Benzodiazepine information (alprazolam, chlordiazepoxide, lorazepam, diazepam, halazepam, oxazepam)

Hundreds of substances have been developed that produce central nervous system (CNS) depression.

These drugs have been referred to as downers, sedatives, hypnotics, minor tranquilizers, anxiolytics, and antianxiety medications.

Unlike most other classes of drugs of abuse, depressants, except for methaqualone, are rarely produced in clandestine laboratories.

Generally, legitimate pharmaceutical products are diverted to the illicit market.

The benzodiazepine family of depressants are used therapeutically to produce sedation, induce sleep, relieve anxiety and muscle spasms, and to control severe epileptic seizures

They are also effective in treating some forms of depression, and anxiety associated with depression and schizophrenia.

Generally benzodiazepines act as hypnotics in high doses, as anxiolytics in moderate doses, and as sedatives in low doses.

Of the drugs marketed in the United States that affect CNS function, benzodiazepines are among the most widely prescribed medications and, unfortunately, are frequently abused.

Fifteen members of this group are presently marketed in the United States and an additional 20 are marketed in other countries.

Benzodiazepines are relatively fast-acting drugs. Most begin to take effect within hours, some in even less time.

Dosage generally starts at a low level and is gradually increased until symptoms diminish. Dosage varies a great deal depending on symptoms and an individual’s body chemistry.

Like the barbiturates, benzodiazepines differ from one another in how fast they take effect and how long the effects last.

Shorter-acting benzodiazepines, used to manage insomnia, include estazolam (ProSom), flurazepam (Dalmane), quazepam (Doral), temazepam (Restoril) and triazolam (Halcion).

Benzodiazepines with longer durations of action include alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), halazepam (Paxipam), lorazepam (Ativan), oxazepam (Serax) and prazepam (Centrax).

These longer acting drugs are primarily used for the treatment of general anxiety. Midazolam (Versed) is available in the United States only in an injectable form for an adjunct to anesthesia. Clonazepam (Klonopin) is recommended for use in the treatment of seizure disorders.

People with serious forms of anxiety demonstrate chronic over activity in the areas of the brain associated with fear or nervousness. An inhibitory neurotransmitter, gamma aminobutyricacid (GABA) works in these areas to diminish this excessive nerve cell activity.

There is evidence that benzodiazepines cause an increase in the activity of GABA, thereby returning the system to a normal level and reducing the associated symptoms of anxiety.

They are also believed to decrease the turnover rate of the neurotransmitters, serotonin and norepinephrine.

Benzodiazepines are classified in the CSA as Schedule IV depressants. Repeated use of large doses or, in some cases, daily use of therapeutic doses of benzodiazepines is associated with physical dependence.

The withdrawal syndrome is similar to that of alcohol withdrawal and is generally more unpleasant and longer lasting than narcotic withdrawal and frequently requires hospitalization.

Abrupt cessation of benzodiazepines is not recommended, and tapering-down the dose eliminates many of the unpleasant symptoms.

Given the number of people who are prescribed benzodiapines, relatively few patients increase their dosage or engage in drug-seeking behavior.

However, those individuals who do abuse benzodiazepines often maintain their drug supply by getting prescriptions from several doctors, forging prescriptions or buying diverted pharmaceutical products on the illicit market.

Benzodiazepines are rarely used as party or good time drugs. Recent studies of drug abuse have found that benzodiazepines are minor euphoriants: they are neither sought nor valued on the same level as cocaine, methaqualone, or even alcohol.

Although they do have mild to moderate euphoriant effects in recreational drug users, detoxified chronic alcoholics and, at very high dosages, detoxified sedative addicts, only a small proportion of patients entering drug abuse treatment programs cite benzodiazepine use as their primary drug problem.

However, it is difficult to estimate the extent to which benzodiazepines are primary drugs of abuse, i.e. the extent of their ability to induce euphoria with psychic dependence and active drug-seeking behavior. (Cole JO, Chiarello RJ)

Abuse is frequently associated with adolescents and young adults who take benzodiazepines to get buzzed.

People who use theses drugs recreatonally are usually low on funds and use them because they are the only drug available for the money. The benzodiazepine intoxication state results in reduced inhibition and impaired judgement.

Concurrent use of alcohol or other depressants with benzodiazepines can be life-threatening. Abuse of benzodiazepines is particularly high among heroin and cocaine abusers.

Approximately 50 percent of people entering treatment for narcotic or cocaine addiction also report abusing benzodiazepines.

The brand name and generic name of the most common benzodiazepines.

Ativan (generic name lorazepam)
Azene (generic name chlorazepate)
Centrax (generic name prazepam)
Clonopin/Rivotril (generic name clonazepam)
Dalmane (generic name lurazepam)
Halcion (generic name triazolam)
Librium (generic name chlordiazepoxide)
Paxipam (generic name halazepam)
Restoril (generic name temazepam)
Serax (generic name oxazepam)
Valium (generic name diazepam)
Xanax/Xanor/Tafil (generic name alprazolam)

Effects Marked sedation, reduced anxiety, addiction and tachyphylaxis.

Symptoms Of Withdrawal Include anxiety, shakiness, head ache, dizziness, sleeplessness, loss of appetite, and in more severe cases, fever, seizures, and psychosis.

A withdrawal reaction may be mistaken for a return of the anxiety, since many of the symptoms are similar.

Long term users may REQUIRE HOSPITALIZATION FOR WITHDRAWL. It is important to know that a sudden stop in taking the drug can produce a seizure.

Patients should discontinue the medicine gradually, if possible, under a doctor’s supervision.

Ways People Take Them For the most part in pill form. Some users dissolve and inject them.

Detectable After Use Varies with the substance. Valium is detectable for at least 7-10 days. Most others have shorter half-lives.