Benzodiazepine dependence

dependencean addiction to the sleeping drug BenzodiazepineBarbiturate type dependencebenzodiazepine dependentbenzodiazepine tolerancebenzodiazepine-dependentdependence producingdrug dependencewithdrawal from benzodiazepines
Benzodiazepine dependence is when one has developed one or more of either tolerance, withdrawal symptoms, drug seeking behaviors, such as continued use despite harmful effects, and maladaptive pattern of substance use, according to the DSM-IV.wikipedia
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Benzodiazepine

benzodiazepinesbenzodiazapinesbenzo
In the case of benzodiazepine dependence, however, the continued use seems to be associated with the avoidance of unpleasant withdrawal reaction rather than from the pleasurable effects of the drug.
However, this advantage is offset by the possibility of developing benzodiazepine dependence.

Physical dependence

dependencedrug dependencyphysical
It is necessary to distinguish between addiction and drug abuse of benzodiazepines and normal physical dependence on benzodiazepines.

Substance dependence

addictiondependencedrug dependence
Tobacco and alcohol are the most common substances that elderly people get a dependence on or misuse.

Diazepam

ValiumDizacCANA
While many of the neuroactive steroids do not produce full tolerance to their therapeutic effects, cross-tolerance to benzodiazepines still occurs as had been demonstrated between the neuroactive steroid ganaxolone and diazepam.
Long term use can result in tolerance, dependence, and withdrawal symptoms on dose reduction.

Depersonalization

depersonalisationdepersonalizeddepersonalised
Some withdrawal symptoms that may appear include anxiety, depressed mood, depersonalisation, derealisation, sleep disturbance, hypersensitivity to touch and pain, tremor, shakiness, muscular aches, pains, twitches, and headache.
Benzodiazepine dependence, which can occur with long-term use of benzodiazepines, can induce chronic depersonalization symptomatology and perceptual disturbances in some people, even in those who are taking a stable daily dosage, and it can also become a protracted feature of the benzodiazepine withdrawal syndrome.

Benzodiazepine withdrawal syndrome

benzodiazepine withdrawalwithdrawal syndromebenzodiazepine
Benzodiazepine dependence is when one has developed one or more of either tolerance, withdrawal symptoms, drug seeking behaviors, such as continued use despite harmful effects, and maladaptive pattern of substance use, according to the DSM-IV.
Benzodiazepine withdrawal syndrome—often abbreviated to benzo withdrawal—is the cluster of signs and symptoms that emerge when a person who has been taking benzodiazepines, either medically or recreationally, and has developed a physical dependence, undergoes dosage reduction or discontinuation.

Effects of long-term benzodiazepine use

Long-term effects of benzodiazepineslong-term use of benzodiazepinesContinued use despite harmful consequences
Long-term use of benzodiazepines leads to increasing physical and mental health problems, and as a result, discontinuation is recommended for many long-term users.
The effects of long-term benzodiazepine use include drug dependence and neurotoxicity as well as the possibility of adverse effects on cognitive function, physical health, and mental health.

Kindling (sedative–hypnotic withdrawal)

kindlingkindling mechanismkindled
Animal studies have shown that repeated withdrawal from benzodiazepines leads to increasingly severe withdrawal symptoms, including an increased risk of seizures; this phenomenon is known as kindling.
The involvement of glutamate in benzodiazepine dependence explains long-term potentiation as well as neuro-kindling phenomena.

Chlordiazepoxide

LibriumLimbitrolA-Poxide
A physical dependence develops more quickly with higher potency benzodiazepines such as alprazolam (Xanax) than with lower potency benzodiazepines such as chlordiazepoxide (Librium).

Alcoholism

alcoholicalcoholicsalcohol
Alcoholics dependent on benzodiazepines should not be abruptly withdrawn but be very slowly withdrawn from benzodiazepines, as over-rapid withdrawal is likely to produce severe anxiety or panic, which is well known for being a relapse risk factor in recovering alcoholics.
The most common dual dependence syndrome with alcohol dependence is benzodiazepine dependence, with studies showing 10–20 percent of alcohol-dependent individuals had problems of dependence and/or misuse problems of benzodiazepine drugs such as diazepam or clonazepam.

Generalized anxiety disorder

general anxiety disordergeneralized anxietyanxiety
A study of patients undergoing benzodiazepine withdrawal who had a diagnosis of generalized anxiety disorder showed that those having received CBT had a very high success rate of discontinuing benzodiazepines compared to those not having receive CBT.
In one study in 1988–90, illness in approximately half of patients attending mental health services at British hospital psychiatric clinic, for conditions such as panic disorder or social phobia, was determined to be the result of alcohol or benzodiazepine dependence.

