Benzodiazepines first appeared in the mid-1960s.1 Drug companies promoted them as safer and as less habit-forming than barbiturates like Phenobarbital and Seconal, which are also prescribed to treat anxiety, seizure disorders, and insomnia. Today more people (ten to 12 percent of all Americans) use benzodiazepines than any other drug family, and they account for almost one-third of all prescriptions.2 Xanax, Ativan and Valium are among the most well known and most popular, famously called "mother's little helpers" by the Rolling Stones.
Half of the top ten abused drugs in the United States are benzodiazepines*:3
Benzodiazepines are Schedule IV drugs, meaning that the U.S. federal government classifies them as having less potential for abuse than the ones in Schedules I to III.4 However, many people do develop both physical and psychological dependences on benzodiazepines. Because they are so commonly used, they are easy to get. If a teen uses benzodiazepines at levels above those medically recommended, withdrawal can be extremely unpleasant and even life threatening.
Forms and Brands
Benzodiazepines come in many different kinds of pills and tablets. Some of these are illegal in the United States, but available on the Internet. Here are the generic drug names for each benzodiazepine, followed by their trademarked names.5
Effects and Use
Doctors prescribe benzodiazepines to treat anxiety, panic attacks, seizure disorders, and insomnia.6 Some American physicians believe that these drugs should be used only in the short-term way British doctors prescribe them - for between two and six weeks.7 Dr. Andrew Weil, prominent Harvard-educated doctor and author, believes that too many people currently abuse benzodiazepines to treat ordinary stress.
"The idea that unwanted mood states are disease states and treatable by taking medications is very popular in our society," Weil writes in his book, From Chocolate to Morphine.8 "The pharmaceutical industry has tried hard to convince doctors and patients that these chemicals (benzodiazepines) are revolutionary drugs that reduce anxiety, make people calm and relaxed. In fact, they are just another variation on the theme of alcohol and other sedatives and hypnotics with the same tendency to produce adverse side effects and dependence." 9
Dr. Ronald Gershman, a doctor who specializes in addiction treatment, has written that benzodiazepines treat emotional pain, which is why withdrawal is so difficult and why suicide is often a side effect of withdrawal.10 If parents are rearing a child under the premise that he should never have to experience stress or loss of self-esteem, then that child becomes more susceptible to benzodiazepine abuse in adolescence.
Teens use benzodiazepines the same way they use alcohol: to relax, to relieve stress, to reduce inhibitions, and to get high.11 Cocaine and heroin users take benzodiazepines to increase their drug sensations or to alter their side effects.12 About half of the people who are in treatment for heroin and cocaine also receive treatment for benzodiazepines.13
The drug called Rohypol is in a class by itself for usage. This drug, illegal in the United States, is ideal for date rape. Usually someone drops one in the drink of an unsuspecting person. Rohypol will cause unconsciousness and then forgetfulness about events that occurred under its influence.14
Dangers and Risks
One of the greatest risks of benzodiazepine use is that it is easy to develop a tolerance for the drugs and then become physically and psychologically dependent on their usage, sometimes within a matter of weeks. Withdrawal is long and unpleasant, and can be life threatening.15
Common side effects of benzodiazepines are confusion, forgetfulness, depression, insomnia, lightheadedness, mood changes, tremors, muscle cramps and weakness, staggering, dry mouth, menstrual changes, sexual dysfunction, anorexia, hypotension, and problems with urination.16 If your child drives while using benzodiazepines, it is like driving while drunk.
Benzodiazepines react with alcohol, sleeping pills, painkillers, female hormones, and cold and hay fever medications. These reactions pose the greatest danger of death by overdose.17Teens have been reported to have "pharm parties" where everyone shares different prescription drugs and alcoholic drinks. Often teens have no idea what they are taking and the dangers of different drug combinations.
Signs of Use
Teens who abuse benzodiazepines may have slurred speech and staggering walks, and may seem confused and "hung over." A benzodiazepine problem can therefore look like alcoholism. Chronic users often seem irritable, confused, depressed and overly sedated. They may experience memory loss, tremors and insomnia.18
If your teen is using drugs, he may seem tired and withdrawn. He may have a new group of friends and become secretive and uncooperative. His grades may drop as he loses interest not only in school, but also normal pastimes and hobbies. He may have unusual sleep habits.19
You may find butane lighters, pipes, and other drug paraphernalia. Your son or daughter may steal money from you, run up your credit cards, and sell personal and household items to raise funds for a drug habit.
