Benzodiazepines AUSTRALIAN DRUG FOUNDATION
03 HOW DRUGS AFFECT YOU
This pamphlet is part of the “How Drugs Affect You� series. It aims to provide the facts about benzodiazepines for anyone interested in understanding more about the misuse of these drugs. It has been written for the general public, including employees, employers, health professionals and their clients.
Other titles in this series include alcohol, amphetamines, analgesics, caffeine, cannabis, cocaine, drugs and their effects, ecstasy, GHB, hallucinogens, heroin, ice, inhalants, ketamine and tobacco.
03 HOW DRUGS AFFECT YOU
What are benzodiazepines? Benzodiazepines (pronounced ben-zoh-dieaz-a-pins) are depressant drugs. This means that they slow down the activity of the central nervous system and the messages going between the brain and the body.
They do not necessarily make a person feel depressed. Other depressants include alcohol, cannabis and heroin. Benzodiazepines, also known as “minor tranquillisers”, are most commonly prescribed by doctors to relieve stress and anxiety and to help people sleep. Some people use benzodiazepines illegally to become intoxicated or to come down from the effects of stimulants such as amphetamines or cocaine.
Some common chemical and brand names Benzodiazepines are known by their chemical (generic) names and/or their brand/trade names. In each case, these are exactly the same drug, usually made by different companies. Some common benzodiazepines include: diazepam (e.g. Ducene® and Valium®); oxazepam (e.g. Alepam®, Murelax® and Serepax®); nitrazepam (e.g. Alodorm® and Mogadon®); and temazepam (e.g. Euhypnos® and Normison®; alprazolam (Xanax® and Kalma®).
Other names Benzos, tranx, sleepers, downers, pills, serras (Serepax®), moggies (Mogadon®), normies (Normison®), xannie (Xanax®).
What they look like Benzodiazepines usually come in the form of tablets and capsules, in a range of colours and designs. They are generally stamped with their name and milligram quantity.
How are they used? Benzodiazepines are usually swallowed. Some people also inject them; however, this method carries significant risk of harms such as vein damage and scarring; infection including hepatitis B, hepatitis C, HIV/AIDS; and deep vein thrombosis and clots causing loss of limbs, damage to organs, stroke and possibly death.
Benzodiazepines in Australia According to the National Drug Strategy Household Survey1, in 2013:
»» 4.5 per cent of the Australian’s aged 14 years
and over had used tranquillisers/sleeping pills (including benzodiazepines) for non-medical purposes at some stage in their lifetime. »» 1.6 per cent had used them in this way in the previous 12 months.
Effects of benzodiazepines The effects of any drug (including benzodiazepines) vary from person to person. How benzodiazepines affect a person depends on many things including their size, weight and health, also whether the person is used to taking it and whether other drugs are taken around the same time. The effects of any drug also depend on the amount taken.
Immediate effects The effects of benzodiazepines may start to be felt within an hour. The duration of the effects depend on whether the benzodiazepines are short, intermediate or long acting. Low to moderate doses Some of the effects that may be experienced after taking benzodiazepines include: Australian Institute of Health and Welfare (AIHW) 2014 2013 National Drug Strategy Household Survey: Key Findings, Canberra: AIHW.
1
Body » fatigue » increased risk of accidents and falling over (especially for older people)
Mouth » dry mouth » slurred speech or stuttering
Eyes double or blurred vision
Psychological effects » depression » confusion » feelings of isolation » feelings of euphoria
Bowel & bladder » diarrhoea » constipation
Stomach » nausea » loss of appetite
Muscles » impaired motor coordination
Brain » memory loss » impaired thinking » headache » drowsiness and sleepiness » impaired coordination, dizziness and tremors
Low to moderate doses
Higher doses Higher doses of benzodiazepines can result in over-sedation or sleep. They may produce an effect similar to drinking a large amount of alcohol. Other effects can include:
»» jitteriness or excitability
»» mood swings and aggression.
