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Benzodiazepines (pronounced ‘ben-zoh-die-AZ-a-peens’) are drugs which slows down messages travelling between the brain and body.
Other depressants include alcohol, cannabis and heroin.
Benzodiazepines can cause a person to overdose, particularly when used with alcohol or other drugs.
They are associated with dependence and withdrawal symptoms, even after a short period of use which is why benzodiazepines are not the first option for pharmacological treatment of insomnia, anxiety or other health concerns.
Some people misuse benzodiazepines to get high or to help with the ‘come down’ effects of stimulants such as amphetamines or cocaine.
Slang names
Benzos, tranx, sleepers, downers, pills, xannies, serras (Serepax®), moggies (Mogadon®), normies (Normison®).
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Types of benzodiazepines
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.
Benzodiazepines are known by their chemical (generic) name or their brand name. In each case the drug is the same – it’s just made by a different company. Some common benzodiazepines are:
Pharmaceutical names
| Generic name | Brand name | Type |
|---|---|---|
| diazepam | Ducene®, Valium® | Long-acting |
| oxazepam | Alepam®, Murelax®, Serepax® | Short-acting |
| nitrazepam | Alodorm®, Mogadon® | Intermediate-acting |
| temazepam | Euhypnos®, Normison® | Short-acting |
| alprazolam | Xanax®, Kalma®, Alprax® | Short-acting |
How are they used?
Benzodiazepines are usually swallowed. Some people also inject them.
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Effects of benzodiazepines
There is no safe level of drug use. The 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:
- depression
- confusion
- feelings of isolation or euphoria
- impaired thinking and memory loss
- headache
- drowsiness, sleepiness and fatigue
- dry mouth
- 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 which can result in 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.
Benzodiazepines are not 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 their use can lead to dependence.8,9 Benzodiazepines taken by elderly people can increase their risk of falls and injury.
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Overdose
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).
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Long-term effects
Regular use of benzodiazepines may cause:3,11
- impaired thinking or memory loss
- anxiety and depression
- irritability, paranoia and aggression
- personality change
- weakness, lethargy and lack of motivation
- drowsiness, sleepiness and fatigue
- difficulty sleeping or disturbing dreams
- headaches
- nausea
- skin rashes and weight gain
- addiction
- withdrawal symptoms (see below).
There is some evidence that long-term, heavy use of benzodiazepines is a risk factor for epilepsy, stroke and brain tumours.
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Using benzodiazepines with other drugs
The effects of taking benzodiazepines with other drugs − including over-the-counter or prescribed medications − can be unpredictable and dangerous, and could cause:
- Benzodiazepines + alcohol or opiates (such as heroin): 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.
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Withdrawal
Giving up benzodiazepines after a long time is challenging because the body has to get used to functioning without them. So it’s important to seek advice from a health professional when planning to stop taking benzodiazepines.
If taking benzodiazepines is suddenly stopped, 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:
- headaches
- aching or twitching muscles
- dizziness and tremors
- nausea, vomiting, stomach pains
- bizarre dreams, difficulty sleeping, fatigue
- poor concentration
- anxiety and irritability
- altered perception, heightening of senses
- delusions, hallucinations and paranoia
- seizures.
Most benzodiazepines are prescribed to help people with insomnia or anxiety. Prescribing for insomnia is most common, especially for older people (over 65 years).
Prescribing for certain anxiety conditions also occurs but alternative medications are more commonly prescribed. Some benzodiazepines can be used to treat health conditions such as epilepsy or for sedation before a procedure or operation.
The most common benzodiazepines prescribed in Australia are temazepam, nitrazepam, diazepam, oxazepam and alprazolam. Other benzodiazepines available are bromazepam, clobazam, clonazepam, flunitrazepam, lorazepam, and triazolam.
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