What are Benzos?

Benzodiazepine (Benzos) is a family of psychoactive drugs. They operate on the nervous system causing a change in mood, cognition, behavior, or perception. The first drug of this type is said to have been discovered by accident in 1955 and was sold by Hoffmann – La Roche i 1963 som medisinering.

Benzos work by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain, inducing sedation, sleepiness, and reducing anxiety. Due to these effects, these drugs have used as a treatment for angst, søvnløshet, agitation, seizures, muscle spasms, Status epilepticus, and Premenstrual syndrome. Benzos are sold under different brand names and come in different types. These drugs are often distinguished by how potent they are and how long they remain effective.

  • Ultrakortspill: Midazolam (Versed), triazolam (Halcion)
  • Korttidsvirkende: Alprazolam (Xanax), lorazepam (Ativan)
  • Langtidsvirkende: Chlordiazepoxide (Librium), diazepam (Valium)

Benzodiazepiner betraktes som tidsplan IV-kontrollerte stoffer.

I følge CSA klassifiseres legemidler som er oppført i Schedule IV som sådan fordi “Misbruk av stoffet eller annet stoff kan føre til begrenset fysisk avhengighet eller psykologisk avhengighet i forhold til stoffene eller andre stoffer i skema III.

In terms of medical use, Benzos are one of the most prescribed medicines in the world. According to IQVIA™, there were 45.0 million alprazolam, 26.4 million lorazepam, 29.2 million clonazepam, 12.6 million diazepams, and 7.0 million temazepam prescriptions dispensed in the U.S.

 

Benzodiazepine drugs abuse

Yet in contrast with its legal status and medical benefits, the drug has shown a high potential for abuse and dependency. The high and the relief that accompanies Benzodiazepines makes the drug subject to recreational use. It is also common as an abused drug due to its popularity. Some people might intentionally abuse it, yet in some cases, a person might take a high dose by mistake. A person who abuses Benzos tries to get prescriptions from several doctors and might even forge ones themselves. Others might steal medicine from other people. In many cases, people obtain their Benzos from illegal sources who smuggle the drugs. In 2017, there were 47,546 alprazolam, 11,430 clonazepam, 4,451 diazepam, 2,315 lorazepam, and 236 temazepam reports from federal, state, and local forensic Laboratories. For 2018, preliminary estimates indicate there were 40,035 alprazolam, 9,900 clonazepam, 3,421 diazepam, 1901 lorazepam og 204 temazepam rapporter fra Federal, statlige og lokale rettsmedisinske laboratorier.

 

What are the effects of Benzos?

Benzodiazepines are seen to be safe as a short-term medication, usually up to 4 weeks, which means that abusing them for longer periods can cause severe side effects. The following are the most common side effekter assosiert med benzodiazepiner:

  • Sedasjon
  • Svimmelhet
  • Svakhet, og
  • Ustabilitet
  • Minne problemer

Andre bivirkninger kan forekomme:

  • Forbigående døsighet som ofte oppleves de første dagene av behandlingen
  • Følelse av depresjon,
  • Tap av orientering
  • Hodepine
  • Sove forstyrrelse
  • Forvirring
  • Irritabilitet
  • Aggresjon
  • Begeistring
  • Hukommelse svekkelse

Benzos antas å ha alvorlige effekter på kognitive funksjoner som å lagre minner. Mens benzodiazepiner kan fungere som en behandling for angst, søvn og uro hos noen pasienter, kan langvarig (dvs. mer enn 2-4 uker) bruk føre til en forverring av selve symptomene medisinene er ment å behandle.

As mentioned above, Benzodiazepines can cause tolerance and dependence over time. As the brain gets used to the effects of Benzos, the effects it creates become mild. To reach the desired effect the person will increase the dose or take it more frequently. Over time, the increase in dosage will lead to dependence on the drug characterized by a  compulsive need to abuse and withdrawal symptoms when the drug is stopped.

