The Long-Term Effects of Misusing Benzodiazepines

September 8, 2022

Table of Contents

Benzodiazepines are usually used as anti-anxiety medications. Their misuse can have long-term effects. Misusing benzodiazepines can increase your risk of drug interactions, reduce your motor skills, affect memory, and lead to dangerous withdrawal symptoms including seizures. 

Why Are Benzodiazepines Prescribed?

Benzodiazepines are a class of medication that are used as anti-anxiety medications and also as anti-epileptic (anti-seizure) medications. They can also be used short term to treat severe alcohol withdrawal.[1] They are also used to treat a number of more rare neurological conditions, including cerebral palsy, paraplegia, and other genetic conditions.

While not without side effects, benzodiazepines are generally safe when used as prescribed.[2] However, if used outside of the way they were prescribed, they can be highly addictive and can have a number of other dangerous side effects. 

Are Benzodiazepines “Addictive”?

Yes. Unlike opioids which can be addictive after only a few doses, true benzodiazepine dependence tends to develop a little more slowly. Yet many people do find themselves addicted to benzodiazepines, particularly if they have been using them for a longer period of time.

Benzodiazepines are generally considered to have low, but present, misuse potential. Most individuals use these drugs as prescribed. Less than 2% of patients report using the drugs at a higher dose than prescribed. [3] According to The National Institute on Drug Abuse, benzodiazepine addiction rate is as low as 0.2% among the general population and 2% among people who use benzodiazepine.[4]

At the same time, benzodiazepine misuse is escalating in the United States. Emergency room visits related to combining opioids and benzodiazepines went from 11 per 100,000 in 2004 to 34.2 per 100,000 in 2011. In that same time, benzodiazepine-related opioid overdose deaths rose from 18% of opioid-related deaths to 31% of opioid-related deaths.[3] Those with a history of substance use have an elevated risk of misusing benzodiazepines. [3] 

Side Effects of Benzodiazepine Misuse

Some potential effects of long-term misuse of benzodiazepines include the following:

  • Drowsiness
  • Slowed reaction time
  • Reduced motor skills
  • Ataxia (reduced coordination and muscle control)
  • Memory problems
  • Higher rate of hip fractures in the elderly
  • Sedation and respiratory depression

You should tell your doctor if you are pregnant or plan to become pregnant when using benzodiazepines. The effects these drugs can have on developing fetuses and babies is not fully understood. While most doctors will continue a woman on benzodiazepines if she has been on them prior to pregnancy, there may be some risks or additional monitoring that she should be aware of. 

Benzodiazepine Withdrawal

Perhaps the most concerning aspect of benzodiazepine dependence is the risks of withdrawal. Sudden stopping of benzodiazepine use after long periods is likely to result in withdrawal. Benzodiazepine withdrawal can last months. Benzodiazepine withdrawal is particularly worrisome because, unlike opioid withdrawal which is never life-threatening, benzodiazepine withdrawal can lead to seizures, coma, and even death in rare cases. If you have been on benzodiazepines for a long period of time, your dose should be tapered slowly under the supervision of a doctor. [5]

Benzodiazepine Interactions with Other Medications

One of the biggest risks of benzodiazepine use is sedation and respiratory depression. This effect is particularly pronounced if the medications are used with other medications that cause sedation or respiratory depression. Benzodiazepines are extremely dangerous, for example, when mixed with opioids and alcohol. Their use is involved in about 16% of opioid overdose deaths. Research has shown benzodiazepines are sometimes mixed into illicit opioids, meaning a person may not always even know they are taking them.[6]

As a general rule, you should not combine benzodiazepines with any drug or substance without first talking to your doctor, particularly any other substance that is also known to be sedating such as opioids, alcohol, anti-histamines, sleep aids or other sedatives.

If you struggle with misusing benzodiazepines, talk to your doctor.  Treatment for substance misuse, including misuse of benzodiazepines, can be life-saving.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

  1. Diazepam. MedlinePlus. https://medlineplus.gov/druginfo/meds/a682047.html. May 2021. Accessed August 2022.
  2. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. Journal of Clinical & Diagnostic Research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606320/. September 2015. Accessed August 2022.
  3. Benzodiazepine Use, Misuse, and Abuse: A review. The Mental Health Clinician. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007645/. June 2016. Accessed August 2022.
  4. Research Suggests Benzodiazepine Use Is High While Use Disorder Rates Are Low. National Institute on Drug Abuse. https://nida.nih.gov/news-events/science-highlight/research-suggests-benzodiazepine-use-high-while-use-disorder-rates-are-low. October 2018. Accessed August 2022.
  5. Risks Associated with Long-Term Benzodiazepine Use. American Family Physician. https://www.aafp.org/pubs/afp/issues/2013/0815/p224.html. August 2013. Accessed August 2022.
  6. Benzodiazepines and Opioids. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/opioids/benzodiazepines-opioids. April 2022. Accessed August 2022.

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