Effects of Benzodiazepine Abuse

People who abuse CNS depressants like benzodiazepines or are addicted to them frequently develop a range of physical and behavioral signs and symptoms. ^[1]

Physical Symptoms of Benzodiazepine Abuse

• Anxiety and depression
• Confusion
• Drowsiness
• Dizziness
• Impaired coordination
• Tremors
• Slurred speech, stuttering
• Fatigue and weakness
• Dry mouth
• Double vision, blurred vision
• Poor concentration, memory problems, impaired thinking
• Slowed breathing
• Low blood pressure
• Diarrhea/constipation, nausea, loss of appetite

Behavioral Signs of Benzodiazepine Addiction

• Personality changes
• Mood swings, hostility, aggression
• Lethargy
• Lack of motivation
• Changes in sleeping habits, disturbing dreams
• Poor decision-making

Benzodiazepine Withdrawal

Benzodiazepines can effectively treat several medical conditions, such as anxiety, insomnia, and seizures. They are also used off-label to treat conditions such as tics and bipolar disorder. However, these drugs are habit-forming. They are usually prescribed for short-term treatment. Using benzodiazepines for more than 3–4 weeks can lead to a physical dependence on them. People who develop a benzodiazepine dependence or addiction frequently experience withdrawal symptoms and severe drug cravings if the dose is reduced rapidly or use of the drug is stopped abruptly.

Benzodiazepine withdrawal symptoms include both physical and psychological effects. These symptoms can begin within a few hours of the last dose and tend to be similar to the person’s original symptoms. For example, a person who was prescribed benzodiazepines to relieve anxiety may experience a return of anxiety symptoms. Some of the clinical features of benzodiazepine withdrawal syndrome include:

• Headache
• Sweating
• Palpitations
• Tremor
• Nausea
• Loss of appetite
• Diarrhea
• Muscle pain and stiffness
• Dizziness, lightheadedness, unsteadiness
• Shooting pains in the neck and spine
• Blurred vision, double vision
• Ringing in the ears
• Confusion, disorientation
• Delirium
• Delusions, paranoia, hallucinations
• Seizures
• Poor memory
• Irritability, agitation, restlessness

To prevent or reduce benzodiazepine withdrawal symptoms, it is important to gradually taper the dose of the drug over several weeks rather than stopping it all of a sudden. Medically supervised withdrawal allows people to come off benzos safely and comfortably. Medications, such as flumazenil, can help patients to rapidly withdraw from benzodiazepines by lowering the dose, ultimately leading to abstinence. However, benzo addiction treatments can be associated with serious side effects and should only be undertaken in specialized addiction treatment units. Call the hotline for more information.

Benzodiazepine Overdose

Benzodiazepine overdoses are relatively safer compared to some other drugs. Toxic doses of benzodiazepines (without other drugs) rarely cause significant effects. Patients with a classic case of single-drug benzodiazepine overdose typically present with central nervous system depression and near-normal vital signs. They are often arousable and are able to provide a reliable drug use history. Some of the typical symptoms of benzodiazepine overdose include: ^[2]

• Slurred speech
• Ataxia (stumbling, falling, incoordination)
• Altered mental status
• Slowed breathing (especially when benzodiazepines are used with other CNS depressants such as opioids or alcohol)
• Coma and death (in cases of severe toxicity)

A benzodiazepine overdose can be intentional or unintentional. The risk for overdose greatly increases when these medications are combined with other drugs that also have sedative properties, for example, opioids, barbiturates, and alcohol.

If you suspect someone has overdosed on benzodiazepines, call 911 immediately. Drug overdoses are medical emergencies. Prompt medical attention is necessary to prevent health complications, permanent damage, and death.

Last updated: March 6, 2024

Hailey Shafir, M.Ed., LCMHCS, LCAS, CCS

Hailey Shafir is a licensed addiction specialist and mental health counselor. She graduated from North Carolina State University with a master of education in clinical mental health counseling in 2012, and has developed deep expertise in the areas of mental health, behavioral addictions and substance abuse. She is passionate about using this knowledge to raise awareness, provide clear and accurate information, and to improve the quality of treatment for these disorders.

Hailey is an LCMHCS (license number: S9539) under the North Carolina Board of Mental Health Counselors, and an LCAS (ID: LCAS-21333) and CSS (ID: CCS-20721) under the North Carolina Addictions Specialist Professional Practice Board.