Benzodiazepines Drugs

What is Benzodiazepines drugs in the USA?

Benzodiazepines drugs, often referred to as “benzos,” are a class of medications commonly prescribed in the USA for various conditions. These medications act as central nervous system (CNS) depressants, influencing the brain’s chemistry in a manner similar to opioids and alcohol. Although effective for short-term use, the effects of benzodiazepines can diminish over time, leading some individuals to increase their dosage beyond the prescribed amount, which poses a risk of developing an addiction. Additionally, some users combine benzodiazepines with other substances to enhance their effects or to counteract the impacts of stimulants like methamphetamine. Such combinations can be extremely hazardous and may result in overdose or death.

Usage and Misuse of Benzodiazepines in the USA

A study conducted  for benzodiazepines (benzos) by Maust et al. in 2019, utilizing data from the National Survey on Drug Use and Health, reported that approximately 30.6 million adults in the USA. use benzodiazepines annually. Among them, 25.3 million use these medications as prescribed, whereas about 5.3 million misuse them. The research indicated that individuals with a history of misuse or dependence on prescription opioids or other central nervous system depressants are at a heightened risk of benzodiazepine misuse. Many individuals without a prescription typically obtain benzodiazepines from friends or family members. The study also highlighted that a significant number of adults aged 50 and older utilize these medications to aid with sleep. It was concluded that the actual rate of benzodiazepine use in the U.S. is higher than previously reported, with around 20% of users engaging in misuse.

Mechanisms of Action

Benzodiazepines function by enhancing the activity of gamma-aminobutyric acid (GABA), the primary inhibitory neurotransmitter in the CNS. This interaction reduces neuronal excitability, thereby producing sedative, anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant effects.

Complications of Long-Term Use

It is recommended that benzodiazepines  in the USA be prescribed at the lowest effective dose and for the shortest duration possible, ideally for severe anxiety or insomnia only, and not for mild anxiety. Healthcare professionals advocate for limiting their use to 2 to 4 weeks to minimize the risks of tolerance and dependency. Prolonged use can lead to dose escalation, most commonly observed after just a few weeks.

While physical dependence, tolerance, and withdrawal symptoms may occur with extended use, it is essential to differentiate this from addiction, which is characterized by continued substance use despite negative consequences. Long-term benzodiazepines (benzos) use may result in significant brain changes, including a down-regulation of GABA neuroreceptors and a reduction in receptor sensitivity in the USA. Furthermore, extended use can often exacerbate issues like anxiety, insomnia, and agitation.

Individuals who have been on benzodiazepines for more than 2 to 4 weeks may face withdrawal symptoms if they discontinue use abruptly, which can be severe in the USA. The American Psychiatric Association indicates that between 40% to 80% of patients experience withdrawal symptoms within 24 hours to several days after cessation. For those with psychological dependence, additional support may be required, including counseling or therapy, and the use of non-addictive anti-anxiety medications like buspirone or certain antidepressants.