Can You Be Dependent On Benzodiazepines?
Benzodiazepines have a high potential for addiction, with dependence causing cravings or urges to use due to physiological changes and interactions happening in the body and brain. Although physical dependence is often part of addiction, people can be dependent on Benzodiazepines without meeting criteria for Benzodiazepine use disorder (addiction).
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How Dependence Develops
To understand the process of Benzodiazepine dependence, it is important to know its effects on the body, particularly the brain.
Benzodiazepines affect the way the brain functions by impacting the neurotransmitter GABA, which has the primary purpose of slowing down brain activity. Benzodiazepines amplify GABA’s effects on the brain, further slowing down both the brain signals and the body’s responses to those signals. This is what creates the powerful calming effect that Benzodiazepines are known and prescribed for.
Brain Adaptations Lead To Physical Dependence
When someone takes Benzodiazepines regularly, the brain adapts to their presence. These adaptations are an attempt to maintain homeostasis, or balance. Since Benzodiazepines amplify GABA, the brain responds by decreasing natural GABA by either decreasing production and release of GABA or by turning off some of the GABA receptors.
These neural adaptations to regular Benzodiazepine use develop into physical dependence because the brain does not produce enough GABA or have sufficient GABA receptors available after the person stops taking Benzodiazepines.
Since GABA receptors are highly concentrated in the parts of the brain involved with emotions, people can become physically dependent on Benzodiazepines for regulating their emotions. If that person then abruptly stops using Benzodiazepines or drastically reduces how much they use, withdrawal symptoms can be intense and opposite of Benzodiazepine effects.
Withdrawal symptoms of Benzodiazepines can include:
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Timeline For Benzodiazepine Dependence
Physical dependence to Benzodiazepines can develop more quickly than one might expect. Even when using Benzodiazepines as prescribed, someone can become physically dependent on them as soon as two weeks after regular use. The time it takes for someone to get physically dependent on Benzodiazepines depends on varying factors such as age, the specific dosage, and other medications and mental health conditions the person may have.
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Signs Of Physical Dependence On Benzodiazepines
The main indicators of physical dependence are tolerance and withdrawal. Tolerance is when the body adapts to the substance, so the effects become less intense over time. One sign of Benzodiazepine tolerance is that using the same amount does not produce the same effects. The other sign of tolerance is needing to increase the amount of Benzodiazepines taken to feel the desired effects.
Onset of withdrawal symptoms for Benzodiazepines can vary based on if the specific medication is classified as short or long acting. Short-acting Benzodiazepine withdrawal can start several hours after stopping while withdrawal symptoms can take several days to start after someone stops a long-acting Benzodiazepine. People experiencing Benzodiazepine withdrawal may try to reduce their symptoms by using other sedatives like alcohol, Cannabis, or Opioids.
Signs of Benzodiazepine physical dependence can include:
- Asking to increase the dose size or frequency of the prescription
- Asking for a more potent medication
- Increasing dose (strength or frequency) on their own without medical oversight
- Seeking Benzodiazepines from multiple medical professionals at the same time
- Trying to increase Benzodiazepine effects by mixing them with other drugs or alcohol
- Ingesting Benzodiazepine pills intranasally or intravenously
- Persistent thoughts about needing Benzodiazepines to tolerate stress and emotions
- Withdrawal symptoms or intense cravings when someone tries to cut back or stop using
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Treating Benzodiazepine Dependence
If you feel like your Benzodiazepine use has gotten out of hand and is negatively affecting your life, then it may be time to seek help.
Connect with a treatment provider today to see what options are available to you on your road to recovery.
Ashish Bhatt, MD, MRO
Doctor of Addiction Medicine
Learn about Dr. Ashish Bhatt
Dr. Bhatt has been Addiction Center's Medical Content Director for more than three years, providing his expertise to ensure quality and accuracy.
Doctor of Addiction Medicine
Expert in adult and child psychiatry
Over 20 years of professional experience