The most frequent symptoms of uttak from benzodiazepines are:

  • søvnløshet, 
  • mageproblemer,
  • skjelvinger, opphisselse,
  • frykt,
  • muskelspasmer

 De sjeldnere effektene er irritabilitet,

  • Svette
  • Depersonalisering
  • Derealisering
  • Overfølsomhet overfor stimuli
  • Depresjon
  • Selvmord oppførsel
  • Psykdom
  • Sanfall
  • Delirium skjelver

 

How to do a Benzodiazepine withdrawal and avoid overdose?

For en sikker gjenoppretting fra bruk av benzodiazepiner, anbefales medisinsk tilsyn for å hjelpe den enkelte med en gradvis reduksjon av dosen. Medisiner kan også hjelpe til med å lindre tilbaketrekning fysiske bivirkninger som smerter og uro. Hvis du trenger hjelp med benzodiazepinavhengighet, ta en titt på vår nettsted.

I noen tilfeller kan misbruk av Benzos føre til en overdose, spesielt når det blandes med andre legemidler. I en studere basert på 6.148 tilfeller var det estimert 212.770 (95% CI = 167.163, 258.377) beredskapsbesøk årlig tilskrevet bivirkninger som involverte benzodiazepiner. Mer enn halvparten var besøk som involverte ikke-medisinsk bruk av benzodiazepiner (119,008; 55,9%, 95% CI = 50,0%, 61,9%).

In 2019, 16 percent of overdose deaths involving opioids also involved benzodiazepines. There also reports of self-harm and suicidal tendencies among Benzo abusers. These numbers demonstrate the dangers of Benzos despite their stature. Even when prescribed medically they can still cause complications and lead to dependency. Recent years have seen an increase in illicit use of Benzos as demonstrated by the increased rates of trafficking and smuggling. In the United States, alprazolam is considered to be among the top three prescription medicines that are diverted from the licit market. According to the Drug Enforcement Administration (DEA), there were almost 40,000 alprazolam reports from federal, state, and local forensic laboratories in 2011 and another 18,068 reports between January and June 2012. There have also been several reports of counterfeit medicines or false medicines containing Benzodiazepines. These medicines do not state that they contain these substances in an attempt to trick the customer into buying their product. Recently, in January 2017, the leader of an online pharmacy that illegally distributed tablets containing flubromazolam with the false claim that they contained alprazolam, in addition to illegally distributing various other prescription drugs and narcotic tablets were sentenced to 8 years in prison.

The dangers of medisinering misbruk og avhengighet are constantly on the rise. People are often burdened by mental and psychological issues and are thus prone to abusing any substances that might relieve their pains. Yet these substances can create bigger health issues and may even lead to death.

 

Referanser

Brunton L, Hilal-Dandan R, Knollmann B, Goodman & Gilman's The Pharmacological Basis of Therapeutics. 13. utg. McGraw-Hill, New York, NY2018

https://doi.org/10.15585/mmwr.rr6501e1er

Fraser AD (oktober 1998). “Bruk og misbruk av benzodiazepiner”Terapeutisk legemiddelovervåking20 (5): 481–9. gjør jeg:10.1097/00007691-199810000-00007PMC 2536139PMID 9780123.

Kortere E (2005). “Benzodiazepiner”. En historisk ordbok for psykiatri. Oxford University Press. s. 41–2. ISBN 978-0-19-517668-1.

Lader M (2008). “Effektivitet av benzodiazepiner: fungerer de eller ikke?”. Ekspertanmeldelse av nevroterapeutika (PDF). 8 (8): 1189–91. gjør jeg:10.1586/14737175.8.8.1189PMID 18671662S2CID 45155299.

Rapoport MJ, Lanctôt KL, Streiner DL, Bédard M, Vingilis E, Murray B, Schaffer A, Shulman KI, Herrmann N (Mai 2009). “Bruk og kjøring av benzodiazepin: en metaanalyse”. Journal of Clinical Psychiatry70 (5): 663–73. gjør jeg:10.4088 / JCP.08m04325PMID 19389334.

Longo LP, Johnson B (april 2000). “Avhengighet: Del I. Benzodiazepiner — bivirkninger, misbruksrisiko og alternativer”Amerikansk familielege61 (7): 2121–8. PMID 10779253.