Causes of Benzodiazepine Overdose
Benzodiazepines have a high potential of becoming addictive. Additionally, benzo users adjust to the drug very fast, meaning they have increased chances of developing benzodiazepine tolerance. If their regular dose does not work, they keep increasing it until they surpass the allowable limit, inducing an overdose. Alternatively, they introduce an alternative drug to boost the effects and, thus, achieve the familiar desired high. When benzodiazepine addicts relapse after withdrawing from benzos for some time, they often go back to the same doses as before without identifying the potential danger of overdose. While many cases of benzo overdose are accidental, some are a deliberate attempt to commit suicide.
Different Types of Benzodiazepines
Benzodiazepine is a drug class that comprises prescription tranquilizers and sedatives. Mental health practitioners often prescribe them to treat various mental health disorders, including anxiety, depression, muscle relaxation, seizure control, and insomnia. These drugs work by producing calming, euphoric, and sedative effects that enhance an individual’s likelihood of using the drugs for recreation or to increase the treatment effects. There are several types of benzos that produce varying effects. The first variation depends on how long they need to be in the body to have the desired effects.
- Short-acting benzos – Used to treat short-term, non-chronic, and intermittent mental health issues.
- Long-acting benzos – Used to treat chronic mental health conditions over a long time. These often lead to dependence, tolerance, and adverse side effects.
About 2000 benzodiazepines exist, but only 15 that have been approved by the Food and Drug Administration (FDA). Some of the most common types of benzodiazepine include:
- Valium is a common long-acting benzo used to treat disorders related to seizures and muscle spasms and provide sedation to anxiety patients.
- Xanax is used to treat short term disorders, including panic attacks, mood disorders, and anxiety.
- Ativan is a short to middle-term medication that treats seizure disorders, insomnia, and anxiety. It can also be used as a sedative before surgery.
- Klonopin is an extremely sedating benzo used to treat severe anxiety disorders, social phobias, PTSD, epilepsy, panic disorders, and mania.
How Benzodiazepines Work
Benzodiazepines interact with the gamma-aminobutyric acid (GABA) system in the brain, affecting the levels of neurotransmitter chemicals in the brain, such as dopamine and norepinephrine. The body’s response to stimuli slows down when a person uses a benzodiazepine; this includes slowed breathing and heart rate. It also induces relaxed muscles and eases anxiety symptoms, such as stirred emotions and racing thoughts. Generally, most benzos produce similar physical effects as well as mental relaxation and sedation.
Short term use of benzodiazepines is safe and effective. However, long-term use can lead to serious side effects. The FDA has issued a black box warning on the use of benzodiazepines in an attempt to warn patients and doctors against the drug’s dangerous effects. Some of the severe effects of using benzodiazepines include:
- Tolerance – The body can adapt to a drug’s presence, making it hard for one to function normally without the drug. Tolerance also makes the drug less effective, thus, encouraging users to increase their intake in either frequency or amount to achieve their desired effects. The American Family Physician reports that benzos become less effective after four to six months of continued use, which means the longer the drug use, the higher the chance of an overdose.
- Dependence – It is the development of drug-seeking behaviors, such as withdrawal symptoms, when the drug is stopped or used is decreased abruptly. Benzo dependence occurs due to long-term use, even at prescribed doses. A dependent person will keep using benzodiazepines regularly despite the obvious harm they are causing them physically, emotionally, and socially.
- Withdrawal – Benzodiazepine withdrawal is dangerous and potentially fatal. It occurs when an individual reduces use in terms of frequency or quantity or discontinues benzo use abruptly. Withdrawal symptoms include hypersensitivity, increased anxiety levels, insomnia, and headaches. To avoid unpleasant withdrawal symptoms, it is advisable to reduce doses gradually. However, the best way to navigate benzodiazepine withdrawal is by seeking professional treatment.
- Overdose – An overdose is likely to occur when benzodiazepines are used without a prescription, when users with prescriptions accidentally use too much, or when benzos are used in ways that differ from their prescribed use. Below is a guide on everything you need to know on benzodiazepine overdose, the signs, how to react, prevention, as well as treatment options for benzo overdoses.
Effects and Symptoms of a Benzo Overdose
During a benzodiazepine overdose, the drugs slow down the central nervous system functions, like breathing, to dangerous levels. Primary signs of benzo overdose include:
- Excessive sedation, making it increasingly difficult to wake a person who has overdosed
- Shallow or slow breathing
- Enlarged pupils
- Extreme fatigue
- Mood swings, agitation, confusion, and anxiety
- Lack of physical coordination and strength
- Blurred vision
- Slurred speech
- Depressed reflexes
- A weak or fast pulse
About 1% of benzo overdose patients exhibit a paradoxical reaction to the overdose, demonstrating the opposite of the drug’s expected signs and symptoms, like agitation, talkativeness, or excitement. Additionally, a significant percentage of pediatric patients who overdose on benzos experience loss of balance and uncoordinated movements, making them seem drunk.
It is crucial to understand and recognize these signs to prevent a potentially life-threatening situation and to ensure you reach out for appropriate help in good time. Serious complications may occur following a benzos overdose, for example, cerebral hypoxia, which is the lack of oxygen in the brain that often leads to comas and brain damage. It is also likely for people to experience accidental injuries and physical trauma due to benzo use disorders. Respiratory disorders, like pneumonia, are also common among benzodiazepine overdose patients.
