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Benzodiazepines and Co-Occurring Disorders in Recovery

Benzodiazepines are a class of drugs, also referred to as benzos. They are psychoactive drugs used primarily to treat insomnia, anxiety, seizures, and muscle spasms. They work by increasing the effects of gamma-aminobutyric acid or GABA, a neurotransmitter. In doing so, they have sedative, hypnotic, and anticonvulsant effects. Benzodiazepine addiction can develop when the medicines are recreationally used or taken in higher doses or for longer than prescribed. Chronic use contributes to dependence and tolerance as well. Benzo withdrawal symptoms can be severe, including anxiety, tremors, and seizures. In severe cases, benzodiazepine withdrawal can include psychosis. Co-occurring mental health disorders are commonly seen among individuals who struggle with benzodiazepine addiction. In recovery, these disorders must receive proper treatment so that symptoms can be well-managed, reducing the risk of relapse. Benzodiazepines are usually prescribed to manage symptoms of mental health disorders such as anxiety, but misuse can worsen underlying mental health issues, complicating treatment. Comprehensive care that addresses both addiction and co-occurring mental health conditions is needed for an effective recovery.

Benzodiazepine Abuse and Addiction

Abuse and addiction to benzodiazepines have become a major public health concern because of how often they’re prescribed and the high risk of misuse. As medications, benzos are prescribed to treat not only anxiety but also insomnia and sometimes other conditions. Unfortunately, there’s a potential for misuse because they have euphoric and sedative effects. Benzodiazepine misuse can involve taking higher doses than what’s prescribed, using them without a prescription, or combining them with other substances to enhance the effects. When a benzo dependence forms, if the drug is stopped cold turkey or the dosage is reduced, it can lead to withdrawal symptoms. Even when these drugs are taken as prescribed, unfortunately, dependence can develop over the long term. Benzodiazepine addiction includes psychological and physical dependence. Psychological addiction involves drug-seeking behavior, cravings, and compulsive use. Risk factors that increase the likelihood of benzo addiction and dependence can include a history of substance abuse, concurrent use of alcohol, opioids, or other substances, certain personality traits, and mental health disorders.

Signs of a Benzodiazepine Addiction

Benzodiazepine addiction can look different for everyone, depending on individual circumstances, but common signs include:
  • Higher doses are required to get the desired effects, which come along with the development of tolerance.
  • Being preoccupied with getting benzodiazepines, as well as using and recovering from the effects.
  • A loss of control over the use of benzos, even if it causes negative consequences like difficulties at school or work, legal problems, or relationship issues.
  • Neglecting responsibilities because of use.
  • Continued use despite experiencing psychological or physical harm or knowing that the use of benzodiazepines is worsening existing health problems.
  • Withdrawing from hobbies, social activities, or interests that were enjoyed previously to use benzodiazepines instead.
  • Being secretive or deceptive about use, like lying to friends or family or hiding the medications.
  • Experiencing financial problems.
  • Going through physical and cognitive changes like impaired coordination, memory problems, slurred speech, or drowsiness.
Having these signs present doesn’t automatically mean someone is addicted to benzodiazepines because some can occur even if the medicine is being used as prescribed. However, if you feel like you’re struggling to control your use, you should consider professional help or advice because it could indicate a substance use disorder.

Co-Occurring Disorders and Benzodiazepine Addiction

Co-occurring disorders or a dual diagnosis is a reference to the presence of an addiction and one or more psychiatric disorders in a person. Mental health disorders occurring with addiction can include:
  • Depression
  • Anxiety disorders
  • Bipolar disorder
  • Post-traumatic stress disorder (PTSD)
  • Schizophrenia
There’s a complicated and bidirectional relationship between mental health and addiction. Substance abuse can make mental symptoms worse and impact the effectiveness of treatment. Mental health disorders can also raise the risk of substance misuse, as people may self-medicate to try to deal with their symptoms or cope with the distress they are causing. Researchers believe there are underlying biological factors contributing to addiction and the development of a mental disorder. For example, imbalances in brain chemicals or genetic vulnerabilities can leave someone predisposed to both. Psychological factors like trauma, stress, or adverse childhood experiences contribute to both types of disorders. Additionally, the chronic use of benzos can lead to changes in the brain. If a person has a co-occurring mental disorder, they might be especially vulnerable to the reinforcement effect of benzos. That raises the risk of addiction. Social and environmental factors, like peers and family history, contribute to addiction and co-occurring disorders in relationships, too.

Benzodiazepines and Co-Occurring Disorders in Recovery

There’s an interplay between substance use disorders and mental health, as pointed out. Key points as far as this relationship include:
  • Frequently, benzodiazepines are prescribed to manage mental health symptoms. When they’re misused or for a long time, however, they can lead to addiction. That complicates treating both a mental health condition and substance use disorder.
  • It complicates treatment when someone has an addiction and a mental health disorder. For example, benzo withdrawal symptoms like insomnia and anxiety can overlap with mental health symptoms. The overlap makes it hard to differentiate between symptoms related to withdrawal and pre-existing mental health symptoms.
  • When someone has a co-occurring disorder that’s not treated, it increases the risk of relapse. The psychiatric condition has to be addressed to reduce the risk that someone returns to the use of benzos as a self-medication or coping strategy.
Effectively treating a co-occurring benzo addiction with a mental health disorder requires an integrated approach. In an integrated dual-diagnosis treatment approach, both conditions are simultaneously treated. The treatment plan is individualized and could include psychotherapy, medication-assisted therapy, support groups, and lifestyle changes. Long-term recovery planning requires ongoing monitoring and support.

Getting Help for Co-Occurring Conditions

If someone hopes to achieve benzodiazepine addiction recovery, they need to ensure they receive care in a dual-diagnosis setting. Addressing both conditions at the same time is crucial for long-term recovery. At San Diego Detox, we offer carefully tailored, expert-guided treatment for co-occurring conditions. Reach out today to learn more.