Benzodiazepine Addiction and Misuse

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), categorizes benzodiazepine addiction as a “sedative, hypnotic, and anxiolytic use disorder.”1Data from 2020 showed that 1.2 million people aged 12 and older were addicted to prescription tranquilizers or sedatives that year.2 This page will help you understand what you need to know about benzos, including what these pills are, whether you can overdose on benzodiazepines, benzodiazepine withdrawal, and how to find benzodiazepine addiction treatment.
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About Benzodiazepines

What Are Benzodiazepines?

Opioid pill bottles

Benzodiazepines are central nervous system (CNS) depressant medications that are often prescribed to treat anxiety and panic disorders, insomnia, and seizures.3 They work by inhibiting abnormal levels of excitation throughout the CNS.3 Although they are legal prescription medications, they have the potential for dependence and misuse, especially among people who have a history of polysubstance use.4

Benzodiazepines are categorized as Schedule IV substances under the Controlled Substances Act; this means that they have an accepted medical use and a low potential for misuse and a low risk of dependence.4,5 When taken as prescribed and for short periods of time, benzodiazepines are generally safe, but people may misuse them for unintended purposes, such as to get high and experience euphoria, potentiate the effects of others drugs, or stave off withdrawal symptoms from other drug use (e.g., cocaine).3

People can legally obtain benzodiazepines via a prescription from their doctor, but people who misuse them may obtain them by getting prescriptions from multiple doctors, forging prescriptions, or buying diverted pharmaceutical products on the illegal market (which can increase the risk of overdose).4

Most benzodiazepines are available in tablet or capsule form, but some also come as liquids or injectables.4 Common street names include benzos, downers, and tranks.4

Benzodiazepine Uses

The U.S. Drug Enforcement Administration reports that the 5 most commonly prescribed benzodiazepines include alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin), diazepam (Valium), and temazepam (Restoril), and these are also the most frequently found illicit benzos.4

Different benzodiazepines may be prescribed depending on their specific purpose and benzodiazepine uses. This includes, but is not limited to, the following:4

  • Anxiety disorder
  • Panic disorder
  • Seizure disorder management
  • Alcohol withdrawal management
  • Insomnia

Despite many of the benefits of benzos when used as prescribed, they can be addictive. The misuse of benzodiazepines increases the risk of continued problem use and addiction development.4

Are Benzodiazepines Addictive?

Woman with psychosis

Benzodiazepines can be beneficial for specific and legitimate psychiatric or medical purposes when used as prescribed by a professional, but they can be habit-forming and addictive, especially when misused.3,4

Even regular use of benzodiazepines can lead to tolerance and dependence, with the risk increasing with regular use or misuse at higher doses.4,7 However, even when taken as prescribed and even if only used for a few weeks, people can develop dependence.7 Tolerance and dependence are not the same thing as addiction, but they increase the risk of developing a sedative, hypnotic, or anxiolytic use disorder.1

Side Effects

Effects of Benzos

Man in withdrawal

Both use and misuse of benzodiazepines can result in a number of short-term effects and long-term risks. Some of these effects may be perceived as desirable, while others can be unpleasant and uncomfortable or are associated with health risks, as well as potentially dangerous.

Short-Term Effects of Benzodiazepines

The short-term effects of benzodiazepines can include:

  • Diminished anxiety.3
  • Drowsiness.6
  • Euphoria.4
  • Confusion.6
  • Headache.6
  • Depression.4
  • Hallucinations.4
  • Nausea or vomiting.6
  • Diarrhea.6
  • Tremors.6
  • Lack of coordination.4
  • Paranoia.4
  • Syncope (passing out).6

Risks of Long-Term Benzodiazepine Use

Benzodiazepines are generally intended for short-term use.7 Long-term use may be defined as use lasting for more than 8-12 weeks.7 When used regularly over long periods of time, benzodiazepines are associated with both tolerance and dependence.

Tolerance occurs when a person needs to increase their doses of benzodiazepines to achieve the desirable effects.4 Dependence, refers to experiencing withdrawal symptoms when the use of a substance like benzodiazepines suddenly stops.4 It’s important to note that some people can develop dependence to benzodiazepines in as little as a few weeks of use.7

All effects of benzodiazepine abuse can vary based on the amount that is consumed and the frequency of use.

