Benzodiazepine use, misuse, and abuse: A review PMC

Finally, respondents provided sociodemographic information including age, gender, race/ethnicity, and household income. Drug abusers often deny their problem by playing down the extent of their drug use or blaming job or family stress. It will assist the doctors if you bring the pill containers with you because it helps them determine the number and type of pills taken. If you have any questions, you could call your doctor, but if you are in doubt whether someone needs immediate medical attention, you should go directly to a hospital emergency department. Every person’s body chemistry is different, and the time it takes for someone to develop a tolerance for benzos will vary from person to person. The amount of benzos someone uses and other factors can also influence how quickly they develop a tolerance to benzos.

4. Limitations of the Present Review

Given their widespread use, abuse potential (23), and related risks, surprisingly little is known about benzodiazepine misuse. We evaluated 104 cases from the FDA Adverse Event Reporting System (FAERS) database of abuse, dependence, or withdrawal involving a benzodiazepine as a single drug substance reported by patients or health care professionals directly to FDA from January 1, 1968, through June 30, 2019. While this is a small subset of FAERS cases received for benzodiazepines as a whole, we selected a focused case series to identify the most descriptive reports of dependence or withdrawal.

Deterrence and Patient Education

The dose required to produce respiratory compromise is difficult to quantify and depends on multiple factors, including dosage, tolerance, weight, age, coingestants, and even genetics. Patients with severe toxicity will present in a stuporous or comatose state, and immediate airway management and mechanical ventilation may be required. Always tell your health care professionals about all the prescription and over-the-counter (OTC) medicines you are taking or any other substances you are using, including alcohol. Take benzodiazepines and all medicines exactly as prescribed by your health care professional. To avoid serious problems, including withdrawal reactions, patients taking benzodiazepines should not suddenly stop taking them without first discussing with your health care professional a plan for slowly decreasing the dose and frequency. Contact your health care professional if you experience withdrawal symptoms or your medical condition worsens.

• This is done if there is any concern that the overdose was swallowed intentionally and that the person may be at risk of harming himself or herself or others.
• People who misuse drugs — including tranquilizers called benzodiazepines — often deny their problem by playing down the extent of their drug use or blaming job or family stress.
• Clinicians should recognize their role as a source of misused benzodiazepines, either through medication they prescribed but was used other than as instructed, or as the source of prescribed medication given for misuse to a friend or relative.
• The studies which showed an increase in benzodiazepine use represent the tip of an iceberg.
• In addition to being mindful of their role as a potential source for misuse, clinicians have an important role in understanding the reason for their patients’ misuse to determine the appropriate intervention.
• Benzodiazepines can also be obtained from people who are not drug dealers – friends, a friend of a friend, coworkers, or family members may share or sell their pills.
• For instance, when drug sellers do not have benzodiazepines available, they may offer other dangerous drugs to the person, which can lead to polydrug abuse.

What is my risk?

The abuse of benzodiazepines is related to both the effects they produce and to their widespread availability. They can be chronically misused or, as seen more commonly in hospital emergency departments, intentionally or accidentally taken in overdose. Unlike most survey data and surveillance systems which can be lagged for a year or more, HIDTA data are made available quarterly, allowing evaluation in almost real time. HIDTA data also distinguish between the presence of fentanyl in pill or powder form. Analyzing these data can therefore help identify trends in availability of illicit substances and act as a type of early warning system to shift public health education or interventional resources more quickly. Some patients are reluctant to consider ceasing their benzodiazepine and are at high risk of relapse or harm.

Ideally, the person who used the benzodiazepine would disclose important facts, such as the amount recently taken. If any serious symptoms emerge such as signs of benzodiazepine overdose the best practice is to seek immediate help, which can include going to a local emergency room or contacting a doctor. If you suddenly reduce your dose of benzodiazepines or stop taking them — even if you’ve been using them as prescribed by a doctor — you could benzodiazepine withdrawal have withdrawal symptoms. Because benzodiazepines have a higher risk for misuse and can be habit-forming, healthcare providers tend to prescribe them cautiously. They may prescribe them only for use as needed, not daily, and they may prescribe lower doses or pick benzodiazepines that aren’t as strong. Your healthcare provider can explain their recommendations for your treatment, including the timeline for which treatments you receive and why.

Additional Common Questions

However, the frequency of benzodiazepine misuse varies widely with study sample and time frame assessed. Most college students with past-year benzodiazepine misuse report misuse on fewer than five occasions in the previous year (Messina et al., 2016; Pickover et al., 2016). In 2017, women and men over the age of 12 in the U.S. reported similar rates of tranquilizer misuse (2.1% vs. 2.3%, respectively) (CBHSQ, 2018b). Indeed, studies among https://ecosoberhouse.com/ adults and adolescents in the U.S. have not demonstrated consistent gender differences in the prevalence of benzodiazepine misuse (Table 3). In contrast, research in countries outside of the U.S. has generally demonstrated a greater likelihood of benzodiazepine misuse and SHA use disorder amongst female adolescents and adults (Table 3). In 2022, over 107,000 people died of a drug overdose, with 75% of those deaths involving an opioid.

• To our knowledge, this is the first analysis of benzodiazepine use in the U.S. to find that adults ≥65 no longer have the highest prevalence.
• PubMed and PsychINFO databases were searched through February 2019 for peer-reviewed publications on benzodiazepine misuse (e.g., use without a prescription; at a higher frequency or dose than prescribed).
• However, a study published in 2022 shed some light on a possible mechanism by which benzos lead to dementia.
• One type of benzodiazepine that’s legally manufactured in other countries but illegal in the U.S. is flunitrazepam (Rohypnol).
• The risk of BZD dependence was officially recognized by the American Psychiatric Association in 1990 [15,16].

The number of pills containing fentanyl seized by law enforcement was 2,300 times greater in 2023 than in 2017 – more than 115 million pills, compared to just under 50,000. HIDTA data does not differentiate between fentanyl and its analogs, nor estimate the amount of fentanyl present in seized substances. However, given the small amount necessary for an overdose, the authors note that the presence of any fentanyl is an important indicator of overdose risk. Currently, the FDA has a call out for a human abuse potential trial with the same doses that were used in that single ascending dosage trial to see if there’s abuse potential with any of those doses. “Another third use it in order to mitigate feelings of anxiety and depression successfully.

What can I do to avoid dangerous events related to benzodiazepines?

But people often take them with alcohol or other drugs, either of which can be dangerous or even deadly. While a standard urine drug screen (UDS) should be ordered, it comes with many limitations. Qualitative immunoassays for benzodiazepines in urine are readily available but do not typically aid in acute management decisions. Most of these screening tests detect only benzodiazepines that are metabolized to oxazepam glucuronide.