Email sent successfully

Message sent

Your message has been sent to Between the Lines.

Message sent

Your message has been sent to Between the Lines.

Dose, strength and purity

As you vary the dose of benzodiazepines, the immediate effects of the drug will change:

• In low to moderate doses: the immediate effects of low doses include mild impairments in thought processes, memory and coordination, drowsiness, tiredness, dizziness, vertigo and blurred vision. Feelings of euphoria, isolation or emotional depression may also occur.
• In higher doses: they can result in drowsiness, over-sedation and sleep.

Using benzodiazepines with other drugs

• Alcohol - It is very generally dangerous to use benzodiazepines with alcohol or other depressants. When combined they can cause amnesia and decreases the protective upper airway reflexes. This increases the risk of inhaling your own vomit while unconscious.
• Other prescription drugs - The effects of benzodiazepines may be increased when combined with antipsychotic drugs, antidepressant drugs, analgesics (pain relievers) containing codeine, anticonvulsants, antihistamines and oral contraceptives. The effects of benzodiazepines are decreased when combined with appetite suppressers and asthma drugs due to the stimulant effects of these drugs. It will make you feel a lot more drowsy compared to if you had twice the amount of just the one drug. Using sedatives and benzodiazepines may also make you collapse, pass out or die from your brain's control of breathing stopping. Paradoxically, you might enter a high energy state - as if you were much more affected in terms of disinhibition without being as sleepy - and you might be violent or do violent things without having any memory of what you've done.

• Methadone - The combination of benzodiazepines and methadone increases the effects of both drugs and is very dangerous due to the high risks of overdose. Around 30% of methadone users also use benzodiazepines. A large number of people on methadone programs use benzodiazepines on a long-term basis to alleviate symptoms of discomfort. Some users also take benzodiazepines to heighten the effect of methadone. So it is not a surprise that it is common for many methadone users to be dependent on benzodiazepines.

If you are planning to take any illicit substance or alcohol while you are going to be on medication that is about to be prescribed to you, talk with your doctor. Unless they have immediate concerns for your safety it will remain confidential. Each drug is different and interactions can be unpredictable and very dangerous. This is especially so if you’re on any highly specialised drugs (e.g. for heart problems, neurological – brain and nerves – problems, blood thinning medications or drugs for cancer).

Bingeing on benzodiazepines

Bingeing is when large amounts of benzodiazepines are taken. When bingeing there is a strong possibility of overdose and high levels of benzodiazepine’s will remain in the bloodstream the day after a binge. Frequent bingeing exposes the user to high risk levels of drug dependence.

Very high doses of benzodiazepines can cause respiratory depression, unconsciousness or coma. Death rarely occurs from benzodiazepine use only and is more common when combined with alcohol or other drugs.

Overdose - what it looks like and what to do

If using benzodiazepines, make sure you and your friends know what to do in a crisis as it could save a life.

If someone overdoses or has a bad reaction to benzodiazepines, it is very important they receive professional help as soon as possible.

Call an ambulance. Don’t worry about getting into trouble because ambulance officers are not obliged to involve law enforcement.

• Stay with the person till the ambulance arrives. If someone knows CPR, have them with you.
• Ensure the person has adequate air by loosening tight clothing.
• Don’t leave the person on their back, turn them on their side into the recovery position. Tilt their head back so their tongue does not block their airway.
• If the person has stopped breathing, give mouth-to-mouth resuscitation.
• If the person has no pulse, perform CPR.
• Provide ambulance officers with as much information as you can such as what benzodiazepine was taken, how much, when and anything else that was taken. Be sure to mention any pre-existing medical conditions.

Mood, environment and personal factors

Like alcohol, personal factors such as weight, height, sex and general health all influence the way in which a drug may affect you.

Method

Injected: Some people inject benzodiazepines however this practice is dangerous as it bypasses all of the body’s natural defences by putting the drug straight into the bloodstream. It also increases risk of blood-borne viruses (such as HIV and AIDS) and infections from using dirty equipment.

Tolerance and withdrawal

With repeated use of most drugs, the body builds up a tolerance to the drug and more of it is needed to get the same effect. This can happen very quickly when using benzodiazepines.

Withdrawal symptoms can include:

• headaches
• aching or twitching muscles
• tremor
• faintness or dizziness
• sweating
• nausea, vomiting and stomach pains
• bizarre dreams
• inability to sleep properly
• fatigue
• difficulty concentrating
• anxiety and irritability
• altered perception
• heightening of the senses of sight, touch, hearing, smell and taste.

While benzodiazepines may help you to get through tougher periods, they do not solve the initial problem. It is important to understand this and when reducing your dosage, actively work towards resolving the underlying issues. Make regular appointments with your health professional to review your medication, progress and possible alternatives.

Stress and anxiety can be dealt with by alternative methods to benzodiazepines such as relaxation, stress management, counseling, healthy diet and plenty of exercise.

Driving

Using benzodiazepines and driving may cause an increase in the risk of you having an accident. If you are taking a high dose, or have just started using them,you are at an even higher risk of impaired driving and, as a result, having an accident.

This is due to some of the effects of benzodiazepines that may affect driving ability, such as drowsiness and fatigue, blurred vision, lack of muscular coordination, slower reaction time, slower information processing, reduced concentration and impaired judgement.

Pregnancy and breastfeeding

It is always a good idea to talk to your doctor about any drugs you may be taking during your pregnancy and make sure they are not going to harm the baby.

Benzodiazepines cross the placental barrier and can affect the growth of a foetus. This is especially so when the mother is not taking the prescribed dose. High doses during pregnancy can lead to the baby being born with a temporary loss of muscle tone, poor feeding, drowsiness and a low temperature.

Benzodiazepines can be passed from mother to baby through breast milk and may have a sedative effect. As the baby cannot process these drugs quickly they may accumulate in high doses.

This fact sheet was prepared with assistance from the Australian Drug Foundation.