Benzodiazepine use disorder

benzodiazepine abuseabusing benzodiazepinesBenzodiazepine misuse
Therefore, long-term benzodiazepine abuse and dependence seems to carry a negative effect on mental health, with a significant risk of causing depression.
Benzodiazepine use disorder, also called misuse or abuse, is the use of benzodiazepines without a prescription, often for recreational purposes, which poses risks of dependence, withdrawal and other long-term effects.

Drug-related crime

drug bustdrug offensesdrug crimes
Benzodiazepines have also been used to facilitate rape or robbery crimes, and benzodiazepine dependence has been linked to shoplifting due to the fugue state induced by the chronic use of the drug.

Long-term effects of alcohol consumption

Long-term effects of alcoholalcohol consumptionalcohol
Approximately half of patients attending mental health services for conditions including anxiety disorders such as panic disorder or social phobia suffer from alcohol or benzodiazepine dependence.

Drug tolerance

tolerancetolerantmedication tolerance
Benzodiazepine dependence is when one has developed one or more of either tolerance, withdrawal symptoms, drug seeking behaviors, such as continued use despite harmful effects, and maladaptive pattern of substance use, according to the DSM-IV. The increased GABA A inhibition caused by benzodiazepines is counteracted by the body's development of tolerance to the drug's effects; the development of tolerance occurs as a result of neuroadaptations, which result in decreased GABA inhibition and increased excitability of the glutamate system; these adaptations occur as a result of the body trying to overcome the central nervous system depressant effects of the drug to restore homeostasis.

Diagnostic and Statistical Manual of Mental Disorders

DSM-IVDSM-IV-TRDSM
Benzodiazepine dependence is when one has developed one or more of either tolerance, withdrawal symptoms, drug seeking behaviors, such as continued use despite harmful effects, and maladaptive pattern of substance use, according to the DSM-IV.

Substance use disorder

addictionsubstance use disordersaddictive
It is necessary to distinguish between addiction and drug abuse of benzodiazepines and normal physical dependence on benzodiazepines.

GABAA receptor

GABA A receptorGABA A GABA A receptors
The increased GABA A inhibition caused by benzodiazepines is counteracted by the body's development of tolerance to the drug's effects; the development of tolerance occurs as a result of neuroadaptations, which result in decreased GABA inhibition and increased excitability of the glutamate system; these adaptations occur as a result of the body trying to overcome the central nervous system depressant effects of the drug to restore homeostasis.

Homeostasis

homeostaticequilibriumimmunomodulation
The increased GABA A inhibition caused by benzodiazepines is counteracted by the body's development of tolerance to the drug's effects; the development of tolerance occurs as a result of neuroadaptations, which result in decreased GABA inhibition and increased excitability of the glutamate system; these adaptations occur as a result of the body trying to overcome the central nervous system depressant effects of the drug to restore homeostasis.

Anxiety

anxiousnervousnessanxieties
Some withdrawal symptoms that may appear include anxiety, depressed mood, depersonalisation, derealisation, sleep disturbance, hypersensitivity to touch and pain, tremor, shakiness, muscular aches, pains, twitches, and headache.

Depression (mood)

depressiondepressedmelancholy
Some withdrawal symptoms that may appear include anxiety, depressed mood, depersonalisation, derealisation, sleep disturbance, hypersensitivity to touch and pain, tremor, shakiness, muscular aches, pains, twitches, and headache.

Derealization

derealisationunrealityFeeling unreal
Some withdrawal symptoms that may appear include anxiety, depressed mood, depersonalisation, derealisation, sleep disturbance, hypersensitivity to touch and pain, tremor, shakiness, muscular aches, pains, twitches, and headache.

Sleep disorder

sleep disorderssleep disturbancesleep disturbances
Some withdrawal symptoms that may appear include anxiety, depressed mood, depersonalisation, derealisation, sleep disturbance, hypersensitivity to touch and pain, tremor, shakiness, muscular aches, pains, twitches, and headache.

Tremor

tremblingshakingmuscle tremor
Some withdrawal symptoms that may appear include anxiety, depressed mood, depersonalisation, derealisation, sleep disturbance, hypersensitivity to touch and pain, tremor, shakiness, muscular aches, pains, twitches, and headache.

Department of Health and Social Care

Department of HealthMinistry of HealthUK Department of Health
The Department of Health substance misuse guidelines recommend monitoring for mood disorder in those dependent on or withdrawing from benzodiazepines.