- Signs Of A Benzodiazepine Overdose
- Sings Of A Benzodiazepine Overdose
- What Are Benzodiazepines?
- How Benzodiazepines Interact With The Body
- Benzodiazepine Tolerance, Dependence And Withdrawal
- What To Do About Benzodiazepine Overdose
- Treatment For Benzodiazepine Overdose And Addiction
- Benzodiazepine Overdose (OD): Signs, Symptoms & Treatment
- Benzo Toxicity/Overdose Symptoms
- Benzo Reversal Drug
- Administering Flumazenil
- Benzodiazepine Overdose Treatment
- Common Overdose Risk Factors
- Next Steps & Follow-up
- Suicidal Intentions
- Relapse & Tolerance Considerations
Signs Of A Benzodiazepine Overdose
When taken as directed, it is rare for benzodiazepine use to result in fatal overdose. However, when someone takes too large a dose, or mixes it with another substance the risk for overdose increases.
Sings Of A Benzodiazepine Overdose
Some signs of benzodiazepine overdose include:
- blurred vision
- slurred speech
- unresponsiveness or weakness
- difficulty breathing
- blue in the fingernails or lips
- uncoordinated movement
- altered mental status
High doses of benzodiazepines can cause extreme drowsiness. In addition to the above symptoms, it is also possible to experience slowed reflexes, mood swings, hostile or erratic behavior, and euphoria.
Symptoms of overdose will vary from person to person, depending on several different factors. These factors include:
- the amount of benzodiazepines consumed
- if it was mixed with another substance
- how long benzodiazepines have been abused
- if a co-occuring disorder is present
- what method of abuse (injection, oral, etc.) was used
Although it is rare, some individuals may experience serious complications following a benzodiazepine overdose, as a result of respiratory distress, lack of oxygen in the blood, or unintentional injury that occured while they were under the influence of benzodiazepines. These complications can include, pneumonia, damage to the body and brain, and death.
What Are Benzodiazepines?
According to the Center for Substance Abuse Research, benzodiazepines are some of the most prescribed depressant medications in the U.S. There are more than 15 different types of benzodiazepine medications that treat a variety of psychological and physical conditions.
Commonly prescribed benzodiazepines include:
- Xanax (alprazolam)
- Librium (chlorodiazepam)
- Valium (diazepam)
- Ativan (lorazepam)
A Substance Abuse and Mental Health Services Administration (SAMHSA) study discovered that, due to their widespread availability, benzodiazepines are the most frequently misused pharmaceuticals in the U.S. The study also found that the number of emergency room visits due to benzodiazepines increased by 36 percent between 2004 and 2006.
Effects caused by benzodiazepines include anxiety relief, hypnotic effects, muscle relaxant, anti-convulsant, and amnesiatic (mild memory-loss inducer). Due to their sedative properties, benzodiazepines have a high potential for abuse, particularly when used with other depressants alcohol or opiates.
There are two categories of benzodiazepines; short-acting and long-acting. A short-acting benzodiazepine is processed at a faster rate than long-acting benzodiazepines which accumulate in the bloodstream, and can take a longer time to leave the body.
How Benzodiazepines Interact With The Body
Benzodiazepines affect the levels of a key neurotransmitter (chemical) within the brain known as the gamma-aminobutyric acid (GABA). When the presence of this chemical increases during benzodiazepine use, it slows nerve impulses throughout the body.
The human nervous system has two types of benzodiazepine receptors. One that causes anti-anxiety effect, and one that produces the sedative effect. Even though most benzodiazepines trigger the same physical effects, their dosage and blood absorption rates can vary, the Center for Substance Abuse Research reports.
Benzodiazepine Tolerance, Dependence And Withdrawal
Over time, it is ly that tolerance to benzodiazepines will occur. Tolerance happens when a person no longer experiences the same effects when taking the same amount of the drug. It is also possible for benzodiazepines to become less effective after four to six months of daily use, according to a report released on American Family Physician.
Individuals usually become tolerant to the milder effects of the drug sedation and lack of motor coordination. The Center for Substance Abuse Research notes that a fair amount of cross-tolerance exists between benzodiazepines and other depressants alcohol and barbiturates. So, as an individual’s tolerance to benzodiazepines builds so will their tolerance to the other substances.
The Treatment Episode Data Set (TEDS) stated 95 percent of all benzodiazepine emergency admissions reported abusing another substance in addition to benzodiazepines. After tolerance is established, physical and psychological dependence begins. Once dependent, someone using benzodiazepines will not be able to function normally without them.
The addictive properties of benzodiazepines are incredibly strong, and tolerance can develop quickly. If someone with a dependence on benzodiazepines suddenly stops using, they will experience physical withdrawal symptoms.
The withdrawal process can be lethal due to the side effects, convulsions, that may occur. Withdrawal symptoms can include sleep disturbance, anxiety, memory problems, hallucinations, seizures and possibly suicide.
What To Do About Benzodiazepine Overdose
If someone is exhibiting signs of a benzodiazepine overdose, contact emergency services immediately. It is important to get medical attention to reduce the lihood of negative consequences and death.
Victims of overdose will be taken to the hospital and treated with the necessary respiratory support, and medications to reverse the effects of the overdose. Flumazenil is a common medication used to treat benzodiazepine overdose in an emergency setting.
Some individuals may face prolonged recovery times depending on the extent of the overdose and how soon they receive treatment.
Treatment For Benzodiazepine Overdose And Addiction
Benzodiazepines are not only dangerous in overdose, but also in withdrawal. People who experience benzodiazepine overdose may find detox programs helpful to come off the drug in a safe manner, by tapering doses and sometimes providing substitution therapy with a long-acting benzodiazepine.
