It is not uncommon for people battling pain to also suffer from anxiety. Many times they will require treatment for both. In fact, the prevalence of individuals who co-use opioids for pain with benzodiazepines has risen an estimated 250% over the last 15 years.
Benzodiazepines have long been prescribed for anxiety. They are classified as a sedative and are also used to treat muscle spasms and seizures. These drugs run a high risk of dependence by themselves. Even though it has long been recognized that it is dangerous to take this medication while also on opioids to treat your pain, it has long been common practice for physicians to prescribe both drugs to some patients.
Opioids are prescribed for many different types of pain, both acute and chronic. They are classified as Schedule II narcotics and are still considered to be the best way to control pain following an injury or surgery. The illegal drug heroin is also classified as an opiate; however, there is no legitimate medical necessity for it to be prescribed. Opioids have gained worldwide attention due to their risk of dependence. As a result, many pain patients find themselves having to find alternatives to prescriptions that used to be so freely written.
Drugs that are classified as benzodiazepines are used to combat anxiety, relax muscle spasms and seizures, and calm symptoms from alcohol withdrawal. The two most commonly used benzodiazepines are Xanax, also known as alprazolam, and Valium, also known as diazepam.
Benzodiazepines are some of the most commonly prescribed medications in the United States. A short course of a small prescription of these drugs by themselves is considered quite safe. If a patient uses benzodiazepines on a long-term basis, they run the risk of becoming dependent on them. As the patient’s tolerance builds, they are tempted to raise their dosages to dangerous levels.
Opioids have been proven to be some of the most effective medications to treat both acute and chronic pain from an injury, surgery, cancer, and various chronic pain conditions. These Schedule II drugs include Vicodin, Percocet, OxyContin, Demerol, Dilaudid, tramadol, and fentanyl. Heroin is also included in this classification.
Over the past several years, due to the opioid crisis, many patients who may have previously relied on a legal prescription turn to illegal versions of their pain medications, heroin, and street drugs containing a type of fentanyl that has proven to be more powerful than the legal pharmaceutical version. The street alternatives are far more dangerous than the legal version they were once accustomed to, which has increased the number of drug overdoses involving opioids over the years.
How the Drugs Affect the Human Body
While both benzodiazepines and opioids have many useful benefits, they also have a number of potential negative impacts on various parts of the human body. The following covers a few of these impacts.
When an individual is prone or sedentary for an extended period of time, the patient’s muscles might begin to break down chemically. During this chemical process, chemical byproducts can begin to poison the kidneys leading to kidney failure.
Both opioids and benzodiazepines can damage the liver. Opioids are even more damaging because most opioids are combined with acetaminophen, which is highly toxic to the liver on its own.
When you use opioids, your circulatory system becomes a prime candidate for damages. You are twice as likely to have a heart attack. If you are administering your medication intravenously, you can actually damage your blood vessels. You can also suffer from infections to the heart.
When a person uses opioids, they run a regular risk of their breathing being suppressed. You also run a greater risk of developing pneumonia or other lung infections.
Digestive System Damage
Opioids tend to slow down the digestive process, which then decreases your appetite. This slow down affects you through nausea, vomiting, distension of the bowels, and constipation.
Using opioids weakens your bones, putting you at an elevated vulnerability to broken bones.
Benzodiazepines mainly impact the brain, which in turn affects other systems in the body. The brain slows in its functioning, which can manifest as impaired balance resulting in frequent falls, breathing suppression, and blood pressure regulation issues.
Mixing Benzodiazepines With Opioids
When we see the many dangers of both benzodiazepines and opioids, it should come as no surprise that mixing the two is responsible for a good portion of opioid-related overdoses. Studies show that 16% of all drug overdoses and 30% of opioid drug overdoses show the presence of both benzodiazepines and opioids in the toxicology.
Both benzodiazepines and opioids have a sedative effect on the patient. When the two drugs are combined, the depressant factor on the central nervous system is increased. If you take the two together, you might notice that both your heart rate and breathing slow down.
Both opioids and benzodiazepines are drugs where tolerance can build relatively quickly. When tolerance increases, the patient is tempted to increase the dose of one or both of the drugs to achieve the same level of euphoria they used to get at lower dosages.
The Role of Age and Physical Health
Your age and general health play an important role in how you are affected by the combination of benzodiazepines and opioids. The primary sedative effect of slowing your metabolism is compounded by age because as we get older, our metabolism slows naturally. When you add a combination of drugs with similar effects, you find yourself at a higher risk of accidental overdose.
