Benzodiazepines
Slang
Benzos, Tranxs, Downers, Sleepers
How it is taken
Orally
Injected
Common effects
- drowsiness, dizziness
- relaxation, calmness, lethargy
- unsteadiness
- slurred speech
- blurred vision
- impaired thinking, memory and coordination
What it is
Benzodiazepines work as a central nervous system depressant. They have anxiolytic (anxiety relieving) and hypnotic/sedative (sleep inducing) properties. Physicians may also prescribe them as muscle relaxants, or to treat epilepsy and other seizure disorders, alcohol withdrawal, panic, and sleeping disorders. Benzodiazepines are prescribed with caution and never patients with personality disorders or a history of substance abuse.
Benzodiazepines have been in wide clinical use throughout the world since the 1960s and are among the most widely used prescribed drugs in the western world. They are used by both men and women of all ages. There are 54 types of benzodiazepines and eight are commonly prescribed in New Zealand.
Benzodiazepines are often prescribed in tablet or capsule form and come in a variety of shapes, sizes, and colours. Upon administration the drug is absorbed into the bloodstream and circulated through the body. The drugs take effect after 30 minutes, with lasting effects depending on dosage, type of benzodiazepines used, condition being treated, and the presence of other drugs.
Common brand names include: Xanax, Rohyphnol, Valium, Imovane, Frisium and Noctamid. The chemical name listed under these brand names most commonly end in ('pam').
Non-medical use of benzodiazepines has become a worldwide concern in the past two decades. Users take benzodiazepine to induce a state of intoxication or euphoria or as a substitute/enhancer to the effects of opiates. They are also used to help counteract the negative effects of other drugs; to help with 'coming down' from a 'high', and to help induce sleep.
Short-term effects
Medically benzodiazepines are intended to be prescribed for a period not exceeding one month (depending on the type of benzodiazepine used, its strength and the condition being treated) with a view to avoiding the development of tolerance and withdrawal symptoms upon discontinuation.
If recommended doses are administered, and for only one to two months, general short-term effects include:
- relaxation
- calmness
- relief from tension and anxiety.
- When benzodiazepines are administered at higher doses similar effects to those of alcohol can be produced including:
- drowsiness
- over-sedation
- sleepiness
- cognitive and coordination impairment
- mood swings
- aggressive outbursts.
It is common for recreational users to take high doses of benzodiazepines as they are not aware of recommended dosages, and are administering to achieve a desired state.
Long-term effects
Long-term use (exceeding one month) of benzodiazepines is not recommended. Tolerance can develop as the body adapts to the same prescribed dose over a prolonged period of time leading to physical dependence and addiction. Long-term use of benzodiazepines may cause:
- drowsiness
- lack of motivation
- unclear thoughts, memory loss
- behavioural and personality changes
- anxiety, irritability
- aggression
- difficulty sleeping and disturbing dreams
- nausea, headaches
- skin rash
- menstrual and sexual problems
- greater appetite, weight gain
- lack of coordination, vulnerability to accidents
- depression
- slurred speech.
Long-term use of benzodiazepines will commonly cause the same conditions that the drug has been prescribed to relieve.
Any adverse effects experienced while on benzodiazepines should be discussed with a health professional. Discontinuation of long-term or heavy use of benzodiazepines - whether by a recreational user or someone using for medical reasons- requires medical attention to help prevent withdrawal syndrome or a relapse to the underlying condition.
Dependence, addiction, and overdose risk
Benzodiazepines dependence can be both psychological and physical. Benzodiazepines are also well known for causing rapid tolerance to their effects leading many users to require substantially increased amounts in order to achieve their desired results.
Regular use of benzodiazepines, whether recreational or prescribed, will lead to addiction. Discontinuation after heavy or long-term use of benzodiazepines, without tapering doses, can lead to the user experiencing withdrawal symptoms if:.
- they become tolerant to their prescribed dose (common if the timeframe is longer than one month, depending on the type of benzodiazepine used)
- they reduce their dose too quickly
- they stop using their drugs abruptly
- short or long-term recreational use is suddenly ended.
Withdrawal symptoms are both physical and psychological and include:
- headaches, nausea
- sweating, shakes
- muscle aches and pains
- visual disturbances
- fatigue
- indigestion
- diarrhoea
- numbness
- anxiety, panic attacks
- confusion
- depression
- rapid mood changes
- memory loss
- changes in perception
- hallucinations
- hyperactivity
- nightmares
- palpitations.
It is important that those who are anticipating stopping their us of benzodiazepines seek medical attention, especially if they have been using them for more than one month, in order to avoid withdrawal symptoms or a relapse to their existing condition.
Overdose is associated with chronic heavy use of benzodiazepines or their use with other drugs. Overdose can cause unconsciousness and possibly death. Anyone showing signs of an overdose, or of the effects of combining benzodiazepines with alcohol or other drugs, should get immediate emergency help. Warning signs include slurred speech or confusion, severe drowsiness, staggering, and profound weakness.
The New Zealand Context
Benzodiazepine trends in New Zealand have only recently been followed and no significant trends have been documented as yet.
The law and penalties
On 1 January 1999 benzodiazepines were reclassified as controlled drugs under the third schedule, Class C, Part 5 of the Misuse of Drugs Act 1975, and are no longer scheduled under the Medicines Regulation Act 1984.
The reclassification of benzodiazepines is part of a global initiative to enforce tighter controls and reducing the amount of these drugs being diverted from legal to illicit markets for use and supply.
The international control of benzodiazepines takes place under the 1971 United Nations Convention on Psychotropic Substance of which New Zealand became a signatory to in 1990.
Medsafe will monitor annual consumption and supply this information to the International Narcotics Control Board. Doctors prescribing benzodiazepines must use a standard prescription form allowing only one month's supply per prescription. Pharmacists do not have to store benzodiazepines in their controlled drug safe, nor are they required to recode dispensing in a controlled drug register.
Penalties for the importation, manufacture or supply of benzodiazepines are up to eight years imprisonment and up to seven years imprisonment for conspiracy to commit an offence. Possession of non-prescribed benzodiazepines can result in up to three months imprisonment or a $500 fine, or both.
Safe use
The combined effects of benzodiazepines and other central nervous system depressants such as alcohol can be very dangerous, leading to unconsciousness, and on rare occasions, to death. Anyone taking benzodiazepines should not drink alcohol and should check with their physician before using any other central nervous system depressants.
Benzodiazepines are intended for oral use only, unless other instructions are given by the prescribing doctor. Benzodiazepines are generally not water soluble and cannot be readily prepared for injection. However benzodiazepines for recreational use are injected by some people to achieve a feeling of 'euphoria', increase the effects of other drugs or help alleviate the come down effects of other drugs.
Severe health problems can occur from this method including:
- collapsed veins
- clotting of veins
- red, swollen, infected skin
- amputation of limbs due to poor circulation
- stroke or even death.
How to get help
There are a number of treatment organisations that can help. If you feel that you or anyone you know needs help, then you can call these services in strict confidence.
If you are faced with an emergency, call 111 immediately.
To talk to someone about your or someone else’s drug use, call the Alcohol Drug Helpline - 0800 787 797.
You can also get contact details for your local alcohol and other drug counsellor or treatment provider by calling the helpline or by visiting www.addictionshelp.org.nz .
Links
HealthAtoz family health website. www.healthatoz.com/healthatoz/Atoz/ency/benzodiazepines.jsp
The Australian Drug Info Clearing House. www.druginfo.adf.org.au/article.asp?ContentID=benzodiazepines
