Benzodiazepines

• Benzodiazepines (sometimes called 'benzos') are also referred to as 'minor tranquillisers'.
• Benzodiazepines (pronounced BEN-ZO-DYE-AS-E-PEENS) are produced through a process of chemical synthesis.
• They are depressants and slow the messages going to and from the brain to the body, including physical, mental and emotional responses.
• Benzodiazepines are most often prescribed in tablet or capsule form. They come in a variety of colours and shapes. Whether taken orally or intravenously, the drug is absorbed into the bloodstream and circulates through the body.
• Some benzodiazepines are prescribed by doctors to relieve stress and anxiety and to help people sleep. They are also used to treat epilepsy (sometimes), to relax muscles, to help people withdraw from alcohol, or as an anaesthetic before surgery.

Brands of benzodiazepines

The benzodiazepine group contains more than twenty-four specific drugs. Each of these has a chemical or ‘generic’ name, and each drug is sold under one or more brand names. The different brand names in each group below are exactly the same drug, usually made by a different company:

Street names

Benzos, tranks or sleepers. Rohypnol is sometimes abbreviated to rohies, temazepam to temazzies, serapax to serries.

Effects

The effects of any drug (including benzodiazepines) vary from person to person.

 Short-term use (less than two weeks) of moderate doses of benzodiazepines may have the following effects:

• relaxation
• calmness
• relief from tension and anxiety.
• drowsiness
• tiredness
• lethargy
• dizziness
• blurred or double vision
• slurred speech
• stuttering
• mild impairment of thought processes and memory
• feelings of isolation
• emotional depression.

 The most probable effects of higher doses are:

• drowsiness
• over-sedation
• sleep.

Before the person falls asleep, or if they do not sleep, higher doses may produce an effect similar to alcohol intoxication. Effects could be confused, slurred speech, poor coordination, impaired judgement, difficulty thinking clearly, loss of memory, blurred or double vision and/or dizziness. Mood swings and aggressive outbursts may also occur. The symptoms intensify as the dose increases. Feelings of jitteriness and excitability often become evident as the effects of large doses wear off.

Long-term use of benzodiazepines may cause:

• drowsiness
• lack of motivation
• difficulty thinking clearly
• memory loss
• personality change
• changes in emotional responses
• anxiety
• irritability
• aggression
• difficulty sleeping
• disturbing dreams
• nausea
• headaches
• skin rash
• menstrual problems
• sexual problems
• greater appetite
• weight gain
• increased risk of accidents
• increased risk of falling over (older people).

 Very high doses of benzodiazepines over a long period of time may cause confusion, lack of coordination, depression and slurred speech, and may lead to increased aggressiveness.

Overdose

Very high doses of benzodiazepines can cause unconsciousness or coma. Death rarely occurs from overdose of benzodiazepines alone, but some deaths have occurred when large doses were combined with alcohol or other drugs. Deaths have occurred due to the inhalation of mucus or vomit while the person has been unconscious.

Harm minimisation

• If you are concerned about your dosage, it is best to talk first with the prescribing doctor. Remember, there is no standard dosage suitable for everyone.
• If you are using benzodiazepines, consider whether you really need them. Talk to the doctor and ensure you have medical support through a gradual withdrawal program.
• If you haven’t seen your doctor for a while, make an appointment to have the medication reviewed and to discuss alternatives.
• Try to work out what triggers the desire to use benzodiazepines. Are there certain situations in which your desire to use them is heightened? If so, what can be done to cope with these situations or ‘triggers’? Keeping a diary of use for one week can help you identify these situations.

Pregnancy and breastfeeding

Benzodiazepines taken during pregnancy cross the placental barrier and can affect the growth and development of the baby. Anyone taking a prescription of benzodiazepines should see a doctor before altering their dosage.

Benzodiazepines can produce withdrawal symptoms in newborn babies, which can last for a week or longer. Withdrawal symptoms can include breathing problems, poor body temperature control, poor muscle tone and sucking difficulties.

Benzodiazepines can be passed from mother to baby through breast milk. The baby’s body cannot process these drugs quickly, and they can accumulate in high doses.

Benzodiazepines and the law

In Victoria, benzodiazepines are governed as restricted substances by the Drugs, Poisons and Controlled Substances Act. Only a doctor may prescribe them. Illegal use, possession or supply of benzodiazepines carries a fine and/or imprisonment.

Where to get help

If a person is concerned about their benzodiazepine use, they need to be encouraged to get help from their local Aboriginal Health Service, their doctor or from a drug and alcohol service. Family and friends who are concerned about someone they care about can also get information and support from these places:

• Direct Line; Phone: 1800 888 236
• Family Drug Help; Phone: 1300 660 068
• Youth Substance Abuse Service (YSAS); Phone: 1800 014 446; Website: www.ysas.org.au
  Drug and alcohol services for people aged between 12 and 21 who are experiencing significant problems related to their drug use.
• Alcoholism and Drug Treatment Centre Moreland Hall; Phone: 9386 2876.

This information has been adapted from the How Drugs Affect You: Benzodiazepines pamphlet produced by the Australian Drug Foundation. For copies of this pamphlet phone 1300 85 85 84 or email druginfo@adf.org.au ( Victoria only), or go to our online shop catalogue (review copies are available).