Due to the high risk of polydrug use involved with benzodiazepine abuse, it is important to seek formal treatment because detoxing from multiple drugs can cause unpredictable and lethal side effects. In order to reduce the risk of relapse, it is vital that all addictions are addressed.
If you need more information on the signs of benzodiazepine overdose, contact us today.
Benzodiazepine Overdose (OD): Signs, Symptoms & Treatment
- Do call 911.
- Do give naloxone (Narcan) if you suspect the person has taken an opioid along with the benzo.
- Don’t wait: benzo overdoses can be deadly.
Yes, you can overdose on benzos.
Benzo overdose deaths are unfortunately increasing in prevalence. From 2019 to 2020, benzodiazepine overdose deaths increased 42.9%. This includes a whopping 519.6% increase in illicit benzo overdose deaths and a 21.
8% increase in prescription benzo overdose deaths.
- What’s the lethal dose of benzodiazepines?
A lethal dose of benzodiazepines can vary widely depending on the drug. Many lethal benzo doses have only been studied in animals, making it difficult to predict with certainty what the lethal dose is in humans.
- What drugs are benzos?
Most benzo names end with -zepam. As such, drugs diazepam, lorazepam, and temazepam are all classified as benzos. Exceptions include chlordiazepoxide and illicit benzos whose names typically end in -zolam, etizolam, flualprazolam and flubromazolam.
Benzo Toxicity/Overdose Symptoms
The following symptoms are most ly to occur as a result of a benzo overdose:
- Slurred speech
- Movement problems
- Altered mental state
- Slowed breathing if the benzo has been taken with another substance alcohol or an opioid
Drug overdose can be fatal. If you suspect someone is experiencing an overdose, call 911 immediately. Do NOT be afraid to seek help. If you do not have access to a phone, contact Web Poison Control Services for online assistance.
Benzo Reversal Drug
In limited situations, doctors can use flumazenil to reverse a benzo overdose. This drug is not routinely used due to the risk of seizures and heart rhythm problems. Its use is generally limited to accidental benzo ingestion in children and waking a person after sedation for a medical procedure.
It is important to note that the opioid reversal agent naloxone (Narcan) does not work on benzo overdoses.
Flumazenil is an intravenous drug and can only be given in a health care setting. It is not available for home use.
Benzodiazepine Overdose Treatment
A benzo overdose is a medical emergency that cannot be treated at home. If you think someone is overdosing on a benzo, call 911. Even if the person is taking benzos without a prescription, you will not get in trouble for seeking help and potentially saving a life.
Common Overdose Risk Factors
You may be at a higher risk of a benzo overdose in certain cases:
- Taking an opioid with a benzo: Benzo overdoses with opioid use are so common and dangerous that the FDA has a Black Box Warning about using the substances together.
- Taking a higher dose of your benzo than prescribed: Taking a higher dose than prescribed, or taking your benzo more frequently than prescribed, can increase your risk of overdose.
- Taking an illicit benzo: Certain benzos, including etizolam, flualprazolam and flubromazolam, have not been approved for medical use and have a high overdose risk.
Next Steps & Follow-up
After a person has recovered from a benzo overdose, it is important for them to seek help. This can include screening for intentional benzo overdose as well as medical detox and rehab. Doctors and loved ones need to be on the lookout for additional risks, suicidal ideation and relapse risk.
Benzos can increase a person’s risk of suicide, especially if they have a history of anxiety and take benzos as their only treatment. Many instances of suicide by benzo overdose have occurred, especially in older adults. For these reasons, doctors should closely monitor a person with a history of mental health problems who is on a benzo.
Relapse & Tolerance Considerations
When a person has been taking a benzo for a long time, their body gets used to the dose, leading to tolerance. When a person is tolerant to a drug, they require higher doses to obtain the same effects. When a person stops the drug, their tolerance decreases.
This means that if a person stops taking the benzo and then relapses, a dose they would have previously been able to take without a problem now puts them at risk of overdose. The risk is especially pronounced in those who take relatively high benzo doses and those who use multiple substances.
If you or your loved one are struggling with benzodiazepine abuse or misuse, help is available. The Recovery Village offers benzodiazepine addiction treatment that addresses the root causes of a person’s relationship with benzos and any co-occurring mental health conditions that may have led to their benzo use. Contact us to get started on the path to lifelong recovery.
- Liu, Stephen; O’Donnell, Julie; Gladden, R. Matt; et al. “Trends in Nonfatal and Fatal Overdoses Involving Benzodiazepines — 38 States and the District of Columbia, 2019–2020.” Centers for Disease Control and Prevention, August 27, 2021. Accessed September 30, 2021.
- Kang, Michael; Galuska,Michael A.
; Ghassemzadeh, Sassan. “Benzodiazepine Toxicity.” StatPearls, July 26, 2021. Accessed September 30, 2021.
- Drugs.com. “Flumazenil.” July 15, 2020. Accessed September 30, 2021.
- Drugs.com. “Diazepam.” October 30, 2020. Accessed September 30, 2021.
- Boggs, Jennifer M. et al.
“Association between suicide death and concordance with benzodiazepine treatment guidelines for anxiety and sleep disorders.” General Hospital Psychiatry, January 2020. Accessed September 30, 2021.
- Carlsten, Anders; Waern, Margda; Holmgren, Per; Allebeck, Peter. “The role of benzodiazepines in elderly suicides.
” Scandinavian Journal of Public Health, 2003. Accessed September 30, 2021.
- Medical Disclaimer
The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes.
We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment.
It should not be used in place of the advice of your physician or other qualified healthcare provider.
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