People who are abusing CNS depressants like benzodiazepines or are addicted to them can display various physical and behavioral signs and symptoms. [1]

Physical Symptoms of Benzodiazepine Abuse

  • Anxiety and depression
  • Confusion
  • Drowsiness
  • Dizziness
  • Impaired coordination
  • Tremors
  • Slurred speech, stuttering
  • Sleepiness, fatigue, 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 are an effective short-term treatment for many medical conditions. However, anyone who uses benzodiazepines for more than 3–4 weeks is likely to suffer from withdrawal symptoms if the dose is reduced or the use of the drug is stopped abruptly. Withdrawal symptoms and severe cravings also occur in people who have developed physical dependence or addiction to benzodiazepines.

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

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  • 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 rapidly withdraw from benzodiazepines to lower doses and ultimately to abstinence. However, these treatments can be associated with side effects and should only be undertaken in specialized addiction treatment units. Call the hotline for more information.

Benzodiazepine Overdose

Benzodiazepines are relatively safer in that when they are taken at toxic doses without other drugs, they rarely cause significant effects. Patients with a classic single-drug benzodiazepine overdose typically present with central nervous system depression and near-normal vital signs. Some of the typical symptoms of benzodiazepine overdose include: [2]

  • Slurred speech
  • Ataxia (stumbling, falling, incoordination)
  • Altered mental status
  • Slowed breathing (common when benzodiazepines are combined with other CNS depressants)
  • 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 with sedative properties, including 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: November 14, 2022

Is you or your family member suffering from substance use issues? Call (844) 289-0879 for confidential help when you need it most. Lines are open 24/7.

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.

References

References
1 Alcohol and Drug Foundation. Benzodiazepines. Date: January 28, 2020. Available online. https://adf.org.au/drug-facts/benzodiazepines/ Accessed August 10, 2020
2 Kang M, Galuska MA, Ghassemzadeh S. Benzodiazepine Toxicity. [Updated 2020 Jul 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482238/