The Long-Term Effects of Misusing Benzodiazepines

Benzodiazepines are primarily used as anti-anxiety medications. Their misuse can have long-term effects. Misusing benzodiazepines can increase your risk of drug interactions, reduce your motor skills, affect memory, and lead to dangerous withdrawal symptoms, including seizures.

Why Are Benzodiazepines Prescribed?

Benzodiazepines are medications used to treat anxiety and seizures. They also be used short term to treat severe alcohol withdrawal.[1] They also treat rare neurological conditions, including cerebral palsy, paraplegia and other genetic disorders.

While not without side effects, benzodiazepines are generally safe when used as prescribed.[2] However, if used outside of the way they were prescribed, they can be highly addictive and have many other dangerous side effects.

Short-Term Benzodiazepine Side Effects

Some potential short-term effects of misuse of benzodiazepines include the following:[3]

• Drowsiness
• Slowed reaction time
• Reduced motor skills
• Ataxia (reduced coordination and muscle control)
• Memory problems
• Higher rate of hip fractures in the elderly
• Sedation and respiratory depression

You should tell your doctor if you are pregnant or plan to become pregnant when using benzodiazepines. The effect these drugs can have on developing fetuses and babies is not fully understood. While most doctors will continue a woman on benzodiazepines if she has been on them before pregnancy, it’s important to be aware of some risks or the need for additional monitoring.

Long-Term Benzodiazepine Side Effects

Benzodiazepine drugs aren’t meant for long-term use. But some people do take them for months or even years. 

Researchers say long-term benzodiazepine use can cause the following side effects:[3]

• Rebound insomnia: Some people use benzodiazepine medications to help them sleep, but the medication can cause persistent chemical changes that result in sleeplessness when people quit taking these drugs. 
• Cognitive impairment: Some people struggle with clear thinking both while they’re using medications and when they quit taking them. 
• Car crashes: Benzodiazepines can slow reflexes, making operating any kind of motorized vehicle very dangerous. 
• Hip fractures: Dizziness from medications can cause people to lose their footing, which makes broken bones more likely.

Few people expect these problems when they start taking benzodiazepines. But they become more likely the longer people use these medications.

Are Benzodiazepines Addictive?

Yes. Unlike opioids, which can be addictive after only a few doses, true benzodiazepine dependence tends to develop more slowly. Yet many people do find themselves addicted to benzodiazepines, particularly if they have been using them for a longer period.

Benzodiazepines are generally considered to have low, but present, misuse potential.[4] Most individuals use these drugs as prescribed. Less than 2% of patients report using the drugs at a higher dose than prescribed.

According to the National Institute on Drug Abuse, the benzodiazepine addiction rate is as low as 0.2% among the general population and 2% among people who use benzodiazepine.[5]

At the same time, benzodiazepine misuse is escalating in the United States. Emergency room visits related to combining opioids and benzodiazepines went from 11 per 100,000 in 2004 to 34.2 per 100,000 in 2011. In that same time, benzodiazepine-related opioid overdose deaths rose from 18% to 31% of opioid-related deaths.[4] 

Those with a history of substance use have an elevated risk of misusing benzodiazepines.

Benzodiazepine Withdrawal Symptoms

Perhaps the most concerning aspect of benzodiazepine dependence is the risk of withdrawal. Sudden stopping of benzodiazepine use after long periods will likely result in withdrawal. Benzodiazepine withdrawal can last months. 

Benzodiazepine withdrawal is particularly problematic because, unlike opioid withdrawal (which is never life-threatening), benzodiazepine withdrawal can lead to seizures, coma and even death in rare cases. 

If you have been on benzodiazepines for a long period, your dose should be tapered slowly under the supervision of a doctor. Never attempt to suddenly stop taking benzodiazepines on your own after long-term use.

Benzodiazepine Interactions With Other Medications

Sedation and respiratory depression are major mixing risks, especially if the medications are used with other medicines that cause sedation or respiratory depression. 

Benzodiazepines are extremely dangerous, for example, when mixed with opioids and alcohol. Their use is involved in about 14% of opioid overdose deaths. Research has shown benzodiazepines are sometimes combined into illicit opioids, meaning a person may not always even know they are taking them.[6]

As a general rule, you should not combine benzodiazepines with any drug or substance without first talking to your doctor, particularly any other substance that is also known to be sedating, such as opioids, alcohol, anti-histamines, sleep aids or other sedatives.

If you struggle with misusing benzodiazepines, talk to your doctor. Treatment for substance misuse, including misuse of benzodiazepines, can be life-saving.