Benzodiazepines is an umbrella term for a family of prescription nervous system depressants that have a calming effect. The most commonly prescribed benzos are Alprazolam (Xanax), Lorazepam (Ativan), Clonazepam (Paxam), and Diazepam (Valium). Benzos are most commonly prescribed for anxiety, panic disorders, and insomnia.
Taking prescription medication that hasn’t been issued to you by a doctor is never a good idea because the dose rate might not be right for your body and you don’t know whether the medication will play nicely with your personal physiology. We recommend you defs don’t do this.
If you feel like you want to try benzos for mental health reasons (and let’s face it, the world is a screaming dumpster fire so no judgement if you’re feeling a bit wobbly), have a chat with your GP first to make sure this family of sedative-type medications is ok for you to take.
Being careful with benzos
Some folk keep benzos on hand when they take other drugs in case things go sideways and they start having a bad time, or they want to take the edge off a particularly brutal comedown. Because benzos are designed to relieve anxiety, they can take the edge off an overwhelming experience and can make things less horrible.
Like we said earlier, taking someone else’s prescription medication is not a good idea and we definitely recommend you don’t do that. But if you do, here are some things to keep in mind:
- Avoid mixing benzos with other depressants like alcohol, GHB/GBL, weed, and opiates.
These can cause difficulty in breathing, which is not great if you have a pre-existing condition like asthma or sleep apnea. The extreme end of this is death due to total cessation of breathing. Mixing benzos with other depressants also runs a higher risk of overdose than taking either substance by themselves.
- Moderate your supply – only carry what you intend to take.
Benzos have a high redose compulsion, so you can accidentally get into high-dose territory super quick. You can build a tolerance to benzos quickly, so it’s possible to work up a habit in a short amount of time. Also, coming off benzos can be a long and potentially dangerous process, and really Not Fun. Avoiding dependence by only carrying what you intend to take is a good idea.
- Have a sober friend on hand
Benzos have a risk of making you pass out. They’re depressants, so you’ll get sleepy, especially if you ignore point 1 and mix them with other things. Having someone you trust to look after you if you do wind up in a vulnerable position means that you’re more likely to wind up in the recovery position if you vomit while unconscious rather than in the morgue.
Also it’s good to have someone on hand to make sure your right to consent is respected while you’re passed out. Remember, if it’s not a ‘fuck yes’ it’s a ‘fuck no’, and unconscious people can’t say yes.
What does it feel like?
Benzos have a sedative and a muscle relaxant effect, which can feel very positive for people if anxiety and stress are a regular Thing in their lives. Each benzo has its own dose potency.
|Name||Low dose||Common dose||High dose||Dangerous dose|
|Lorazepam||0.25 – 0.5mg||0.5 – 1.5mg||1.5 – 2mg||2mg +|
|Diazepam||2 – 5mg||5 – 15mg||15 – 30mg||30mg +|
|Alprazolam||0.25 – 0.5mg||0.5 – 1.5mg||1.5 – 2mg||2mg +|
Benzos can make you
- Less emotional
- Feel like your thought patterns have slowed down
Benzos can also make you
- Lose control of how you move
- Dehydrated or make you drool excessively
- Dizzy and disoriented
- Have periods of amnesia
- Slur your speech
Find a medic or call an ambulance if you or a friend you’re looking after
- Slows or stops breathing
- Passes out
- Starts vomiting
Benzo withdrawal syndrome — Negative stars. Do not recommend.
If you have been taking benzos either therapeutically or recreationally for a wee while and find you want to stop, make sure you talk to a doctor that you trust about it FIRST.
If you go cold turkey or accidentally fuck up the taper off rate, you run the risk of benzodiazepine withdrawal syndrome.
According to The Handbook of Clinical Psychology, benzos are more hazardous to withdraw from than opioids because they not only mess with your body and make you feel all kinds of sick and potentially give you seizures, but they mess with your head and your perceptions of reality as well, and can lead to an increased risk of suicide or psychosis.
This is NOT something you want to fuck around and find out with.
Also, there’s no logical timeline to benzo withdrawal syndrome. With other substances the withdrawals are super intense at the beginning, and gradually get less and less horrid as your body gets used to the new normal.
Benzo withdrawals, however, have no rhyme or reason to their intensity levels. If you’re on short-acting benzos the withdrawals can come on after a couple of days. If you’re on long-acting ones, they can take 2-3 weeks to appear.
They also come in waves and there’s no real way to anticipate how you’re going to feel from day to day. They can also last for many months, or even a few years, depending on how you do your tapering off. (Pro tip: cold turkey is a VERY BAD IDEA).
Best case scenario — you feel super weird and have a rough few weeks.
The common symptoms of withdrawal are a resurgence of the symptoms you started taking the benzos for in the first place. These can be at re-emergence level, where the symptoms feel as bad as they did before you started taking them, or at rebound level, where the symptoms feel far worse than they did at the start.
Coupled with the anxiety, insomnia, paranoia, nightmares, and so on, you can also get added features like nausea, vomiting, chest pain, aversion to bright lights, muscle spasms and/or cramping, dizziness, and headaches.
Worst case scenario — you can die (please don’t)
Yeah. Benzo withdrawal in its more acute form is absolutely fucking savage. This tends to be found after what the doctors call ‘rapid discontinuation’, or cold turkey. You suddenly stop taking the substance and your body has a massive freak out.
Symptoms at this end of the withdrawal spectrum are
- Catatonia, which can result in death because it stops you eating and drinking.
- Seizures, which can also result in death from injuries sustained in falling, stopping breathing, or suffocating from choking on your tongue
- Suicidal ideation
- Delerium tremens (DTs)
- Coma (super rare, but still enough of a risk to not want to roll the dice on)
Read an article on benzodiazepine withdrawal presentations in the ED on Emergency Medicine News
Read up on benzo withdrawal syndrome on PubMed
The benzodiazepine withdrawal syndrome by Petursson
A fatal case of benzodiazepine withdrawal by Lann and Molina
Like we said, benzodiazepine withdrawal is brutal, so definitely talk to your doctor about the best way to come off them for your situation. The world is a much nicer place with you in it.
Mother’s little helper
Diazepam was first synthesized in 1959 and marketed in the US as Valium in 1963. By 1968 it was America’s most-prescribed medication, reaching its peak in 1978 with 2.5 billion pills being sold in the US that year.
Mostly marketed to women with anxiety, benzos, particularly Valium, became synonymous with 1960s housewives having to deal with what we now recognise as an excessive amount of societal bullshit and very few life choices.
By the mid 1960s benzos’ potential for habit-forming was raising red flags. The number of people negatively affected by benzos was so widespread by 1966 the Rolling Stones released their song Mother’s Little Helper about the growing number of people addicted to benzos.
In 1975 the Justice Department designated Valium a Schedule IV controlled substance because of its potential for abuse and dependence, limiting refills and imposing sanctions for illegal sales.
Special thanks to Finn and Reece for their help with this post