Symptoms of a Benzodiazepine and Opioid Overdose
The symptoms of benzodiazepine and opioid overdose include:
- Slowed shallow breathing
- Extreme sleepiness
- Loss of coordination
- Loss of balance
- Impaired judgment
- Muscle weakness
- Slowed heart rate
- Loss of consciousness
When Is the Best Time to Quit?
If you notice that you are taking dosages larger than the prescribed amount or believe that the medication is no longer helping your symptoms, you will know that it is time to quit taking your opioids and benzodiazepine medications. You will want to consider quitting if you have or develop other health issues related to addiction, such as sleep apnea or kidney disease. It may also be time to quit if you realize that you are behaving differently or losing interest in activities you have always participated in.
How to Quit
Benzodiazepines and opioids have numerous aspects in common. When it comes time to either substantially lower your dosage or quit taking them completely, you will need to do it both slowly and under medical supervision. You and your doctor will need to sit down and develop a taper-down plan. Quitting this combination of drugs cannot be done cold turkey.
During your taper down process, your doctor will want to:
- Regularly monitor your temperature, blood pressure, and heart rate
- Take regular blood and urine samples to monitor the amount of medication in your system in addition to any other substances, both legal and illegal
- Get your authorization to communicate with your other doctors, pharmacist, and members of your family to obtain pertinent information to help you go through the taper-down process more smoothly
- Introduce other holistic pain therapies as needed
- Potentially prescribe medication to help you manage withdrawal symptoms
Dosages need to be lowered over time to avoid the discomfort of withdrawal symptoms. Some withdrawal symptoms, especially if there is heroin or fentanyl involved, can become life-threatening if not monitored. Withdrawal symptoms include:
- Runny nose and watery eyes
- Mood swings
- Excessive irritability
- Stomach cramps
- Nausea and vomiting
- Sleep disorders such as insomnia
- An increase in pain levels
- Muscle cramps and joint pain
- Trouble regulating body temperature, going from chills to sweats
- Increased heart rate
- Changes in blood pressure
- Suicidal thoughts
- Difficulty awakening from sleep
Many times, in cases where the taper-down period is difficult or there is a need for continuous medical monitoring, your doctor may prefer that you go through an inpatient medication-assisted detoxification program.
Granite Recovery Centers
Granite Recovery Centers has everything you need for a successful treatment experience. Before you begin treatment, you will sit down with one of our experienced counselors to discuss all of your needs and options and set up the right treatment plan for you. When you are coming off chronic use of a mixture of benzodiazepines and opioids, you will need to go through a detox program that may or may not be medication assisted. This will be followed by an inpatient treatment program. Granite Recovery Centers provides medical detoxification for people who do not need immediate medical intervention, are not a danger to themselves, and are capable of self-evacuation in the event of an emergency.
Our founders designed the drug rehab program around what they found helped them the most when they began their own sober journey. They discovered that an evidence-based treatment program built on the 12-step principles of Alcoholics Anonymous offered the greatest chance for success.
Each of our locations is situated in a tranquil setting conducive to healing. The Granite Recovery Centers treatment program is centered on behavior modification ideals that teach you new, healthy activities to replace the damaging, addictive behaviors you have become accustomed to.
Once you complete your inpatient treatment, you may choose to continue with an intensive outpatient program before moving on to aftercare. Granite believes that the amount of time you spend in an inpatient program should not be limited to a typical 28-day schedule. Many patients find greater success with an extended stay in supervised treatment. When you do leave supervised treatment, you may want to give yourself a better chance at staying sober by moving into one of our sober living facilities where you can continue your recovery surrounded by peers who share the same sober goals. Sober living is a great option if your surroundings at home are not conducive to staying off your medications or any other addictive substances.
Every Granite graduate has long-term access to our aftercare program. We have found that the protocols we follow in all of our treatment programs are proven to provide you a successful introduction to recovery. Our experienced staff of medical, support, and psychiatric personnel can take care of every aspect of the treatment process.
If you are gathering information out of concern over a friend or loved one, we have experienced intervention professionals standing by to guide you in planning your intervention event. Once the program is complete, it is actually rather common for an individual to suffer a relapse into their addictive behaviors, particularly in the early days of their sobriety. Those who suffer relapse can re-enter treatment without judgment and get back on their path to recovery, and usually, those who do relapse find their way back to treatment.