The Risk Factors for Benzo Overdose
Several factors increase an individual’s chances of benzo overdose. Some of the primary factors include a person’s weight and genetics. The method you use to consume the drugs, whether oral or injection, also determines your likelihood to overdose on benzos; other risk factors are discussed below.
Combining Benzos With Other Substances
Benzo overdoses are rarely fatal when the medication is used alone. However, it becomes mostly fatal when combined with other central nervous system depressant substances, such as alcohol and opioids. That is because the benzodiazepine medications enhance the effects of the other substances, leading to intense sedation, breathing difficulties, and even death. For this reason, the FDA requires warnings to be included on the boxes of benzos, opioids, and cough medicines.
Age also influences one’s chances of experiencing an overdose. That is because, with age, the body’s ability to metabolize and eliminate drugs is slowed down. For instance, older adults using benzos alongside other prescription medicines like opioid painkillers and tricyclic antidepressants are at a higher risk of overdosing. The common effects can be confusion, memory loss, and sedation.
Benzo Tolerance, Addiction or Dependence
People who misuse benzos or use it for recreational purposes are at a higher risk of overdose. This is because they often use excessive amounts of the drug and combine it with other medications to achieve their desired high. Additionally, the longer and more frequently you abuse benzodiazepines, the higher your chances of suffering an overdose.
What to Do in Case of an Overdose
When you notice someone is experiencing some of the signs of an overdose listed above, you should immediately contact emergency services. Dial 911, and provide the emergency service respondent with as much information as possible, including:
- The overdose symptoms you have observed
- The person’s age
- Name of the drug used
- Amount taken and time they took it
- If possible, where they got the drug
While you wait for the emergency response team, try to chat up the person if they are still conscious. Also, prevent them from taking any more drugs or alcohol while you wait for help. If they are unconscious, lay them on their side to prevent and protect them from the adverse effects of choking on their own vomit. However, avoid inducing vomiting as a way of removing toxins from the stomach.
The emergency team will take the patient to the hospital, where they get medication to counter the overdose’s effects. Flumazenil is the most common benzodiazepine agonist. It binds to the same receptors as benzodiazepines to reverse their effects in the brain partially. However, the administration of this drug should be left to the doctors as it only mitigates the effects of the benzos and does not entirely stop the overdose reaction. Flumazenil is preferable at the beginning of treatment as it works within the first 10 minutes after administration. However, additional medical treatment is required to stop the overdose all together.
Doctors may induce vomiting by pumping the stomach to remove the remaining benzodiazepines. The patients are also provided with the necessary respiratory support to stabilize their breathing and heart rate. Intravenous fluids are also administered to boost hydration and stabilize a patient’s blood sugar levels, thus, preventing seizures and heart attacks. After an overdose, the recovery times vary, depending on the extent or degree of the overdose and the promptness of treatment.
Treatment Options for Benzodiazepine Overdose and Addiction
Although benzodiazepine overdose is life-threatening and has many severe effects, with the right help and care, people can recover fully and move on with their lives as normally as they did before. To overcome benzodiazepine addiction, the first step should be connecting with a reputable addiction recovery center to provide you with the support and resource you will need. Granite Recovery Centers offers different programs, both long-term and short-term, to adults struggling with benzodiazepine and other substance use disorders in New England and beyond. Our programs feature medical detox, sober living, medication-assisted treatment, primary residential treatment, outpatient care, and counseling as well as extended care.
The Process Of Benzodiazepine Addiction Recovery
- Medical Detox
This is usually the first step towards recovery. It can be conducted at detox specialty centers, hospitals, or inpatient drug rehabs. The level of detox care varies, depending on the extent of benzodiazepine use. Acute level detox is emergency detoxification given to benzo overdose patients. On the other hand, non-life-threatening recovery cases receive a sub-acute medical detox.
- Inpatient Drug Rehabilitation
Inpatient or residential treatment centers provide patients with 24-hour care, focusing on several recovery programs. We offer a safe, secure, and beautiful environment that our patients appreciate as encouraging to their recovery efforts. Patients are offered structured and supervised living where they develop and practice life skills, engage in group therapy and community building, as well as practice recovery-oriented recreation, exercise, and study.
- Outpatient Drug Rehab
Outpatient care is more flexible than IDR as it allows patients to live at home, in a sober living facility, or at a facility for extended care. It is appropriate for patients looking for extended care after living in an inpatient care facility. The patients can enjoy all the benefits of rehabilitation either way.
- Extended Care Program
Suitable for patients looking for continued support and structure.
- Co-occurring Disorders in Drug Rehab
Co-occurring disorders occur when patients struggle with substance use, behavioral, and psychological disorders, like in the case of many benzodiazepine addicts and overdose patients. We understand the counter effect this disorder has on recovery; hence, we have clinicians who can help you with this at most of our care facilities.
Help at Granite Recovery Centers
Unlike many other drug rehabilitation facilities, we use a unique approach to help our patients recover. Our 12-step approach is based on clinical research and evidence-based psychotherapy, which gives patients a renewed perspective on recovery. The approach is also holistic, involving therapy and exercise to ensure patients recover fully both physically and emotionally.