dependency is the result of using an addictive substance over and over again. It’s a condition that’s marked by the body being unable to function normally without using the substance. Someone physically dependent on a drug will exhibit tolerance and/or withdrawals.
It’s important to recognize that just because someone is physically dependent on a substance does not mean they are addicted. Patients all over the world regularly experience tolerance to medications over the course of treatment, even when those medications are taken according to a doctor’s orders. That doesn’t mean they have developed a full-blown substance use disorder.
Physical dependence, then, is not the same as addiction.
Using a substance doesn’t always mean you’re abusing a substance. Instead, abuse is defined as using a substance in a way it wasn’t meant to be used. That can mean drinking far more than the recommended amount of alcohol or taking pills that weren’t legally prescribed to you.
In terms of illicit drugs like heroin or cocaine, using them at all is considered abuse since these drugs are 100% illegal. But with prescription drugs like benzodiazepines, there’s much more grey area in terms of what makes is abuse.
For benzos, all the following scenarios would be considered abuse:
- Taking the medication without a proper prescription
- Using someone else’s dose, even if you have the same condition
- Taking more of the medication than what’s prescribed
- Taking the medication at a time that isn’t prescribed
- Mixing benzodiazepines with other substances like alcohol or marijuana
- Giving or selling your legally prescribed benzos to others
Addiction has been defined by a variety of reputable organizations in a number of different ways.
According to the National Institute on Drug Abuse (NIDA), it’s defined as:
a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works.
According to the American Society of Addiction Medicine (ASAM), addiction is:
a chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction of these circuits leads to characteristic biological, psychological, social and spiritual manifestations.
And the American Psychiatric Association (APA) defines addiction as:
a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence.
Essentially, addiction comes down to continued compulsive drug use despite the negative consequences.
It’s also an actual brain disease, not some sort of moral failing or character flaw. And it’s marked by physical changes in the brain that have been observed by brain imaging studies. It’s these changes that scientists believe account for the inability of addicts to regulate their own behaviors and control their substance abuse.
It’s also worth remembering that addiction and physical dependency are not the same. An individual can be dependent on a drug without being technically addicted. And in that same vein, someone can be addicted without being dependent (though many addicts are).