How Benzodiazepines Affect You
Benzodiazepines became popular in the 1960s as apparently safe and effective drugs to treat anxiety or insomnia. They quickly became some of the biggest earners for the pharmaceutical industry and remain so today.
Approved Benzodiazepines in use in the United States include:
While there are some people who find benzos helpful, around 20-40% struggle when attempting to stop the medication. There is no way to predict who or why one group of people are affected with significant withdrawal symptoms, while others are not. It probably has to do with the interplay of their genetics and environmental factors. Some of those who struggle to come off the benzos, describe their circumstances as life-changing and hellish as these symptoms have taken over many aspects of their daily life. Furthermore, 10-20% of those that suffer are seriously affected with a condition called Benzodiazepine- Induced Neurological Dysfunction. This is a newly coined term to explain the changes that happen in the brain, both due to the toxicity of the benzo on the brain and the adaptive changes that happen to create homeostasis. It is widely believed that many of these changes are reversible upon long term cessation of benzo use.
Back in the 1980s, Professor Heather Ashton was the first to conclude that physical dependency to Benzodiazepines was a serious problem and associated with severe withdrawal symptoms. She recognized that standard detox treatments designed for people abusing drugs were inappropriate for those taking benzos.
Unfortunately, most within the medical industry continue to be largely unaware of the withdrawal issues faced by such a high proportion of patients who are taking benzos. In some, severe symptoms are experienced while taking the benzodiazepine and only worsen when trying to withdraw. Some physicians have simply stopped prescribing benzos to patients even when patients are experiencing severe withdrawal symptoms, believing that the individual has an addiction and that the medication needs to be discontinued.
While some physicians are aware of the implications of long-term benzo use, there remain very few who support a slow and methodical taper. Many physicians are in favor of the standard addiction based, rapid withdrawal and detox protocols, even though less than 1% of those who use benzodiazepines are diagnosed with an addiction or substance use disorder. For the vast majority of patients, coming off of benzodiazepines should be done as an outpatient and as slow as necessary guided by patient comfort.
Research has shown that benzodiazepines affect the body and the brain in a unique manner that is still not clearly elucidated. More research is needed to explain the myriad of symptoms experienced by a significant number of patients who have used benzodiazepines consistently for more than a few weeks.
Dependence is characterized by withdrawal symptoms when stopping or lowering the dose of the prescribed medication but is not indicative of an addiction.
Tolerance, needing more of the medication for the same effect, is apparent in benzo prescribed patients, sometimes within just two to four weeks of use.
Both withdrawal from and tolerance are indicative of neurodaptive changes occurring in the brain. These physiologic changes in the brain produce a myriad of symptoms, including increased anxiety, panic, phobias, insomnia and can cause patients to lose focus and can experience significant disconnection from their identity. In many cases, the symptoms for which the benzos were originally prescribed, worsen and new inexplicable symptoms appear, ranging from mild physical symptoms such as abdominal cramps to severe cognitive and behavioral impairments including memory loss, aggression, and, in extreme cases, paranoia and suicidal thoughts.
Although there are many features in common, every individual has his/her own personal pattern of withdrawal symptoms. These differ in type, quality, severity, time-course, duration, and many other features. Such variety is not surprising since the course of withdrawal depends on many factors:
Duration of Action
Length of Use
The reason it was Prescribed
The Genetics and Epigenetics
The Patient’s Lifestyle
The rate of Withdrawal
The Degree of support available during and after Withdrawal