CBT (cognitive behavioral counseling) has been shown highly effective in learning to recognize and deal with intense https://ecosoberhouse.com/ cravings and other triggers to prevent relapse after detox 6. It’s also common for people in alcohol withdrawal to be irritable and easily agitated. With a weakened heart and without the help of substance abuse treatment programs, you may experience heart failure.

4. Special Populations and Withdrawal

• The same rate of current benzodiazepine misuse was found in a 2008–2009 household survey of 2,280 individuals ages 15 and older residing in the Ubon Ratchathani Province region of Thailand (Puangkot et al., 2010).
• The following are typical timelines for the symptoms of withdrawal to subside in benzodiazepine recovery 14.
• For the present study, participants were included in analyses if they provided informed written consent to research and were undergoing their first admission to this program.
• We also chose to include studies among those with SUDs that defined benzodiazepine misuse based on urine drug screen results, as opposed to clear definitions of misuse.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional.

Effects of Benzodiazepine Abuse

• Staying at the scene of an overdose is important to help save the life of the person experiencing an overdose.
• According to a 2022 study in European Addiction Research, over 20% of long-term benzodiazepine users showed overall cognitive impairment, particularly in processing speed and sustained attention.
• Using benzos along with other drugs, especially “downers” like opioids, is particularly risky.

These changes in sleep architecture can have adverse cognitive effects and lessen time in deep sleep. Psychologically, long-term use of benzodiazepines may lead to overreliance on the need for the agent, loss of self-confidence and varying degrees of drug-seeking behavior.8 Patients may be reluctant to discontinue the drug because of misplaced fears or anticipatory anxiety. Some patients combine alcohol with benzodiazepines when they are not able to acquire the desired or “needed” effects.

Risks related to benzodiazepine use

• Many patients underestimate the degree of impairment caused by benzodiazepines.8 Benzodiazepines increase the risk of addiction, withdrawal, cognitive decline, motor vehicle crashes, and hip fracture.
• However, the FDA recognizes that even medical use can lead to dangerous situations.
• Because benzodiazepines are controlled substances with abuse potential, special attention must be directed toward the patient’s addiction history before these agents are prescribed.
• This paper reports a planned analysis of an ongoing naturalistic study of adults receiving acute care (partial hospitalization) for psychiatric disorders.

First, our search strategy was limited to the search terms used, and therefore we might have missed relevant studies that did not include these key words. Second, we chose to use the term “benzodiazepine misuse” throughout the present review, although many studies combined benzodiazepines with other sedative and tranquilizer medications. We described study findings in this manner to balance accuracy with interpretability; however, it Sober living house is unknown how the inclusion of other sedatives and tranquilizers in the reviewed literature impacted results. We also chose to include studies among those with SUDs that defined benzodiazepine misuse based on urine drug screen results, as opposed to clear definitions of misuse. Although these studies suggest, or imply, that this constitutes problematic use, these studies may have included participants who were using benzodiazepines as prescribed.

ASAM Recommendations for Alcohol Withdrawal Management

Black market benzos can become extremely dangerous when illicit manufacturers combine drugs to make their products more potent. Someone might combine a small amount of alprazolam with fentanyl or other opioids. Putting these two depressants into one pill puts users at risk of overdose, respiratory distress, and death. To help FDA track safety issues with benzodiazepines, we urge patients and health care professionals to report side effects involving benzodiazepines or other medicines to the FDA MedWatch program, using the information in the “Contact FDA” box at the bottom of this page.

Many drugs have been tested as a treatment for withdrawal, with few proving efficacious in randomized control trials. Future research is warranted for further exploration into alternative methods of treating BZD withdrawal. This call to action proves especially relevant, as those seeking treatment for BZD dependence and withdrawal are on the rise in the United States. Little is known about benzodiazepine misuse in older adults, despite high rates of prescribing in this group (Maust et al., 2018; Schepis et al., 2018b).

Benzodiazepine Use Dangers

Younger adults are more likely to lack health insurance (30), while the most common reasons for misuse (e.g., to relax/relieve tension) were all reasons for which a clinician might prescribe a benzodiazepine or refer for behavioral treatment. A significant proportion of the NSDUH-defined “misuse”, therefore, could reflect use for untreated symptoms among those with poor access to care—specifically behavioral treatments for insomnia (31, 32) or anxiety disorders (33, 34). The development of interventions such as web-based cognitive behavioral therapy for insomnia may help increase access to benzodiazepine alternatives for those who lack access to providers or insurance or both (35).

Notably, this estimate is slightly higher than the estimate for heroin use disorder. Approximately 198,000 individuals met criteria for a sedative use disorder (0.1%), making sedative use disorder the second least common SUD (the least common being inhalant use disorder). Among individuals with opioid use disorder (OUD), conditional dependence, or the percentage of people with misuse who benzo withdrawal timeline meet criteria for dependence, for benzodiazepines is lower than for other substances (Wu et al., 2012).

The most common source of misuse for both age groups was from a friend or relative. When combining all benzodiazepines—free, bought, or stolen—a friend or relative was the source for nearly 70% of respondents reporting misuse. Model is adjusted for all respondent demographic, general health, and substance use characteristics presented as rows in the table. This analysis uses NSDUH, which measures the prevalence and correlates of drug use among the U.S. civilian, non-institutionalized population (24). The survey uses a 50-state design with an independent, multistage area probability sample, is administered by RTI International, and sponsored by the Substance Abuse and Mental Health Services Administration.

For these reasons, if used, benzodiazepines generally should not be prescribed continuously for more than one month. Psychotherapy and antidepressants are the treatments of choice for anxiety disorders. Short-term medications that can be used for anxiety without risk of addiction include propranolol, anticonvulsants, or major tranquilizers. Finally, insomnia can be treated with trazodone, doxepin, or ramelteon (Rozerem) without risk of rebound insomnia. An analysis of 2008–2014 NSDUH data found that approximately 7.6% of those with AUD, including those with DSM-IV alcohol abuse or dependence, reported past-year sedative/tranquilizer misuse, a rate 3–4 times greater than among the U.S. general population (Votaw et al., 2019). Rates of misuse might be higher among those with greater AUD severity, as evidenced by an analysis of NSDUH data wherein approximately 12% of those with DSM-IV alcohol dependence reported past-year sedative/tranquilizer misuse (Hedden et al., 2010).

Benzodiazepines Risk, Abuse, and Dependence

Mental health professionals need to be prepared for issues that may arise due to COVID-19 such as anxiety, depression, fear, coronophobia, trauma and grief due to loss of a loved one. The risk of developing benzodiazepine tolerance, abuse and addiction must be considered by health care professionals before prescribing them. This review summarizes the trends observed during the pandemic and emphasizes the importance of weighing risks versus benefits before the prescription of benzodiazepines. The studies which showed an increase in benzodiazepine use represent the tip of an iceberg.