A very high dose of benzodiazepines can cause a person to overdose. The symptoms include:
»» slow, shallow breathing »» unconsciousness »» coma
»» death (more likely when taken with alcohol or depressant drugs such as heroin).
Coming down As the effects of benzodiazepines begin to wear off, a person may experience a range of effects the next day such as:
»» a general hangover effect »» reduced alertness
»» sleepiness »» headache.
Long-term effects Some of the long-term effects of benzodiazepines are: Brain
»» memory loss »» impaired thinking »» lethargy and lack of motivation
»» fatigue »» headaches »» drowsiness, sleepiness and fatigue »» difficulty sleeping or disturbing dreams Stomach »» nausea
Psychological effects »» personality change »» anxiety »» irritability, paranoia and aggression »» depression »» lack of motivation Muscles »» weakness Body »» fatigue »» skin rashes »» weight gain
Tolerance and dependence People who use benzodiazepines regularly can develop dependence and tolerance to them. Tolerance means they need to take larger amounts of benzodiazepines to get the same effect. Dependence on benzodiazepines can be psychological, physical, or both. People who are dependent on benzodiazepines find that using them becomes far more important than other activities in their life. They crave benzodiazepines and find it very difficult to stop using them. People who are psychologically dependent on benzodiazepines may find they feel an urge to use them when they are in specific surroundings or socialising with friends. Physical dependence occurs when a person’s body adapts to benzodiazepines and gets used to functioning with the benzodiazepines present.
Withdrawal Giving up benzodiazepines after using them for a long time is challenging because the body has to get used to functioning without them. Withdrawal symptoms can last from a few weeks to a year. Withdrawal symptoms vary from person to person and are different depending on the type of benzodiazepine being taken. Some of the withdrawal symptoms that may be experienced include:
»» headaches »» dizziness and tremors »» sweating »» nausea, vomiting and »» difficulty sleeping
»» fatigue »» difficulty concentrating »» altered perceptions »» heightening of the senses »» delirium »» delusions and
»» anxiety and irritability »» aching or twitching
»» seizures »» paranoia.
stomach pains
or bizarre dreams
muscles
hallucinations
People who have been using benzodiazepines for more than a month should not suddenly stop taking them, as it is possible to have serious withdrawal symptoms such as seizures. To lessen the severity of withdrawal symptoms, a slow decrease in dose is recommended. Consult your health professional for more information.
Benzodiazepines and driving It is dangerous to drive after using benzodiazepines. The effects of benzodiazepines, such as feeling drowsy and reduced concentration and coordination, can affect driving ability. People with reduced concentration and coordination are unable to respond as quickly when driving, which increases the chance of an accident. The symptoms of withdrawal can also affect a person’s ability to drive safely.
Benzodiazepines and the workplace Under occupational health and safety legislation, all employees have a responsibility to make sure they look after their own and their co-workers’ safety. The effects of benzodiazepines and the symptoms of withdrawal can affect a person’s ability to work safely and effectively.
Pregnancy and breastfeeding In general, using drugs when pregnant can increase the chances of going into labour early. This can mean that babies are born below the normal birth weight. Benzodiazepines cross the placenta and can build up in the unborn child. Babies whose mothers have used benzodiazepines during pregnancy may experience withdrawal. Some of the withdrawal symptoms can include:
»» breathing problems »» irritability »» sleep problems
»» sweating and fever »» feeding difficulties.
If a mother uses benzodiazepines while breastfeeding, the drug may be present in her breast milk. This may have an effect on the health of the baby. Check with your doctor or other health professional if you are taking or planning to take any drugs during pregnancy or while breastfeeding.
Benzodiazepines and other drugs The chances of an overdose are increased if benzodiazepines are taken with other depressant drugs such as alcohol or opiates such as heroin. Taking benzodiazepines with other depressant drugs increases the risk of breathing difficulties and/or overdose. Using benzodiazepines to help with the symptoms of the “comedown” after using stimulants can lead to a cycle of dependence on both drugs.
