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Benzodiazepines

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Also known as

 

  • Alprazolam: Xanax, xans, bars, green hulks, red devils.
  • Diazepam: Valium, vallies, blues.
  • General: Benzos, zeds, downers.

 

 

About

  • Benzodiazepines are a class of sedative drug used clinically to treat conditions such as panic disorder/severe anxiety, seizures, muscle spasms, and alcohol withdrawal.
  • Benzodiazepines are categorised as short, intermediate, or long acting.
  • Despite their medical uses, they are considered risky due to their dangerous withdrawal symptoms, the potential for tolerance and physical dependence, and the potential for misuse. As such, many GPs are reluctant to prescribe benzodiazepines, particularly for extended periods of time.
  • For those who use illicit benzodiazepines (i.e. drugs obtained without a prescription), the desired effects tend to be relaxation, reduction of anxiety, and sleepiness.
  • Unwanted effects include memory problems (including “black-out”), impaired motor skills, and increased anxiety.

Appearance

  • Illicit benzodiazepines tend to be sold in tablet form.
  • In many cases, this will mimic the appearance of legitimate medication (e.g. alprazolam, or Xanax, may be sold as a white “bar” shaped tablet; diazepam, or Valium, may be sold as a small, round white or pale blue tablet).
  • Illicit Xanax is also sold in various other colours, such as green and red, which are generally used to indicate the strength of the tablet.

Method of use

Illicit benzodiazepines are generally sold in tablet form and taken orally. In clinical settings, other routes of administration may be used.

Risks

  • Regular use of benzodiazepines can cause tolerance (needing more of the drug to get the same effect) and dependence (experiencing physical and psychological withdrawal symptoms when you stop). At their most serious, the withdrawal effects of benzodiazepines are potentially fatal.
  • In the long run, use of benzodiazepines can actually greatly increase feelings of anxiety and difficulty sleeping.
  • In some people, benzodiazepines can increase the likelihood of self-harming behaviour or can lead to people self-harming more seriously.
  • Benzodiazepines can cause memory black-outs and disinhibition/out-of-character behaviour. This is particularly likely when mixed with alcohol. This can cause a lot of anxiety for users, as well as potential issues with personal relationships and even legal trouble due to their behaviour whilst under the influence.
  • People tend to be more vulnerable whilst under the influence of benzodiazepines which can lead to them being targeted and falling victim to theft, assault, or sexual offences.
  • Mixing benzodiazepines and alcohol increases the effects of both, in a way that is not always predictable. This increases the risk of overdose, having an accident, being victimised, being sick/choking whilst unconscious, or even respiratory arrest.
  • Benzodiazepines impair concentration, reaction times, and co-ordination. This is particularly noticeable when used with alcohol. People who are under the influence are at greater risk of having an accident and hurting themselves. Driving under the influence is particularly dangerous.
  • When someone buys benzodiazepines illicitly, they have no way of knowing for sure what they are taking. Many illegal manufacturers intentionally mimic the appearance of the legitimate medication, which leads users to believe they are taking a standardised product. In reality, illicit benzodiazepines can vary massively in their composition and strength, which can lead to accidental overdose or an individual taking a substance they did not intend to. This is particularly true of alprazolam (Xanax), which is not prescribed on the NHS, and is very rarely prescribed privately in the UK.
  • People who use benzodiazepines to block out unpleasant feelings may be less inclined to develop healthy, sustainable ways of coping with problems.

Keeping safe

  • If you choose to use a benzodiazepine, use it in a safe environment and in the company of someone you trust. Ideally, this person will not have used the substance themselves and will be in a position to get help if things go wrong.
  • Take small amounts first to test strength and effects; start low and go slow.
  • Be mindful of the strength of the drug you are taking. For example, alprazolam is a more potent drug than diazepam and is likely to have a much more drastic effect. This includes the negative effects.
  • Do not drive while under the influence of benzodiazepines.
  • Remember that mixing benzodiazepines with alcohol is extremely risky and will increase the effects of both. It will also greatly increase the likelihood of a memory black-out.
  • If you have used and are going to sleep, then sleep on your side in case you are sick. Place sleeping or unconscious friends in the recovery position.
  • Anyone using benzodiazepines for a sustained period of time (i.e. four weeks or longer) should seek advice from their GP or local drug agency before discontinuing. Stopping abruptly can be very dangerous.
  • If you are using benzodiazepines to manage difficult feelings, seek support via your GP or a mental health service so you can learn more effective ways of coping.

Legal status

  • All benzodiazepines are Prescription Only Medicines under the Medicines Act. This means they can only be legally supplied by a pharmacist in accordance with a doctor’s prescription.
  • They are also controlled as a Class C drug under the Misuse of Drugs Act. The maximum sentence for possessing is 2 years imprisonment. The maximum sentence for supplying to someone else and for production is fourteen years and a fine.