Benzodiazepine addiction: A lesser known but still insidious and growing problem

Since the 1990s it has become more readily acknowledged by health care providers that these drugs are highly addictive

Unless the day has particular meaning for you, chances are July 11 is not a date that jumps off the calendar. But it is the day selected by a group of patient advocates and concerned health care professionals to recognize an international drug crisis many say is no less severe than the opioid drug epidemic. The drug in question is actually a group of drugs known as benzodiazepines. July 11 is Worldwide Benzodiazepine Awareness Day.

Benzodiazepines are a group of drugs developed in the 1960s to treat serious anxiety disorders. The first to hit the market was diazepam (Valium). It was soon followed by lorazepam (Ativan), alprazolam (Xanax) and clonazepam (Klonopin). These drugs proved so effective that over the years they became more prescribed for people with milder anxiety issues such as stress and worry. Because they are sedatives they also became a drug of choice to treat related issues and disorders.

Over the past decade the adverse side effects associated with these drugs have become more widely known. In spite of this, 26 million prescriptions for one of the various forms of the benzodiazepines were written in Canada in 2017.

There are a number of problems associated with benzodiazepines. Since the 1990s it has become more readily acknowledged by health care providers that these drugs are highly addictive, that is to say, they only work until they don’t at which point patients begin to use higher dosages to get the same effect. This leads to a second major consideration, the adverse effects of long term use. Many people confuse sedation with sleep. They are not the same. Being sedated looks like sleep, but it is not the same as the restorative sleep that is a necessary requirement within the daily life cycle. And then there are the consequences for the neurotransmitters in the brain.

Long-term use of drugs that affect neurocircuitry can cause long term effects in the structure of those circuits. To date there are no peer reviewed studies that suggest that recovery should take more than six months to a few years but there is much anecdotal evidence to suggest that some people never recover. It is not uncommon for insomnia, as well as anxiety, to become much worse than before starting the drugs.

Because of the highly addictive nature of the benzodiazepines, the pharmaceutical industry introduced a new class of sedatives in the 1990s known as the Z drugs. In Canada the most widely prescribed has been Zopiclone (Imovane) and in the United States, Zolpidem (Ambien). These are part of a class of drugs known as hypnotics. They are especially used to treat insomnia. Even though these drugs are not generally considered to be as addictive as the benzodiazepines, they act on the same neuroreceptors in the brain (the GABA system) and the same consequences are associated with long term use.

If you have been prescribed a benzodiazepine or a Z drug as a long-term solution for an anxiety or sleep problem, you owe it to yourself to become knowledgeable about the dangers associated with the use of these drugs. Go on line and check out the website — Worldwide Benzodiazepine Awareness Day (W-BAD).

Besides the information on that web page you will find links to a number of other websites. You will meet is Dr. Heather Ashton. Until her recent passing she was emeritus professor of neurology at Newcastle University. She was a leading crusader in the struggle to better inform the public about benzodiazepines and, in fact, July 11 was specifically chosen to honour her contribution. It was her birthday. As a very empathetic person she made available online and free for downloading, the compendium of her research. It is published as The Ashton Manual.

On this continent, Dr. Daniel Kripke, from the University of California, has established himself as one of the most concerned scientists addressing the issue of benzodiazepine addiction.

Sedatives do have an important role to play in medicine. They are obviously necessary in those medical situations where patients need to be sedated. They can be legitimately prescribed for short-term use for patients who are experiencing an acute transitional crisis or trauma. But it is generally understood today that anything more than two weeks’ use leaves a patient open to the potential for becoming dependent.

Knowledge is power. If you have reason to believe benzodiazepines have touched your life in an unhealthy way, become informed and then have a long conversation with your doctor.