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Benzodiazepine Addiction And Abuse

The time it takes to metabolize benzodiazepines depends on several factors.  A person’s weight, gender, and age influence the time a benzodiazepine remains in their system.  Other factors such as the type of benzodiazepine, duration of use, and co-occurring medical conditions also play a role.  

If a person is using other medications, this can also affect how long benzodiazepines stay in the body.  So, it’s difficult to provide a specific timeline.  But, some general guidelines are used to determine approximate timelines for how long benzodiazepines stay in your system.  

First, we’ll look at the different types of benzodiazepines, their uses, and how they work in the body.  

Types of Benzodiazepines

Benzodiazepines are anti-anxiety medications that reduce the symptoms of panic attacks and anxiety.  They work by enhancing the activity of the GABA neurotransmitter.  This chemical, found in the brain, helps a person feel calm.  It can also produce drowsiness.  As such, the drug is often used as a muscle relaxant, and to induce sedation during medical procedures.  

Benzodiazepines are also used to treat seizures and alcohol withdrawal symptoms.  The drugs are also known as tranquilizers, sedatives, or hypnotics. Because this class of drugs can lead to addiction, they are classified as Schedule IV drugs under the Controlled Substances Act.  Today, they are the most widely used psychoactive drug worldwide.

The most frequently prescribed benzodiazepines:

Valium

Valium (Diazepam) treats anxiety, seizures, and alcohol withdrawal.  It may also relieve muscle spasms and is often used to sedate a person for medical procedures.  Valium provides quick onset of action and starts working within about 30 minutes. 

The drug has a high risk of abuse, addiction, overdose, and death.  Using Valium in combination with alcohol or opioids can cause fatal breathing problems.  

Ativan, Xanax, and Klonopin

Ativan (Lorazepam), Xanax (Alprazolam), and Klonopin (Clonazepam) are all used to treat anxiety disorders.  They can begin working at different intervals and the effects vary in duration.  For instance, Xanax and Ativan duration of action is about 11 to 20 hours. Klonopin’s duration of action is around one to three days.  

People using these drugs may experience poor coordination.  The drug will also compound the effects of other drugs, including alcohol. Higher doses of the drugs can cause memory problems.

Other benzodiazepines include Librium (Chlordiazepoxide), Tranxene (Chlorazepate), Restoril (Temazepam), and Halcion (Triazolam).  

Side Effects of Benzodiazepines

As central nervous system depressants, benzodiazepines can produce serious side effects, especially if mixed with other drugs or alcohol.  At low doses, however, the side effects are usually mild.  

Common side effects of benzodiazepines can include, but are not limited to the following:

Mild side effects:

  • Dizziness
  • Drowsiness
  • Sedation
  • Loss of balance

Moderate to severe side effects:

  • Depression
  • Amnesia
  • Confusion
  • Disorientation
  • Difficulty breathing

Some individuals experience agitation, nightmares, or hallucinations while using benzodiazepines.  Memory problems can occur but are resolved when the drug wears off.  The drugs can also produce a “hangover” effect for some individuals.  

How Long Do Benzodiazepines Stay in Your System?

Each person responds to the effects of a drug differently.  How long benzodiazepines stay in your system depends on your metabolism, medical history, age, weight, and more.  If you use other drugs, legal or illicit, they can affect the metabolic timeline of benzodiazepines.   

If the dosage is upped or taken more often than prescribed, the drugs will remain in the system longer.  

Here is a timeline to give you a general idea of how long benzodiazepines remain active:

Long-acting benzodiazepines can cause a buildup of sedation effects that make a person feel fuzzy-headed or in a daze most of the time.  This effect happens if the dose is too high or the individual abuses the medication.  

Long-acting Intermediate-acting Short-acting
Librium, Valium, Dalmane Ativan, Xanax, Restoril Halcion, Versed
Stays in the system for about 10-30 days. Stays in the system for about 5 days. Stays in the system for about 7 to 15 hours.

The duration of benzodiazepines in the body can also affect drug testing results.  For people who undergo drug testing at work, this information can be helpful.  