Benzodiazepines and social problems All areas of a person’s life can be affected by drug use.
»» Disagreements and frustration over drug use can cause family arguments and affect personal relationships.
»» Legal and health problems can also add to the strain on personal, financial and work relationships.
Benzodiazepines and the law Benzodiazepines are restricted drugs in Australia and only a doctor may prescribe them. Using benzodiazepines without a prescription from a doctor, or selling or giving them to someone else, is illegal. There are also laws against forging or altering a prescription or making false representation to obtain benzodiazepines or a prescription for them. Penalties can include fines and/or imprisonment. Some states and territories have programs that refer people with a drug problem to treatment and/or education programs where they can receive help rather than going through the criminal justice system. For more information contact a legal aid service in your state or territory.
Treatment options In Australia, there are many different treatment options for drug problems. Some aim to help a person to stop using a drug, while others aim to reduce the risks and harm related to their drug use. Treatment is more effective if adapted to suit each person’s situation. Some of the different options include individual counselling, group therapy, medication (pharmacotherapy), residential therapy and supervised/home withdrawal.
Preventing and reducing harms Many Australians take at least one psychoactive drug on a regular basis—they might take medication (i.e. over-the-counter or via a prescription), drink alcohol, smoke tobacco or use an illegal drug. All drugs have the potential to cause harm. As use increases, so does the potential for harm.
Australia’s national drug policy is based on harm minimisation. Strategies to minimise harm include encouraging people to avoid using a drug through to helping people to reduce the risk of harm if they do use a drug. It aims to reduce all types of drug-related harm to both the individual and the community.
There is no safe level of drug use Use of any drug always carries some risk—even medications can produce unwanted side effects. It is important to be careful when taking any type of drug.
What to do if you are concerned about someone’s drug use If you are concerned about someone’s drug use, there is confidential help available. Contact the alcohol and drug information service in your state or territory. The telephone numbers are listed on the back of this pamphlet. There are many ways to deal with stress and anxiety without using benzodiazepines. Relaxation, stress management, counselling, a healthy diet and plenty of exercise all help. Talk to your doctor or contact your local community health service to find alternative ways of dealing with stress and anxiety.
What to do in a crisis If someone overdoses or has an adverse reaction while using benzodiazepines, it is very important that they receive professional help as soon as possible. A quick response can save their life.
»» Dial triple zero (000) to call an ambulance.
Ambulance officers are not obliged to involve the police.
»» Stay with the person until the ambulance arrives.
Find out if anyone at the scene knows cardiopulmonary resuscitation (CPR). »» Ensure that the person has adequate air by keeping crowds back and opening windows. Loosen tight clothing. »» If the person is unconscious, don’t leave them on their back—they could choke. Turn them on their side and into the recovery position. Gently tilt their head back so their tongue does not block the airway. »» If breathing has stopped, apply CPR.
Benzodiazepines
For information, counselling or other assistance, contact the alcohol and other drug service in your state or territory. AUSTRALIAN DRUG FOUNDATION
ACT (02) 6207 9977
Tas. 1800 811 994
NSW (02) 9361 8000 (Sydney) 1800 422 599 (NSW)
Vic. 1300 85 85 84 (information)
NT 1800 131 350
QLD 1800 177 833 SA
1300 131 340
1800 888 236 (counselling)
WA (08) 9442 5000 (Perth) 1800 198 024 (WA)
Produced by the Australian Drug Foundation Š 2014. Celebrating more than 50 years of service to the community, the Australian Drug Foundation is Australia’s leading body committed to preventing alcohol and other drug problems in communities around the nation. www.adf.org.au For further copies of this pamphlet: Post: PO Box 818, North Melbourne, Vic 3051 Street: Level 12, 607 Bourke Street, Melbourne Vic Email: druginfo@adf.org.au Web: www.shop.adf.org.au
03 HOW DRUGS AFFECT YOU