Benzodiazepines are drugs classified as depressants. They are legally produced and prescribed to treat anxiety, insomnia and depression. They can be taken recreationally to counteract the “crashing” effects of stimulants like cocaine and amphetamines. There are many types of benzodiazepines, marketed under different names. One of the most common is diazepam, marketed under the name Valium. Long-term use of benzodiazepines carries a high risk of addiction.
These types of drugs were discovered by an Austrian chemist, Dr. Leo Sternbach, in 1954. Dr. Sternbach worked for Hoffman-La Roche, a pharmaceutical company whose laboratories had submitted the drug for scientific study. It was soon discovered that benzodiazepines were more effective than barbiturates and had less risk of addiction and overdose. The first benzodiazepine drug (chlordiazepoxide) was patented in 1959. It was marketed worldwide in 1960 under the name Librium and was prescribed to treat anxiety. Related compounds were tested in the following years, leading to the introduction of diazepam, marketed as Valium, in 1963. Further experimentation with benzodiazepines led to the creation of other derivatives such as nitrazepam, known as Mogadon, in the 1960s and alprazolum, known as Xanax, in the 1980s. It was in the 1980s that benzodiazepines became the most prescribed depressant in the world. It was also at this time that benzodiazepine dependence and abuse was recognized as a widespread problem.
Benzodiazepines slow down the activity of the central nervous system and the brain. When taken in large doses, they can cause feelings of euphoria and intoxication, especially when combined with other depressants such as alcohol.
Benzodiazepines come in tablet or capsule form, usually white or blue. Tablets can come in different sizes, usually depending on the size of the dose per capsule. They often bear the logo of the pharmaceutical company that manufactured them. They are most often tablets that are swallowed, but some illicit users make them into a powder and mix it with a liquid to inject.
Benzodiazepines are usually referred to by their chemical name or by the name under which they are marketed. Diazepam is best known as Valium, but is also marketed as Dulcene. The benzodiazepine oxazepam is called Alepam, Serepax and Murelax. Nitrazepam is sold under the name Alodorm and Mogadon. Temazepam is marketed as Euhypnos and Normison. Flunitrazepam, marketed under the name Rohypnol, has become notorious for its use in sexual assaults, being dubbed in the media as the “date rape drug”.
Street names for benzodiazepines include “benzos”, “tranx”, “sleepers”, “serras” (for Serepax), “moggies” (for Mogadon) and “normies” (for Normison). Diazepam tablets may be called “vallies”, “diazzies” and “wobblies”, or “blues”, “whites” or “yellows”, referring to the color of the tablets.
Benzodiazepines are sometimes also called “painkillers” or may be referred to by vague terms such as “pills” or “tablets”.
The effects of benzodiazepines usually begin to be felt within an hour. Depending on the dosage, their effects can last from a few hours to a few days. Most often, benzodiazepines make you feel deeply relaxed and drowsy, and reduce your anxiety. They can also cause dizziness, isolation or confusion. Difficulty speaking, dry mouth, blurred or double vision and short-term memory loss are all common effects of benzodiazepines taken in high doses. Other effects may include mood changes, euphoria, inability to judge distance or movement, constipation, diarrhea, nausea and vomiting. A person taking high doses of benzodiazepines may go into a coma or dieBenzodiazepines carry a high risk of addiction if taken over a long period of time, i.e., regularly for more than two or three weeks. People who take benzodiazepines over a long period of time may experience a permanent lack of energy, irritability, nausea, frequent headaches, increased appetite and nightmares. Long-term use of benzodiazepines can lead to feelings of depression and suicidal thoughts. It can cause skin rashes, loss of libido and, in women, disrupt the menstrual cycle.
Combining benzodiazepines with other depressants such as alcohol or opiates such as heroin can amplify the effect of the drug and increase the risk of overdose.
When benzodiazepines are combined with stimulants such as ecstasy or amphetamines, the body is under enormous stress trying to manage the conflicting effects of the drugs
Benzodiazepines are legally manufactured under license in most industrialized countries around the world. In the United States and all European Union countries, the drug is available only by prescription. In some countries, such as India, Thailand and Turkey, it can be purchased without a prescription.
Of all the mood-altering drugs prescribed, benzodiazepines are the most prescribed in the world.In terms of illicit production of benzodiazepines, one source is from prescription drugs that have been diverted for recreational use, There are also cases of theft of drugs from pharmacies and pharmaceutical warehouses.
It is believed that benzodiazepine dealers who sell the drugs for illicit purposes travel to countries where the drugs can be purchased without a prescription, but Internet ordering has become increasingly common in recent years.
The benzodiazepine phenazepam was first developed in the former Soviet Union and is now legally produced in Russia and other countries in the so-called Commonwealth of Independent States, including Ukraine and Kazakhstan. Phenazapam is most commonly used to treat epilepsy, but is also used in anesthesia, particularly for dental procedures. In the United States and most of Europe, this drug is not controlled by the authorities and can be purchased legally on the Internet. As a result, it has begun to be taken recreationally, in place of other drugs such as diazepam (Valium). Nine cases of phenazepam overdose were recorded in the UK in 2010.
FACTS AND STATISTICS
Benzodiazepines are medications prescribed for anxiety, insomnia and depression. They include many different drugs, marketed under various names. They carry a high risk of addiction when taken for a long time and the withdrawal effects when they are stopped are quite unpleasant. Here are some other key facts about benzodiazepines.
