Benzodiazepnes are often medically classified as sedatives/hypnotic (inducing sleep) or anxiolytics (relieving anxiety). Other medical uses include treatment of epilepsy, as a muscle relaxant, alcohol withdrawal, or as an anaesthetic before surgery. non-medical uses include becoming intoxicated, substituting/enhancing the effects of opiates, and counteracting the effects of other drugs.
Benzodiazepines work as a central nervous system depressant. They have anxiolytic (anxiety relieving) and hypnotic/sedative (sleep inducing) properties. Physicians may also prescribe them as muscle relaxants, or to treat epilepsy and other seizure disorders, alcohol withdrawal, panic, and sleeping disorders. Benzodiazepines are prescribed with caution and never patients with personality disorders or a history of substance abuse.
Benzodiazepines have been in wide clinical use throughout the world since the 1960s and are among the most widely used prescribed drugs in the western world. They are used by both men and women of all ages. There are 54 types of benzodiazepines and eight are commonly prescribed in New Zealand.
Benzodiazepines are often prescribed in tablet or capsule form and come in a variety of shapes, sizes, and colours. Upon administration the drug is absorbed into the bloodstream and circulated through the body. The drugs take effect after 30 minutes, with lasting effects depending on dosage, type of benzodiazepines used, condition being treated, and the presence of other drugs.
Common brand names include: Xanax, Rohyphnol, Valium, Imovane, Frisium and Noctamid. The chemical name listed under these brand names most commonly end in ('pam').
Non-medical use of benzodiazepines has become a worldwide concern in the past two decades. Users take benzodiazepine to induce a state of intoxication or euphoria or as a substitute/enhancer to the effects of opiates. They are also used to help counteract the negative effects of other drugs; to help with 'coming down' from a 'high', and to help induce sleep.
Slang
Benzos, Tranxs, Downers, Sleepers
Short-term effects
Medically benzodiazepines are intended to be prescribed for a period not exceeding one month (depending on the type of benzodiazepine used, its strength and the condition being treated) with a view to avoiding the development of tolerance and withdrawal symptoms upon discontinuation.
If recommended doses are administered, and for only one to two months, general short-term effects include:
It is common for recreational users to take high doses of benzodiazepines as they are not aware of recommended dosages, and are administering to achieve a desired state.
Long-term effects
Long-term use (exceeding one month) of benzodiazepines is not recommended. Tolerance can develop as the body adapts to the same prescribed dose over a prolonged period of time leading to physical dependence and addiction. Long-term use of benzodiazepines may cause:
Long-term use of benzodiazepines will commonly cause the same conditions that the drug has been prescribed to relieve.
Any adverse effects experienced while on benzodiazepines should be discussed with a health professional. Discontinuation of long-term or heavy use of benzodiazepines - whether by a recreational user or someone using for medical reasons- requires medical attention to help prevent withdrawal syndrome or a relapse to the underlying condition.
Benzodiazepines dependence can be both psychological and physical. Benzodiazepines are also well known for causing rapid tolerance to their effects leading many users to require substantially increased amounts in order to achieve their desired results.
Regular use of benzodiazepines, whether recreational or prescribed, will lead to addiction. Discontinuation after heavy or long-term use of benzodiazepines, without tapering doses, can lead to the user experiencing withdrawal symptoms if:
Withdrawal symptoms are both physical and psychological and include:
It is important that those who are anticipating stopping their us of benzodiazepines seek medical attention, especially if they have been using them for more than one month, in order to avoid withdrawal symptoms or a relapse to their existing condition.
Overdose is associated with chronic heavy use of benzodiazepines or their use with other drugs. Overdose can cause unconsciousness and possibly death. Anyone showing signs of an overdose, or of the effects of combining benzodiazepines with alcohol or other drugs, should get immediate emergency help. Warning signs include slurred speech or confusion, severe drowsiness, staggering, and profound weakness.
On 1 January 1999 benzodiazepines were reclassified as controlled drugs under the third schedule, Class C, Part 5 of the Misuse of Drugs Act 1975, and are no longer scheduled under the Medicines Regulation Act 1984.
The reclassification of benzodiazepines is part of a global initiative to enforce tighter controls and reducing the amount of these drugs being diverted from legal to illicit markets for use and supply.
The international control of benzodiazepines takes place under the 1971 United Nations Convention on Psychotropic Substance of which New Zealand became a signatory to in 1990.
Medsafe will monitor annual consumption and supply this information to the International Narcotics Control Board. Doctors prescribing benzodiazepines must use a standard prescription form allowing only one month's supply per prescription. Pharmacists do not have to store benzodiazepines in their controlled drug safe, nor are they required to recode dispensing in a controlled drug register.
Penalties for the importation, manufacture or supply of benzodiazepines are up to eight years imprisonment and up to seven years imprisonment for conspiracy to commit an offence. Possession of non-prescribed benzodiazepines can result in up to three months imprisonment or a $500 fine, or both.
Benzodiazepine trends in New Zealand have only recently been followed and no significant trends have been documented as yet.
The Drug Foundation’s message is clear: no drug use is the safest drug use. But we realise there will be occasions when people ignore warnings and use drugs. In order to limit the harm from their drug use, we provide information about effective methods of drug harm minimisation. Such information directly benefits the person using drugs, and also protects the wider community.
The combined effects of benzodiazepines and other central nervous system depressants such as alcohol can be very dangerous, leading to unconsciousness, and on rare occasions, to death. Anyone taking benzodiazepines should not drink alcohol and should check with their physician before using any other central nervous system depressants.
Benzodiazepines are intended for oral use only, unless other instructions are given by the prescribing doctor. Benzodiazepines are generally not water soluble and cannot be readily prepared for injection. However benzodiazepines for recreational use are injected by some people to achieve a feeling of 'euphoria', increase the effects of other drugs or help alleviate the come down effects of other drugs.
Severe health problems can occur from this method including:
There are a number of treatment organisations that can help. If you feel that you or anyone you know needs help, then you can call these services in strict confidence.
If you are faced with an emergency, call 111 immediately.
To talk to someone about your or someone else's drug use, call the Alcohol Drug Helpline - 0800 787 797.
You can also get contact details for your local alcohol and other drug counsellor or treatment provider by calling the helpline or by visiting www.addictionshelp.org.nz.
HealthAtoz family health website. www.healthatoz.com/healthatoz/Atoz/ency/benzodiazepines.jsp
The Australian Drug Info Clearing House. www.druginfo.adf.org.au/article.asp?ContentID=benzodiazepines