Benzodiazepines help many Americans cope with anxiety disorders and many other conditions, but these drugs can also lead to dependence and addiction.

Benzodiazepines are habit-forming and can cause addiction within a relatively short time frame. Most people who are prescribed a benzodiazepine use it according to their doctor’s orders. However, addiction can still develop even within the safety of medical supervision.

Despite the medical uses for these drugs, the Drug Enforcement Administration classifies the drugs as Schedule IV controlled substances. Although it is illegal to distribute, sell, or use benzodiazepines without a legitimate medical prescription, these drugs often appear on the black market because they can be abused to get high.

The dangers of illicit benzodiazepine use are significant. However, addiction can occur regardless of whether the drug was acquired from a doctor or through illicit means. It is crucial to keep an eye on yourself or your loved one if any signs or symptoms of benzodiazepine abuse or addiction emerge.

Signs of Benzodiazepine Abuse

Users often exhibit certain signs when they abuse or become addicted to benzodiazepines. These drugs impact the mind and body alike, so the signs of benzodiazepine abuse and addiction can manifest both physiologically and emotionally.

It is important to know how to recognize the signs of drug abuse. If you or a loved one is using benzodiazepines, it is even more important that you look out for these specific signs. The most common ones include risky, unusual, or erratic behavioral changes, such as the following:

  • Loss of job
  • Hiding pill bottles
  • Uncharacteristic desire to be alone
  • Lowered academic performance
  • “Doctor shopping” to obtain additional, unnecessary benzodiazepine drugs
  • Taking increasing amounts of benzodiazepines
  • Stealing or using other illicit means to obtain money

Benzodiazepine Abuse Symptoms

Similar to the way that signs can indicate benzodiazepine addiction, a person’s physical and emotional symptoms also serve as cues. Some of the most common abuse symptoms include:

  • Nausea and vomiting
  • Sleep problems
  • Drowsiness
  • Dizziness or vertigo
  • Cloudy mental state
  • Forgetfulness

If a person is using benzodiazepines illicitly, they may also experience the very symptoms these drugs are meant to relieve: anxiety, insomnia, and panic.

Some people wonder which benzodiazepine causes the most severe symptoms, but there is no one answer to this question. Each user has a unique physical makeup, meaning that different drugs impact each person in unique ways. Other medications can also impact the efficacy of the drug. In general, however, the higher the potency of a benzodiazepine, the more noticeable its symptoms.

The three benzodiazepines with the highest potencies are as follows:

  • Xanax (alprazolam): Although Xanax may be the most renowned benzodiazepine, it doesn’t mean that it causes the strongest symptoms in every person. Alongside Ativan, professionals consider Xanax to have the most potential for abuse when compared to other benzodiazepines. Xanax is approved for adults.
  • Ativan (lorazepam): Some medical professionals consider Ativan (alongside Xanax) to be the benzodiazepine with the highest potential for abuse. Ativan is approved for children ages 12 and up and for adults.
  • Halcion (triazolam): Unlike Xanax and Ativan, Halcion is primarily meant for the treatment of insomnia. Halcion is approved only for adults.

More meaningful than the formulation is the dosage. Higher doses are more closely associated with the following symptoms:

  • Drug-seeking behaviors
  • Depressed mood
  • Hyperactivity

Benzodiazepine Side Effects

Benzodiazepines possess sedative qualities and are meant to reduce anxiety. They do this by suppressing the central nervous system’s functions, such as heart rate, breathing, and blood pressure — all of which increase during moments of stress. This slowing down of the body and mind can lead to side effects that manifest physically and mentally.

The effects of benzodiazepines change based on the dosage, the formulation of the particular benzo, and the length of time that a person uses it. Addiction is more likely to develop with higher doses, faster-acting formulations, and longer treatment durations. Even when benzos are used for a short period of time, the drugs can cause immediate side effects.

When abused, common side effects include:

  • Irritability
  • Fatigue and increased need for sleep
  • Physical weakness
  • Anxiety
  • Forgetfulness
  • Vision problems
  • Headaches
  • Mental confusion
  • Generalized pain
  • Libido loss
  • Sexual impotence in men
  • Slowed reaction time
  • Impaired motor coordination
  • Anterograde amnesia
  • Slurred speech
  • Restlessness
  • Paranoia

Addiction is not the only consequence of long-term drug misuse. Abuse increases not only the risk of negative physical health consequences but also negative social and career consequences.

Long-term effects of benzodiazepine abuse include the following:

  • Tolerance: Benzodiazepine tolerance can develop quickly, but it is usually the result of long-term use. If a person develops a tolerance, they will require increasingly larger amounts of the drug to achieve the effect they desire. Withdrawal symptoms such as anxiety, insomnia, tremors, and seizures may occur if drug use is stopped suddenly.
  • Relationship damage: Personality changes often accompany drug abuse and addiction. For example, some people experience a lack of impulse control that they did not previously exhibit.
  • Career or academic damage: In addition to the all-consuming drug-seeking behaviors that accompany addiction and detract from other important areas of life, long-term benzodiazepine abuse has been shown to cause brain damage and reduced mental function. Job loss may result, and students may fail to reach their academic goals.
  • Death: Long-term abuse can result in an overdose. Though it is unusual for a person to overdose on benzodiazepines alone, it is common for an overdose to involve alcohol, opioids, or another depressant drug in combination with the benzo.
  • Depression: Secondly, benzodiazepines have been shown to increase feelings of depression in some people. Suicide attempts and deaths from suicide are risks that accompany these drugs. If you or someone you love is experiencing suicidal thoughts or tendencies, immediately call the National Suicide Prevention Hotline at 1-800-273-8255.
  • Legal entanglements: Law problems may result from benzodiazepine abuse, especially when it comes to certain formulations of these drugs. Flunitrazepam is the only benzodiazepine that is treated as a Schedule I drug in the court system. This means that the legal consequences for illicitly using, possessing, or distributing this particular benzodiazepine are far more severe than those associated with all other benzodiazepines in Schedule IV.
  • Alzheimer’s disease (in the elderly): Though people of all ages experience the side effects of benzodiazepine use, elderly persons are particularly vulnerable. This may be tied to higher usage rates among the elderly since around 3% to 14% of elderly people have diagnosable anxiety. One study found a link between long-term benzodiazepine use and Alzheimer’s disease.

If you or someone you love is struggling with benzodiazepine misuse or addiction, The Recovery Village is here to help. Contact us today to learn more about treatment programs that can work well for your situation.

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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
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Medically Reviewed By – Eric Patterson, LPC
Eric Patterson is a licensed professional counselor in the Pittsburgh area who is dedicated to helping children, adults, and families meet their treatment goals. Read more

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Drug Enforcement Administration. “Drug Fact Sheet: Benzodiazepines.” April 2020. Accessed June 27, 2020.

Moody, David. “Drug Interactions with Benzodiazepines: […]Cytochrome P450 3A4.” Springer, July 12, 2011. Accessed June 27, 2020.

O’brien, Charles. “Benzodiazepine Use, Abuse, and Dependence.” The Journal of Clinical Psychiatry, 2005. Accessed June 27, 2020.

University of Minnesota. “Benzodiazepines.” (n.d.). Accessed June 27, 2020.

MedlinePlus. “Triazolam.” April 15, 2019. Accessed June 27, 2020.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.