Benzodiazepines

Benzodiazepines (pronounced BEN-ZOH-DIE-AZ-A-PINS) are depressant drugs. Benzodiazepines, also known as "minor tranquilizers’", are prescribed by doctors to relieve stress and anxiety and to help people sleep. Some people use benzodiazepines illegally, to become intoxicated.

Like other depressants, benzodiazepines work by slowing down the activity of the central nervous system. In the short term, they can help with relaxation, calmness and relief from tension and anxiety. But they do not solve the problem that caused the anxiety in the first place and they can have a range of unwanted side effects.

What do they look like?

Benzodiazepines usually come in the form of tablets and capsules, in a range of colors and designs. They are generally stamped with their name and milligram quantity.

How are they used?

Medical use 
Benzodiazepines are prescribed as sedatives/hypnotics (to induce sleep) or anxiolytics (to relieve anxiety). They vary in how quickly they work and how long they last. They are also used to treat epilepsy, to relax muscles, to help people withdraw from alcohol, or as an anesthetic before surgery.

Non-medical use
Some people use benzodiazepines illegally to become intoxicated. They may use them when they can't get heroin, when they are trying to get off heroin or to increase the effects of heroin. People who use stimulant drugs such as amphetamines (speed) or MDMA (ecstasy) may use benzodiazepines to help when they are "coming down" from a "high", and to help them sleep.

Chemical and brand names
Benzodiazepines are known by their chemical (generic) names and their brand/trade names. In each case, these are exactly the same drug, usually made by different companies. There are over 24 different prescribed benzodiazepines, including:

Effects of Benzodiazepines

The unwanted negative effects of benzodiazepines vary according to dose.

Low to moderate doses
The immediate effects of low to moderate doses include mild impairment of thought processes, memory and coordination; drowsiness, tiredness and lethargy; dizziness; vertigo; and blurred or double vision. The person may experience a dry mouth, slurred speech and stuttering, tremors, nausea and vomiting, loss of appetite, constipation or diarrhea. Feelings of euphoria or isolation and emotional depression may also occur.

Higher doses
Higher doses can result in drowsiness, over-sedation and sleep. They may produce an effect similar to alcohol intoxication. Other effects can include confusion, slurred speech, poor coordination, impaired judgment, difficulty thinking clearly, loss of memory, blurred or double vision and/or dizziness. Mood swings and aggressive outbursts may also occur. The symptoms intensify as the dose increases. Feelings of jitteriness and excitability often become evident as the effects of large doses wear off.

Overdose

Very high doses of benzodiazepines can cause respiratory depression, unconsciousness or coma. Death rarely occurs from overdose of benzodiazepines alone, but deaths can occur if large doses are combined with alcohol or other drugs. Deaths can also occur from inhalation of mucus or vomit when a person is unconscious.

Long-term Effects

The use of benzodiazepines over a long period of time (more than two to three weeks) should be carefully monitored by your doctor. Some of the health effects of using high doses of benzodiazepines in the long term include: 

• muscle weakness
• menstrual irregularities
• memory loss
• confusion and difficulty thinking clearly
• lethargy and lack of motivation
• drowsiness
• difficulty sleeping and disturbing dreams
• nausea
• personality change and changes in emotional responses
• anxiety
• irritability, paranoia and aggression
• depression.

Tolerance and Dependence

People who are physically dependent on benzodiazepines can develop tolerance to the drug. This can happen very quickly and means that more of the drug is required to get the same effect.
 
Dependence on benzodiazepines can be psychological or physical, or both. Dependence can occur after using them for a few months and is not related to the size or physical effect of the daily dose taken. Dependency can still develop for people on long-term, low doses.

People who are psychologically dependent feel as though they can’t cope without benzodiazepines. They crave the drug and find it very difficult to stop using it.

People who are physically dependent on benzodiazepines have become used to functioning with the drug present.

Withdrawal

If a dependent person suddenly stops taking benzodiazepines, or severely cuts down their dose, they may experience physical withdrawal symptoms as their body readjusts to functioning without the drug.

Withdrawal symptoms from benzodiazepines vary from person to person, but can be quite severe. Some people have no symptoms at all, while others may have symptoms lasting from a few weeks or months to a year. Symptoms tend to come and go, but all withdrawal symptoms eventually disappear as the body adjusts to functioning without the drug.

Withdrawal symptoms can include:

• headaches
• aching or twitching muscles
• tremor
• faintness or dizziness
• sweating
• nausea, vomiting and stomach pains
• bizarre dreams
• inability to sleep properly
• anxiety and irritability
• altered perception

Other less common withdrawal symptoms may include delirium, delusions, hallucinations, seizures and paranoia.
People who have been using benzodiazepines for more than a month should not suddenly stop taking them without seeing a doctor or health worker. A slow reduction in dose over time is recommended to reduce the severity of the withdrawal symptoms.

What to do in a Crisis

If someone overdoses or has an adverse reaction while using benzodiazepines, it is very important that they receive professional help as soon as possible. A quick response can save their life. 

• Call an ambulance. Dial 000. Don’t delay, because you think you or the person might get into trouble. Ambulance officers are not obliged to involve the police.
• Stay with the person until the ambulance arrives. Find out if anyone at the scene knows mouth-to-mouth resuscitation or cardiopulmonary resuscitation (CPR).
• Ensure the person has adequate air by keeping crowds back and opening windows. Loosen tight clothing.
• If the person is unconscious, don’t leave them on their back - they could choke. Turn them on their side and into the recovery position. Gently tilt their head back so their tongue does not block the airway.
• If the person has stopped breathing, give mouth-to-mouth resuscitation. If there is no pulse, apply CPR.
• Provide the ambulance officers with as much information as you can - what benzodiazepines were taken, how