- The drug was discovered in 1954 and manufactured by the pharmaceutical company Hoffman-La Roche.
- Diazepam, known as Valium, is one of the most widely prescribed benzodiazepines.
- People who take benzodiazepines regularly can develop tolerance, causing them to take higher and higher doses to achieve the same effect.
- Benzodiazepines are physically and psychologically addictive.
- Dependence can occur within four weeks of regular use.
- The drug acts on the brain and central nervous system.
- Mixing benzodiazepines with other medications increases their effects and can lead to overdose and death.
- Benzodiazepines come in pill or tablet form, with various strengths.
- Rohypnol is a benzodiazepine nicknamed the “date rape drug” because of its use in several sexual assault cases.
- In small doses, benzodiazepines can cause a feeling of general well-being, relaxation and drowsiness.
- In high doses, they can have effects similar to drunkenness, with loss of coordination and difficulty speaking.
- A person suffering from benzodiazepine withdrawal will experience symptoms such as anxiety, confusion, seizures and muscle pain.
- In most countries, benzodiazepines are only available by prescription, but in some countries such as India and Thailand, they can be purchased without a prescription.
- In 1975, 103 million prescriptions for benzodiazepines were dispensed in the United States.
- Between 1990 and 1996, benzodiazepines were found to be responsible for 1,810 deaths in the United Kingdom, a figure greater than deaths from all other Class A drugs combined, including deaths from heroin and cocaine.
- Between 2002 and 2007, prescriptions for the drug jumped from 69 million to 83 million in the United States.
- A 2007 study of teenagers found that in thirty-five European countries, an average of 8% of 15-16 year olds were prescribed benzodiazepine tranquilizers and 4% of this same age group had taken these drugs without a prescription. Poland was found to have the highest number of non-prescription users of benzodiazepine tranquilizers among this age group, with 18% of 15-16 year olds admitting to taking them. This was followed by
- Lithuania, where 16% of 15-16 year olds had taken benzodiazepines without a prescription, France with 15% and Italy with 10%.
- In the UK, more than 10 million prescriptions for benzodiazepines were written in 2008
- The International Narcotics Control Board found that in 2009, Europe was the largest consumer of benzodiazepines.
- There are about 1.5 million people addicted to benzodiazepines in the UK, although the number of prescriptions is down from a peak of 31 million in 1979.
- Of all the people addicted to this drug in the UK, it is estimated that half a million have taken it for a medium duration and about 3 million have taken it for a short duration.
- It is estimated that over 2000 different types of benzodiazepines have been synthesized to date and that there are about 40 commercially available benzodiazepine derivatives.
SIGNS OF ADDICTION
A person who has taken large amounts of benzodiazepines may exhibit behaviour similar to that associated with drunkenness, such as slurred speech and loss of coordination. They may also appear drowsy and lethargic.
Benzodiazepine addiction can be difficult to detect, as a person may take the drug legitimately on a doctor’s prescription and develop a tolerance over time. This means they may need to increase their dose to achieve the same therapeutic effect. In as little as four weeks of regular use, she can become dependent on the drug, with serious consequences if she tries to stop taking it.
A person in withdrawal from benzodiazepines may show signs of insomnia, with dark circles and a pale complexion. They may seem nervous or tense, depressed, confused, distant or paranoid. She may complain of stiffness in her muscles, have uncontrollable tremors or convulsions, or have flu-like symptoms. Blurred vision, hypersensitivity to light, extreme lethargy, indigestion, abdominal cramps, nausea and memory loss are other signs of benzodiazepine withdrawal.
A person who is dependent on benzodiazepines may increase his or her dosage, resulting in an overdose. A person overdosing on benzodiazepines may lose consciousness, have a slow heart rate, shallow breathing, cold, clammy skin and blue lips, signs of oxygen deprivation.
Although benzodiazepines are almost exclusively swallowed as pills or tablets, some addicts may grind them into a powder and mix them with a liquid that they can inject, in which case needle-stick marks may be seen on the arms, legs, ankles or back of the knees.
In the event of a benzodiazepine overdose, hospitalization is essential. If the medication was taken within two hours, a doctor may pump the stomach, injecting a large amount of water into the stomach through a tube to try to remove any benzodiazepines that have not yet been absorbed into the bloodstream. Liquid charcoal is sometimes given to stop the absorption of the drug. To counteract the sedative effects of benzodiazepines, certain medications such as flumazenil, also known as Romazicon, may be given, although these medications can have serious side effects in chronic benzodiazepine users.
The most common way to treat a person addicted to benzodiazepines is to gradually decrease the dose of the medication in order to minimize the most dangerous withdrawal side effects. Stopping benzodiazepines suddenly after the body has become dependent can have serious, even fatal, consequences.
Many people who are addicted to benzodiazepines originally took the drug to treat anxiety or insomnia, in which case alternative therapies must be put in place to treat these conditions. Other medications, such as antidepressants, may be given to help with withdrawal. Medications called beta-blockers may be prescribed to treat physical withdrawal symptoms such as seizures and convulsions. Inpatient detoxification may be appropriate for people addicted to benzodiazepines to support them in their difficult battle with addiction. More often, however, detoxification and tapering of benzodiazepines can be done on an outpatient basis.