Those who take benzodiazepines at doses above medically recommended levels may have anxiety, vomiting, seizures, delirium, confusion, low blood pressure, muscle cramps, and slurred speech. Some will sleep so deeply that it becomes almost impossible to awaken them. Teens who take benzodiazepines in combination with alcohol, oxycodone, hydrocodone, and other drugs put themselves at heightened risk for overdose, which can be fatal.
Withdrawal and Treatment
Withdrawal from benzodiazepines is more unpleasant and can take longer than withdrawal from narcotics, including heroin.20 Most people need to be hospitalized and put under medical supervision. Because a person can die if she stops using benzodiazepines too quickly, doctors usually taper off usage gradually and substitute other drugs.
Withdrawal symptoms will begin 12 to 24 hours after the last dosage and will peak 24 to 72 hours later. During that time, an addict may experience anxiety, tremors, nightmares, insomnia, vomiting, nausea, low blood pressure, seizures, delirium, fever, and visual and auditory hallucinations.21 Some people require two weeks to "detox," that is, to eliminate all the drugs from their bodies. If a person has been using benzodiazepines to control anxiety or panic attacks, his symptoms may come back with a vengeance during withdrawal. This is called "rebounding."
Teens and college students who are chemically dependent on benzodiazepines often need residential treatment at therapeutic boarding schools, where they are under constant supervision, receive intensive psychotherapy, and can get away from their drug environment at home. Recovering benzodiazepine addicts need to learn new ways of dealing with everyday stress and negative moods and emotions, and to set realistic goals for school achievement and careers. They need to develop positive new interests and hobbies. Once they return home, they have to use aftercare programs and support groups to prevent relapses and remain drug-free.
"Drug Abuse Sourcebook" Bellenir, Karen. Detroit: Omnigraphics, 2000.
"Benzodiazepines," DEA Briefs and Background Papers, posted at http://www.justice.gov/dea/concern/benzodiazepinesp.html
"Prescription Drug Abuse" Colvin, Rod. Omaha, NB: Addicus Books, 2002.
Cox, Steve (MD). "Dr. Steve's Guidelines for Discontinuing Xanax," The University of Kentucky at http://lexington-on-line.com/naf_xanax.html
"The AARP Guide to Pills" Hochadel, Maryanne (PharmD). New York: Sterling Publishing Co., 2006.
(Articles on pills by name) in Physicians Desk Reference, 61st Edition 2007.
"Valium," public information from Physicians Desk Reference posted at http://www.pdrhealth.com/drugs/rx/rx-mono.aspx?contentFileName=Val1473.html&contentName=Valium&contentId=618
"From Chocolate to Morphine" Weil, Dr. Andrew. New York: Howard Mifflin, 1998.
"Xanax," public information from Physicians Desk Reference, posted at http://www.pdrhealth.com/drugs/rx/rx-mono.aspx?contentFileName=Xan1491.html&contentName=Xanax&contentId=641#Printt
1Bellenir, Karen. Drug Abuse Sourcebook. Detroit: Omnigraphics, 2000, pg. 133.
3Colvin, Rod. Prescription Drug Abuse. Omaha, NB: Addicus Books, 2002, pg. 13.
4"Benzodiazepines," DEA Briefs and Background Papers, posted at http://www.justice.gov/dea/concern/benzodiazepinesp.html
5See Physicians Desk Reference and the websites of various drug manufacturers.
6"Benzodiazepines," op cit.
7Colvin, op cit, pg. 86.
8Weil, Dr. Andrew. From Chocolate to Morphine. New York: Howard Mifflin, 1998, pg. 74.
10Colvin, op cit. p. 85-86.
11Weil, op cit, pg. 69.
12Bellenir, op cit, pg. 134.
13Ibid, p. 137.
14"Benzodiazepines," op cit.
15Bellenir, op cit, pg. 282.
16Various articles on individual drugs like Valium and Xanax in Hochadel, Maryanne (PharmD). The AARP Guide to Pills (New York: Sterling Publishing Co., 2006).
17Colvin, op cit, pg. 155.
18Bellenir, op cit, pg. 134.
19Ibid, pg. 384.
20Bellenir, pg. 136.
21Ibid, pg. 283.