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Why Are Benzodiazepines So Addictive?

Many drugs produce habit-forming and compulsive behavior overwhelming brain receptors by mimicking neurotransmitters (like heroin) or attaching themselves to dopamine transporters (such as cocaine). Typically, these chemical interactions produce intense feelings of euphoria and other artificially manipulated feelings of happiness, hallucinations, or overall well-being.

Once the drug wears off though, the body has been depleted of naturally occurring receptors or neurotransmitters. Feelings of anxiety, anger, moodiness, obsessiveness, and depression overtake the person who is no longer using the drug. The party is over, and the pain is real.

Benzos, short for benzodiazepines, such as Xanax, Valium, Ativan, and Klonopin alter brain chemistry in a fundamentally different manner. The difference is fundamental to understanding how benzo addiction works so that it can be treated better.

Medical Uses for Benzos

Benzos are a type of drug commonly referred to as sedatives. They are generally prescribed to alleviate symptoms of mania, resulting from bipolar disorder. Helping control manic symptoms like restlessness, agitation, and insomnia, they are used to control symptoms until mood-stabilizing medications can begin working. Rarely are benzos prescribed for more than two weeks in these scenarios.

Because benzos do such an excellent job at alleviating stress and anxiety, they have been prescribed to treat short-term symptoms of chronic mental and physical health conditions. Long-term use of benzos to manage chronic health conditions such as PTSD (Post-traumatic stress disorder) or COPD (chronic obstructive pulmonary disease) reportedly increases the risk of depression and suicide.

For people in their 60s, 70s, and 80s, benzodiazepines are being overprescribed at alarming rates. Treating anxiety disorders, insomnia, and dementia symptoms, a new review of 25 research studies found that older people were excessively prescribed well beyond what is appropriate for benzo use. Misuse and overuse of benzos result in more frequent falls, memory loss, depressed moods, weakness. For older adults, these alone can be life-threatening moments.

The problem with benzos isn’t that they don’t treat symptoms. They do, but they might treat symptoms of anxiety and stress too well, leading to over-use of medications that have dangerous long-term health complications, resulting in seizures, and even death.

Benzos and the Brain – A Perfect Addiction Storm

Benzos produce pleasurable sensations because, like other drugs, they boost dopamine levels in the brain’s pleasure-reward areas. The brain experiences a strident surge in dopamine by reducing a built-in mechanism to limit dopamine flooding. Benzos affect these inhibitor cells, named “inhibitory interneuron.” As the inhibitory interneurons are compromised, the neurons that produce dopamine go unfettered, releasing dopamine as if the brain is in need of increased levels even though the mind is being overwhelmed by pleasure.

Another way to think of the way benzos affect the brain is an analogy to speed governors in cars. Automobile governors limit the speed a car will go, often kicking in before the vehicle reaches speeds of 100 mph. Once the car hits the speed threshold, the engine automatically slows down bringing the car back to a safe speed before the engine cylinders can start firing again.

What benzos do to dopamine levels is similar to what someone who is driving a car without a governor, and who refuses to take their foot off the gas. The car will continue to gain speed until it crashes, or the engine overheats and blows. The pace is as exhilarating as the dopamine rush is for the person under the influence of benzos.

And just like a car engine that overheats, significant long-term damage occurs from a short, exciting (and dangerous) event. Chronic benzo use has long-lasting impacts on the dopamine regulation systems in the brain. Quickly, the mind begins experiencing larger and larger dopamine surges with each dose of benzo. This phenomenon starts abruptly and produces many of the withdrawal symptoms associated with benzo addiction, including:

  • Increased tension and anxiety
  • Hand tremors
  • Difficulty in concentration
  • Dry vomiting and nausea
  • Muscular pain and stiffness
  • Perceptual changes

If someone uses benzos at high dosage amounts and rates, more severe health complications occur in the withdrawal stage. These include:

  • Seizures
  • Psychotic reactions
  • Death

Withdrawals typically last between 10 – 14 days, with the most common symptom being increased anxiety and paranoia (the same disorders that benzos are prescribed). Sometimes, increased anxiety can last months, depending on the individual, co-occurring disorders, cross addictions, and other factors.

Getting Off Benzos

Because of the heightened risks of seizures and physical pain, it is recommended to detox from benzos under the supervision of medical personnel. Intensive outpatient programs are valuable treatment options that provide experiential therapies and therapeutic modalities to help relearn healthy mechanisms for dealing with stress and anxiety.

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