Drug Tests and Benzodiazepines

Many people today must submit to drug testing before starting a new job., Or, they must undergo random testing if they already have a job.  Also, athletes are required to be tested for drugs due to their celebrity status and influence on young people.  

Drug tests don’t work the way most people believe.  For instance, they don’t test for the drug itself.  The test detects metabolites in the body and determines what drug was consumed by the metabolites.  

Metabolites are created when the body breaks down or metabolizes a drug.  They spread throughout the body.  So, different parts of the body must be tested, as shown below:

Types of Drug Testing 
Urine Testing – The most common type of testing.  It is accurate for several weeks, depending on the substance.  Measures metabolites filtered in the kidneys.
Saliva Testing – Most accurate if done within hours after drug consumption.  Less invasive than urine testing.
Blood Testing – Accurate if done within a few days of drug use.  Invasive and expensive. Results are available immediately.
Hair Testing – Detects drug use even after three months.  
Perspiration Testing – A fairly new test used mostly to monitor drug use long-term.  Takes about 2 weeks to complete.

Benzodiazepines can help control symptoms of anxiety, but misuse can quickly lead to dependence and addiction.  They are intended for short-term use due to their addictive qualities.  Yet, many people remain on the drugs for years.  Individuals with a history of substance abuse should avoid these drugs if possible.

Benzodiazepines and Addiction

When used short-term and according to dosage directions, benzodiazepines have a low risk for addiction.  Individuals who continue using the drug long-term or in high doses significantly increase their risk for addiction. 

Physical dependence and increased tolerance are the first stages of possible addiction.  The process often goes like this: 

Physical Dependence 

Even when taken as directed, long-term use of benzodiazepines causes the body to adapt to the drug.  Mild withdrawal symptoms may appear when the drug is withheld. This effect is not an addiction, but it can progress to addiction over time.  

Tolerance

Often confused with physical dependence, tolerance develops with repeated use of a drug.  But, increased tolerance means the person needs more of the drug for the desired effects.  The normal dose no longer works as well, and the person finds it difficult to be without the drug.  

Occasional use of benzodiazepines for the sleep-inducing effects does not usually develop high tolerance.  Furthermore, tolerance to the anti-anxiety effects is less likely to develop with short-term use.  However, when tolerance to one benzodiazepine develops, it leads to tolerance of other drugs that have similar uses or effects.

Addiction

After several months of benzodiazepine use, a person may experience withdrawal symptoms when the drug is discontinued.  The symptoms cause the individual to seek more of the drug to stop the discomfort.

According to ASAM, addiction is:

“A treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”

Causes of Benzodiazepine Addiction

The most common cause of benzodiazepine addiction is long-term use or misuse.  Risk factors for addiction include:

  • Using the drug beyond four weeks
  • Repeated use in high doses
  • Combining the drug with alcohol or barbiturates

The criteria for addictions outlined in the DSM-5 include physical dependence, withdrawal symptoms, and the inability to reduce or quit drug use.

Signs of Benzodiazepine Addiction

Similar to the signs for addiction to other substances, the signs of benzodiazepine addiction can include:

  • Unable to stop using benzodiazepines
  • Feeling unable to function without the drug
  • Continues to increase the doses 
  • Serious withdrawal symptoms when the dosage is reduced 

Some individuals who are addicted to benzodiazepines display self-harming behaviors, suicidal ideations, psychosis, and convulsions. 

Treatment for Benzodiazepine Addiction at Cycles of Change Recovery

If you or a loved one is struggling with benzodiazepine abuse or addiction, we can help.  At Cycles of Change Recovery, clients learn effective methods for coping with anxiety without the need for harmful drugs.  

We provide a comprehensive, accredited program that can be customized to address your specific needs and preferences.  Contact us at our Palmdale, CA facility today to learn more about our program.  One of our advisors will be happy to answer your questions and conduct a confidential assessment to determine the best treatment approach for you.

Source:

  • psychologytoday.com – The Use of the Minor Tranquilizers:  Xanax, Ativan, Klonopin, and Valium