Are You Addicted to Benzos?
Benzodiazepines are highly addictive — as addictive as morphine or heroin. But because they are usually prescribed, most longer term users (more than two weeks) aren't aware they could be drug dependent or addicted.
They are not usually told that benzos were NEVER intended for long term use, for example for sleep or anxiety. The brain becomes tolerant to benzos very quickly. This means that the effect of benzos on sleep, for example, is very short-lived and soon disappears.
After a while benzos cease to have any significant effect because the brain has reached tolerance and demands more of the drug. When a person does not increase the dosage, symptoms of addiction experienced as “between dose withdrawals” appear. In many cases, these symptoms are not recognized as being due to the drug.
One of the earlier “signs” of this addiction is a patient becoming obsessive about the next dose and worrying about supply and access. Many benzo users don't like to go anywhere without their pills and they need to know there are extras on hand. If their doctor isn't available…they might “doctor shop.” And if a doctor or family members raise a question about benzo use…the reaction may be denial, anger or promises “to cut back” always at some future date when one is “stable.” Most people don't like being on benzos. It is anxiety, real symptoms and fear of withdrawal that drives these reactions.
Between dose withdrawals means that people on benzos start experiencing characteristic withdrawal symptoms while they are still TAKING the drug. And in the case of benzos these “withdrawal” symptoms are myriad — more and increased anxiety (aren't benzos supposed to help with anxiety?), panic attacks, increased insomnia, muscle pains often misdiagnosed as arthritis, difficulty swallowing, jaw pain, stomach upset, skin rashes — all these can be signs that your body/brain is suffering from withdrawal. Ironically, many between dose withdrawal symptoms are exactly the same as the ones for which people are prescribed benzos! So an anxious person is prescribed benzos and later they may develop even MORE anxiety caused by the benzos!
Other symptoms such as skin burning, strange headaches and hormonal problems can occur as well as depersonalization, dizziness and depression. This is especially pronounced in short acting benzos — these are benzos that disappear from the blood stream rapidly. Ativan, one of the most commonly prescribed benzos, is short-acting as are all the drugs used for sleep. Drugs like Zopiclone act in the same way as benzos even though they are not technically benzos.
Depression is also a long term adverse effect of benzos, (they are central nervous system depressants), and one that is pretty much inevitable if one takes them long enough. So if you have been taking benzos for a while and are depressed, the drug could be your problem.
Between dose withdrawal systems can be tricky to understand and, unless doctors have a lot of experience with benzos, they don't recognize the cause. For example, I have known several people who started having panic attacks every day when they hadn't had them before. Later on, it become clear that this was an addiction to Ativan and other sleeping pills that didn't manifest itself in symptoms until the day after the drugs were taken. I have seen people with such intense TMJ pain that they had multiple teeth removed. Many people taking benzos are subjected to multiple medical tests, searching for the reason for their gastric, muscular or other problems.
Because doctors do not see these new symptoms as being caused by the drug, they decide that the patient has a worsening mental illness and should be prescribed other drugs, more benzos or higher doses. This one of the main reasons why most patients taking benzos for a while will be prescribed additional types of benzos and sleeping pills, antidepressants and even antipsychotics or mood stabilizers. Because benzos affect many systems in the body, most longer-term users will also be prescribed other drugs to address well known side effects such as gastric problems (proton pump inhibitors), chronic pain (painkillers, including opioids) and growing insomnia. These additional drugs add to the list of adverse effects experienced by patients. This “prescription cascade” is one of the hallmarks of addiction to psychiatric drugs like benzos.
Others who experience between dose withdrawals frequently self-medicate by using over the counter drugs, alcohol or cannabis. It is important to remember that alcohol potentiates the effects of benzos making one drink act like two. People on benzos should never routinely use these drugs.
One of the cruelest myths (and one that patients often believe) is that they can wait to taper when they are “stabilized” on benzos. But because the brain always reaches tolerance and demands more — stabilization is unlikely. And people who decide to taper will simply have further to reduce when they do decide to withdraw.
If you recognize yourself in any of these words, check out Heather Ashton's manual, Benzodiazepines: How They Work and How to Withdraw, or obtain a copy of The Accidental Addict for more information. Be aware of the potential for between dose withdrawals. Remember that if you do get these symptoms, it is likely that it is a sign you are addicted to the drug.
Become fully informed and discuss the potential for tapering with somebody who understands benzo withdrawal. Question any recommendations to take more drugs and NEVER stop taking benzos abruptly. Remember that safe and effective withdrawal from benzos IS possible.
Updated: November 24, 2017