Benzodiazepines, known colloquially as benzos, are a class of depressants usually prescribed for their calming effects. Along with anxiety relief, they are also prescribed to treat:
They are considered safe to use when patients follow the prescribed instructions. They are sold in pill or capsule form and come in three categories.
You may have heard of widely known brands such as Xanax (short-acting), Ativan (intermediate-acting), and Valium (long-acting). All of these require a prescription and are Schedule IV controlled substances.
Benzodiazepines affect a group of cells called inhibitory interneurons, according to the National Institutes of Health (NIH). These cells ensure that excessive dopamine levels are not produced. Dopamine is a hormone that causes people to feel good.
Because benzos get in the way of how these cells work, the brain ends up producing more dopamine. Drugs and medication that cause addiction can even change the brain as it gets used to working with these spikes in dopamine.
Any addiction can become difficult to address once the brain has gotten used to the drugs that caused it. This is because the presence of drugs affects the basal ganglia — the part of the brain that drives us to feel positive emotions, such as feeling happy after exercise, sex, eating, or engaging in social activities. This is often referred to as the brain’s reward system or reward circuit.
The brain’s reward system also plays a role in how one forms habits and gets used to routines. It becomes overly excited when drugs are consumed, and this makes it hard to feel good unless you are taking the drug.
Drugs, in general, affect the extended amygdala. This part of the brain that experiences stress, anxiety, and discomfort. As a drug is consumed, this part of the brain becomes more sensitive with repeated use. It is the part of the brain that is most sensitive to withdrawal. People usually seek drugs again to dissipate these feelings and feel comfortable again.
Repeated drug use also affects the prefrontal cortex. This part of the brain lets you make plans, think about the future, make decisions, and exercise discipline. Changes in the basal ganglia and extended amygdala because of continued drug use influence the prefrontal cortex. People who continuously take drugs have a reduced ability to control impulses because of the prolonged effects.
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Scientist Leo Sternbach discovered benzodiazepines, which became available to the public in 1957. According to the Center for Substance Abuse Research (CESAR) at the University of Maryland, benzos work by stimulating a neurotransmitter called gamma-Aminobutyric acid (GABA). GABA can stop the activity of other neurons or slow it down.
Benzodiazepines can improve the effectiveness of GABA, which causes the body’s central nervous system to slow its pulses. Two receptors in the body respond to benzodiazepines. The first reduces the effects of anxiety, and the second calms you down.
Most benzodiazepines work the same on everyone, but the dosage provided can affect how fast they are absorbed into your blood. Short-acting benzos are meant to exit the body more quickly. Intermediate-acting benzodiazepines stay in the body longer. Long-acting prescriptions stay in the body the longest, and some collect in your blood so they can do their job effectively.
RISKS AND SIDE EFFECTS
People who use benzodiazepines for longer periods run the risk of developing tolerance. This does not mean a person will become addicted or dependent, but it does increase the chances of this happening. According to the National Institutes of Health (NIH), benzodiazepines can be as easy to misuse as opioids and cannabis.
Because benzos are depressants, they may also make you more tolerant of other depressants such as alcohol. This is known as cross-tolerance. Taking benzodiazepines could also cause various short-term side effects such as:
In the long-term, benzos can cause different side effects. Among them are:
Teenagers and young adults who use benzodiazepines and other drugs are more vulnerable to changes in their brain. According to the U.S. Drug Enforcement Administration, this is because their brain is growing at a very fast pace at this age. The prefrontal cortex grows until a person is in their early 20s. This means the part of the brain that assists with making decisions changes along with their drug use.
To top it off, teenagers’ brains are wired to make questionable decisions from time to time even without drugs, according to a paper published by the University of Minnesota Medical School.
A teen’s brain starts changing at around ages 11 or 12. This puts teens in a more difficult position because their brain will react to drugs by rewarding them for continuing to use them. As a result, they are set up for addiction as they continue to grow.
Although more research is needed about how benzos can affect their brain, there is research on what alcohol can do. Alcohol is also a depressant and known to affect the way a teen’s brain develops.
