Benzodiazepines (pronounced 'ben-zoh-die-AZ-a-peens') are depressant drugs. This means that they slow down the activity of the central nervous system and the messages travelling between the brain and the body. They do not necessarily make a person feel depressed. Other depressants include alcohol, cannabis and heroin.
Benzodiazepines, also known as minor tranquillisers, are most commonly prescribed by doctors to relieve stress and anxiety and to help people sleep. They can also be used to treat alcohol withdrawal and epilepsy. However, there is increasing concern among medical professionals about the risks of using these drugs, particularly when they are used for a long time.
Benzodiazepines can cause overdose, particularly when used with alcohol or other drugs. They are also associated with dependence and withdrawal symptoms, even after a short period of use. As a result, benzodiazepines are not suggested as the first option for pharmacological treatment of insomnia, anxiety or other health concerns.1
Some people use benzodiazepines illegally to get high or to help with the ‘come down’ effects of stimulants such as amphetamines or cocaine.
There are three types of benzodiazepines: long, intermediate and short-acting. Short-acting benzodiazepines have stronger withdrawal or ‘come down’ effects and can be more addictive than long-acting ones.2
Benzodiazepines are known by their chemical (generic) name or their brand name. In each case the drug is exactly the same – it’s just made by a different company. Some common benzodiazepines are:
Alepam®, Murelax®, Serepax®
Xanax®, Kalma®, Alprax®
Adapted from: Brands B, Sproule B & Marshman J. (eds) (1998) Drugs & Drug Abuse (3rd ed.) Ontario: Addiction Research Foundation.
How are they used?
Benzodiazepines are usually swallowed. Some people also inject them.
Effects of benzodiazepines
There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.
Benzodiazepines affect everyone differently, but the effects may include:
feelings of isolation or euphoria
impaired thinking and memory loss
drowsiness, sleepiness and fatigue
slurred speech or stuttering
double or blurred vision
impaired coordination, dizziness and tremors
nausea and loss of appetite
diarrhoea or constipation.
Injecting benzodiazepines may also cause:
vein damage and scarring
infection, including hepatitis B, hepatitis C, HIV and AIDS
deep vein thrombosis and clots causing loss of limbs, damage to organs, stroke and possibly death.
Injecting drugs repeatedly and sharing injecting equipment with other people increases the risk of experiencing these effects.4
Benzodiazepines are not generally recommended for use during pregnancy or breastfeeding, as they are associated with pre-term delivery, low birth weight and potential birth defects.5-7 They may also be dangerous for people with acute asthma, emphysema or sleep apnoea; advanced liver or kidney disease; or people with a history of substance use disorders, as it can lead to dependence.8,9 Benzodiazepines should be prescribed with caution for elderly people, as it can increase the risk of falls and injury.10
Benzodiazepines are often present in patients who have intentionally or accidentally overdosed. If you take a large amount, you could overdose. Call an ambulance straight away by dialling triple zero (000) if you have any of the symptoms below (ambulance officers don’t need to involve the police):
over-sedation or sleep
jitteriness and excitability
mood swings and aggression
slow, shallow breathing
unconsciousness or coma
death (more likely when taken with another drug such as alcohol).3
Regular use of benzodiazepines may cause:3,11
impaired thinking or memory loss
anxiety and depression
irritability, paranoia and aggression
weakness, lethargy and lack of motivation
drowsiness, sleepiness and fatigue
difficulty sleeping or disturbing dreams
skin rashes and weight gain
withdrawal symptoms (see below).3
There is some evidence that long-term, heavy use of benzodiazepines is a risk factor for epilepsy, stroke and brain tumours.12
Using benzodiazepines with other drugs
The effects of taking benzodiazepines with other drugs can be unpredictable and dangerous, and could cause:
Benzodiazepines +alcoholor opiates (such asheroin): breathing difficulties, an increased risk of overdose and death.
Benzodiazepines + some pharmaceutical drugs: strong pain-relievers, antidepressants, anticonvulsants, anti-psychotics, some anti-histamines and over the counter medications can have an adverse effect when taken with benzodiazepines and lead to breathing difficulties, an increased risk of overdose and death.8
The use of benzodiazepines to help with the come down effects of stimulant drugs (such as amphetamines or ecstasy) may result in a cycle of dependence on both types of drug.
Giving up benzodiazepines after using them for a long time is challenging because the body has to get used to functioning without them. This is why it’s important to seek advice from a health professional when planning to stop taking benzodiazepines. Do not stop taking benzodiazepines suddenly, as sudden withdrawal can cause seizures.1
Withdrawal symptoms vary from person to person and are different depending on the type of benzodiazepine being taken. Symptoms can last from a few weeks to a year and can include: