Here’s a situation that may be familiar:
Say an office worker is feeling especially stressed one day. Their co-worker shares a quarter bar of a Xanax pill with them as a gesture.
Or how about this: a traveler decides to borrow a Klonopin from their spouse/friend/parent before a long flight so they can sleep better.
Both of these situations qualify as drug abuse. Prescription tranquilizers such as Xanax, Klonopin and Valium are useful in treating various anxiety and substance disorders. When taken, they produce sensations of calm and relaxation.
So why did USC’s Keck School of Medicine refer to this family of drugs as “the next US drug epidemic” in early 2020?
When used along with other substances, it can cause memory blackouts, breathing difficulties and even death. For people attempting to purchase these pills from street dealers, there are additional risks as well.
There’s an assumption that prescription medications are safe because they’re prescribed by a doctor and generally taken under specific instructions. Just like prescription painkillers, however, tranquilizers come with plenty of risks and potential for abuse. Even when used correctly, it’s all too easy to lose control and spiral into addiction.
What Is Xanax?
Xanax, Valium, Klonopin and other related drugs belong to a family of prescription sedatives known as benzodiazepines, informally known as benzos. These tranquilizers, chiefly used to treat anxiety, are among the most prescribed medications in the US. Benzos work by enhancing the effect of the neurotransmitter GABA (gamma-aminobutyric acid), which reduces nerve activity.
Benzos play a legitimate role in medicine, and in a medically supervised setting can help people with anxiety disorders or who are recovering from alcohol abuse. Unfortunately, they’ve also been frequently abused since their debut in the 1960s.
Risks of Interactions, Abuse & Addiction
In 2018, a study published by researchers from Stanford University analyzed prescription drug market data and discovered a major increase in benzo prescriptions. Between 1996 and 2013, the total number of adults filling a prescription for benzodiazepines jumped from 8 to almost 14 million. Alarmingly, the National Institute on Drug Abuse (NIDA) also reports overdose deaths from benzodiazepines dramatically increased between 1999 and 2017.
Although overdosing on benzos by themselves is possible, the risk is far higher (and more dangerous) when they’re combined with other drugs like alcohol and opioids. A study in North Carolina discovered deadly overdoses were 10 times higher in patients who were using both prescriptions.
Much like opioids and alcohol, Xanax and other benzos can slow a person’s breathing on their own. When benzos are combines with those other substances, they can slow breathing down so much a person suffocates. This tendency spurred a 2016 warning from the Centers for Disease Control and Prevention. Prescription benzodiazepines and opioids now carry a “black box” warning cautioning patients against mixing the two drugs.
Even when used correctly, benzos still carry a risk of addiction, especially if they’re used over a long period of time. It’s largely understood how addictive drugs work – they affect the brain’s reward pathways, causing a flood of the neurotransmitter dopamine. This creates the euphoric rush which drives addiction.
However, it wasn’t understood until recently that benzos can create this sensation as well. Researchers discovered benzos weaken cells in an area of the brain which regulate dopamine levels, allowing more dopamine to be released.
Interestingly, research cited by the National Institute on Drug Abuse (NIDA) shows although benzo use is high, cases of substance use appear to be low, even when users are abusing the drug. NIDA’s data also shows, much like the examples at the beginning of this article, most abusers of benzos obtain them from friends and family with only around 20% receiving them from a medical professional.
Low addiction cases or not, professional treatment is critically important for anyone dealing with an addiction to benzos. Benzo withdrawal can be dangerous, particularly if the user stops using all at once.
Withdrawal Doesn’t Have A Timeline
Like other drugs, use of benzos over time can result in the brain becoming dependent on them to function. When the user stops taking the substance after dependence, they will experience withdrawal symptoms as the body tries to return to regular functions without the substance.
Withdrawal is never a pleasant experience. Unfortunately, the length of the withdrawal period is particularly hard to judge with benzos. A 2020 report from the Food & Drug Administration stated withdrawal symptoms can last from weeks or years. Research estimates between 10 to 15 percent of long-term benzo users experience a condition called “post withdrawal syndrome,” a prolonged withdrawal period which can last for years.
A major risk factor for this especially long period of withdrawal may be connected to taking a rapid, “cold turkey” approach where the user immediately stops using. The Benzodiazepine Information Coalition, a non-profit advocacy group, says suddenly stopping the use of benzos can also result in severe withdrawal symptoms, including long withdrawal times, seizures and even death.
A professional, evidence-based rehab facility understands recovery isn’t a race. For a patient looking to free themselves from addiction to benzos, they will generally work out a plan where the patient tapers their use off over time. While this won’t fully eliminate all withdrawal symptoms, it will generally avoid dangerous complications such as seizures.
It’s easy to forget even prescription drugs can be misused. Despite being purchased at a pharmacy in a childproof container, prescription abuse can damage one’s life every bit as much as an illicit drug purchased online or on the street.
After detoxing comes rebuilding a new life free from substance abuse. Key to that new life? Sober living. Sharing a living space with people who genuinely get the sober lifestyle and live by it is a huge advantage in recovery.
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