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:
- Muscle spasms
- Severe anxiety
- Panic attacks
- Drug or alcohol withdrawal
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.
- Short-acting, such as temazepam, oxazepam, and alprazolam
- Intermediate-acting, such as clonazepam, flunitrazepam, and nitrazepam
- Long-acting, such as diazepam
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.
How Benzos Affect the Brain
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.
How Benzodiazepines Work
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 them 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:
- Slurred speech
- Mood swings
In the long term, benzos can cause different side effects. Among them are:
- Weakness in the muscles
- Cognitive issues
- Memory impairments
Benzos and the Developing Brain
Teenagers and young adults who use benzodiazepines and other drugs are more vulnerable to changes in their brains. 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 brains 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.
What To Do if a Teenager Is Abusing Benzos
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. Benzodiazepine use is common among adolescents. Among young people ages 12-17. 1.5% (381,000) misused prescription benzodiazepines in the past year in 2019, according to the 2019 National Survey on Drug Use and Health (NSDUH). Percentages for benzo use among adolescents remained stable during the four-year period between 2015 and 2019.
Teenagers who abuse drugs and alcohol may be struggling with a mental health disorder, such as anxiety, depression, or post-traumatic stress. If they are abusing substances, such as benzos, for these reasons, then they will need adolescent benzo addiction treatment that addresses their substance use disorder and their mental health disorder, too.
You may be wondering if there are any signs to look for that would alert you to teen benzo abuse and what benzodiazepines do to the developing brain. Since benzos, such as Xanax, Ativan, and Klonopin, share similar characteristics with alcohol, you may notice the following in your adolescent, which is similar to the symptoms mentioned earlier:
- Lowered or loss of coordination
- Slurred speech
- Confusion or an inability to think clearly
- Memory loss
Your teen may become increasingly self-isolated, neglect their physical appearance, and struggle in school. If you notice a decline in their academic performance, this could be a sign of teen depressant benzo abuse. It could also be a sign of them abusing any kind of substance. It could even be possible that they are abusing more than one drug at the same time. Polydrug use is common among recreational drug users.
Benzos and Alcohol Share Common Effects
The National Institute on Drug Abuse (NIDA) goes into greater detail about how alcohol affects the teenage brain. While it doesn’t specifically address benzo use among teenagers, how alcohol affects the teenage brain gives clues to the effects of Xanax and other benzos can have on the teenage brain.
Alcohol intoxication causes people to act out in certain ways that could also serve as red flags to benzo abuse. These include failing to recognize unsafe or inappropriate behavior, taking risks that could result in serious injury, engaging in unsafe sexual behavior or violent behavior or struggling to make sound decisions. If you notice any of these and you suspect benzo misuse or abuse, seek professional help right away.
Some ways you can help a teenager or young adult who is misusing benzodiazepines include:
- Asking for assistance from trained professionals, such as their primary doctor. Professionals can help you determine if your teenager is using drugs, and they can make referrals to treatment if needed.
- Speaking directly to someone who specializes in addiction treatment. Many addiction treatment facilities are dedicated to helping adolescents and teens.
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. They’ll address issues that are specific to this demographic in therapy and group meetings.
Long-term benzo abuse in the teen years could permanently alter the way a person learns and processes information in their lives. It also puts adolescents at risk of developing other substance use disorders in later life. Teen benzodiazepine addiction treatment can take place in an inpatient/residential or outpatient setting, depending on how severe the addiction is. An inpatient setting will likely be recommended for teens who need intense adolescent benzo addiction treatment over a longer period.
Severe teen abuse can take some time to recover from. If an adolescent is in the early or mild stages of benzo abuse, then they may be able to receive therapy and counseling in an intensive outpatient program (IOP) or an outpatient program (OP). The difference between them is that an IOP requires nine or more hours while an OP requires fewer than nine hours.
Professional treatment for teen benzodiazepine abuse can include:
- Professional medical detox to help them make it through benzo withdrawal safely and regain medical stability after chronic benzodiazepine use (at-home detox is strongly discouraged)
- Intensive therapies and counseling that help them address specific challenges they are dealing with
- Family therapy to help the adolescent receive support from the family unit
- Learning the stages of relapse and strategies to avoid relapse
- Life development skills to build self-esteem, confidence, social skills that can help them interact with their peers
- Teen-based support and recovery groups in the 12-step format
- Aftercare programs that promote success in school, finding a job, and other help
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.