If alcohol is used at high doses for a long time, the brain will struggle to work as it should.
Using alcohol while young can also lead to dependence as the teen becomes an adult.
According to the National Institute on Drug Abuse, while many teenagers experiment with drugs, some are unable to stop their use. If you suspect your teenager is abusing benzodiazepines, it’s important to step in and help.
You can help a teenager or young adult who is misusing benzodiazepines by:
Teenagers and young adults depend on their family for assistance. They may require gentle pressure from their family to enter treatment, but ultimately, the decision is up to their parents if they are younger than 18 years old. Talking to a professional will help you find effective ways to talk to your teen about getting help.
Teens require a different treatment setting than adults. Choose a treatment center that caters to this age group. It will address issues that are specific to this demographic in therapy and group meetings.
Ultimately, with evidence-based treatment, your teenager can leave benzodiazepine abuse in the past. It’s important to act promptly, as cycles of drug abuse can quickly spiral into serious cases of addiction.
(October 2013) Benzodiazepines. University of Maryland. Retrieved December 2018 from http://www.cesar.umd.edu/cesar/drugs/benzos.asp
(April 2012) Well-Known Mechanism Underlies Benzodiazepines’ Addictive Properties. National Institutes of Health. Retrieved December 2018 from https://archives.drugabuse.gov/news-events/nida-notes/2012/04/well-known-mechanism-underlies-benzodiazepines-addictive-properties
(November 2010) Brain Damage from Benzodiazepines: The Troubling Facts, Risks, and History of Minor Tranquilizers. Psychology Today. Retrieved December 2018 from https://www.psychologytoday.com/us/blog/side-effects/201011/brain-damage-benzodiazepines-the-troubling-facts-risks-and-history-minor
(July 2016) Weekly Dose: Valium, the ‘safer choice’ that led to dependence and addiction. The Conversation. Retrieved December 2018 from https://theconversation.com/weekly-dose-valium-the-safer-choice-that-led-to-dependence-and-addiction-59824
Risks associated with benzodiazepines. Drug and Alcohol Services of South Australia. Retrieved December 2018 from https://www.sahealth.sa.gov.au/wps/wcm/connect/7592c9004f50b005aba6ef330cda8a00/Risks+associated+with+benzodiazepines+%2800506%29+2017.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-7592c9004f50b005aba6ef330cda8a00-meDa2Qr
(July 2018) Benzodiazepines for the Treatment of Anxiety. Verywell Mind. Retrieved December 2018 from https://www.verywellmind.com/benzodiazepines-for-the-treatment-of-anxiety-2584334
(December 2018) Benzodiazepines: Schedule IV Controlled Substances. Verywell Mind. Retrieved December 2018 from https://www.verywellmind.com/why-are-benzodiazepines-controlled-substances-2584333
(July 2018) Drugs, Brains, and Behavior: The Science of Addiction. National Institutes of Health. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain
(July 2012) Adolescent Brain Development and Drugs. Department of Psychiatry, University of Minnesota Medical School. Retrieved December 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3399589/
(September 2018) How Drugs Alter Brain Development and Affect Teens. Get Smart About Drugs: A DEA Resources for Parents, Educators, and Caregivers. Retrieved December 2018 from https://www.getsmartaboutdrugs.gov/consequences/how-drugs-alter-brain-development-and-affect-teens
(March 2018) This is Your Body on Xanax. VICE. Retrieved December 2018 from https://www.vice.com/en_us/article/9kzx8z/this-is-your-body-on-xanax
(February 2010) Valium ‘works like heroin.’ The Telegraph. Retrieved December from https://www.telegraph.co.uk/news/health/news/7204693/Valium-works-like-heroin.html
(January 2016) What to Do if Your Teen or Young Adult Has a Problem with Drugs. National Institute on Drug Abuse. Retrieved December 2018 from https://www.drugabuse.gov/related-topics/treatment/what-to-do-if-your-teen-or-young-adult-has-problem-drugs