Benzodiazepine Overdose

Can You Overdose on Benzodiazepines?

Yes, you can overdose on benzodiazepines, but when they are the only substance used, overdoses are rare and typically not fatal. Most overdoses occur among people who use benzos along with other substances, especially opioids or alcohol.8 Additionally, people who misuse benzodiazepines in combination with other drugs typically take much higher doses of benzos than those who misuse benzos alone, which increases the risk of overdose.8

Mixing Benzos with Other Drugs

Benzos tend to be the secondary substance of misuse for many people; the most common primary substances of misuse for people who misuse benzos are reported to be alcohol and opioids, with one study reporting rates of concurrent opioid use (54.2%) and alcohol use (24.5%).8 Additionally, the same study reports that 1 in 5 people who misuse benzos also misuse alcohol.8

Combining CNS depressants like alcohol or other substances like opioids with benzodiazepines is a dangerous practice that can increase the risk of overdose and fatal outcomes.9

Fatal overdoses involving benzos together with opioids have been on the rise; the Centers for Disease Control and Prevention reports that more than 90% of  all prescription and illicit benzodiazepine-involved overdose deaths also involved either prescription or illicitly manufactured opioids.10 The dangers of using benzos and opioids include increased risks of sedation and suppressed breathing, therefore combining these substances can substantially increase a person’s risk of brain damage, overdose, and death.9,10

The same applies to combining benzos and alcohol – if you use these substances together, you can also have an increased risk of brain damage, overdose, and death.9

The signs of benzo overdose include signs of extreme sedation, such as:10

  • Slurred speech.
  • Confusion and impaired mental status.
  • Coma and respiratory depression (when used in large doses).

When benzos are combined with opioids or with alcohol or other CNS depressants, overdose symptoms can include:9

  • Slow, shallow, or stopped breathing.
  • Weak pulse/heart rate.
  • Extreme sedation or loss of consciousness.

An overdose is a medical emergency. If you suspect that someone has overdosed, you should contact 911 right away; do not leave the person alone until medical personnel arrive. If you suspect opioid involvement, you should also administer naloxone if you are able to do so.9


Benzodiazepine Withdrawal

Withdrawal symptoms from benzodiazepines can be mild to severe , some of which can be painful and potentially life-threatening. According to the DSM-5, withdrawal symptoms can include:1

  • Autonomic hyperactivity, such as sweating or pulse rate greater than 100 bpm.
  • Hand tremor.
  • Insomnia.
  • Nausea or vomiting.
  • Transient visual, tactile, or auditory hallucinations or illusions.
  • Psychomotor agitation, such as restlessness and uncontrollable movements.
  • Anxiety.
  • Grand mal seizures.

Undergoing detox from benzos in a professional facility where a person can be medically supervised is advised by the Substance Abuse and Mental Health Services Administration due to safety concerns and the risk of needless suffering.11 You should therefore not attempt to detox on your own at home without first talking to a doctor.

Benzodiazepines are generally tapered under a professional’s guidance or with supervision at a medical detox center, as people who are withdrawing from benzos can develop life-threatening delirium and other dangerous symptoms.1,11


Benzodiazepine Addiction Treatment

Our drug rehabs in New England, which treats benzodiazepine misuse and addiction, can include a combination of medication and therapy, such as cognitive-behavioral therapy.12 Generally speaking, medication in the case of benzo withdrawal and addiction treatment typically means tapering off your current benzo or replacing it with a longer-acting one (depending on the half-life of the benzo you use) over a period of several weeks or months.11,12

Rehab can involve different levels of addiction treatment, such as inpatient or outpatient care, depending on your individual needs and recovery goals. AdCare provides comprehensive levels of service to help people overcome active benzo addiction and regain control of their lives.

If you’re ready to start the recovery process, please call our free, confidential helpline at any time of day or night to speak with one of our admissions navigators to gather more information about your addiction treatment options. You can also learn more about rehab admissions, does insurance cover rehab, rehab payment options, and easily verify your insurance online by filling out our We are here to answer all of your questions. Call us right now.

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