Understanding the Three Types of Benzodiazepines

There are three types of benzodiazepines to be aware of when prescribed these central nervous system depressant drugs. First, benzos are primarily prescribed to treat sleep and anxiety disorders. Secondly, other treatment options for these drugs are to treat alcohol withdrawal or epilepsy. Finally, some physicians prescribe these mild tranquilizers to address extreme stress or panic disorder. 

Benzodiazepines slow down the messages between the brain and the body. However, short-term use is the goal, as long-term usage could lead to benzodiazepine abuse. Although benzos are safer than barbiturates, they can quickly become misused or cause accidental addiction. As a result, it is essential to be knowledgeable about the three types of benzodiazepines and their length of usage. 

Differences between Short-Acting, Intermediate, and Long-Acting Benzodiazepines

There are three types of benzodiazepines: long, intermediate, and short-acting. Benzos are categorized into these three categories based on how quickly the effects occur and how long the effects continue. In addition, it is essential to understand the half-life of a drug to grasp the difference in categories. All types of benzodiazepines must be prescribed by a physician and monitored closely. 

Why is the half-life of a drug important?

Understanding the concept of half-life helps determine excretion rates and steady-state concentrations for any specific drug. Different drugs have different half-lives. However, they all follow this rule: fifty percent of the initial drug amount is processed and removed from the body after one half-life. Therefore, one of the factors physicians use to determine which of the three types of benzodiazepines to prescribe is how long the effects of the medication need to last. 

What is a short-acting benzodiazepine?

Short-acting benzodiazepines quickly bind to the brain. Short-acting benzos have a half-life of one to twelve hours. In addition, these benzodiazepines have a more substantial “come down” or withdrawal effect. Benzodiazepine abuse is a danger to be aware of because these drugs can be highly addictive. 

The following short-acting benzodiazepines include a description of how they work, familiar brand name, and side effects:

• Alprazolam lessens abnormal excitement in the brain: Xanax, Kalma, and Alprax are commonly prescribed for anxiety, panic disorders, and premenstrual dysphoric disorder. This drug can cause drowsiness, memory problems, slurred speech, and lack of concentration and coordination.
• Diazepam is a minor tranquilizer: Ducene and Valium are commonly prescribed for panic attacks, restless leg syndrome, insomnia, seizures, and alcohol withdrawal with the side effects of drowsiness, confusion, and shakiness.
• Estazolam slows activity in the brain: Esilgan, Eurodin, and Nuctalon are commonly prescribed for insomnia and can cause grogginess, dizziness, constipation, dry mouth, and aggression.

What is an Intermediate Benzodiazepine?

An intermediate benzodiazepine has a longer half-life of twelve to forty hours. Therefore, intermediate-acting benzos are fast acting but could produce residual side effects if used as a hypnotic effect in the beginning days of use. Ativan is one of the most widely prescribed of the three types of benzodiazepines. It is also hazardous to drink alcohol while on Ativan, as it can cause respiratory difficulties. 

The following intermediate-acting benzodiazepines include a description of how they work, familiar brand name, and side effects:

• Chlordiazepoxide is a longer-acting benzo: Librium® commonly prescribed for alcohol withdrawal and anxiety and preoperative anxiety. This drug can cause a feeling of calmness, drowsiness, upset stomach, changes in appetite, and dry mouth.
• Lorazepam slows activity in the brain to induce relaxation: Ativan® is commonly prescribed for anxiety, seizures, and anesthesia and could cause paranoia or suicidal ideation, impaired memory, judgment, and coordination.
• Nitrazepam is anticonvulsant and hypnotic: Alodorm® and Mogadon® commonly prescribed for panic disorders, severe anxiety, insomnia, and seizures – however not approved for use in the United States.

What are Long-acting Benzodiazepines?

Of the three types of benzodiazepines, the long-acting benzos work by improving the effects of GABA (gamma-aminobutyric acid) in the brain. Reducing over-activity in the brain, this neurotransmitter calms anxiety and seizures. In addition, the half-life of long-acting benzos is one to three days. Therefore, long-lasting benzodiazepines stay in the body for a more extended period and take longer to withdraw. 

The following long-acting benzodiazepines include a description of how they work, familiar brand name, and side effects:

• Clonazepam is an anticonvulsant or antiepileptic drug: Klonopin is commonly prescribed for panic disorder, seizure disorders, and agitation and can induce drowsiness, dizziness, lack of coordination, muscle or joint pain, and frequent urination.
• Oxazepam has an anti-seizure effect: Alepam, Murelax, and Serepax are commonly prescribed to treat anxiety or alcohol withdrawal when used with other drugs, can cause adverse breathing complications. 
• Prazepam is an anxiolytic, anticonvulsant, sedative, and skeletal muscle relaxant: Centrax is commonly prescribed for short-term anxiety or anxiety disorders and can cause drowsiness.
• Temazepam: Euhypnos, Normison, and Restoril, commonly prescribed for insomnia, can cause disturbed sleep, drowsiness, light-headedness, and dry mouth.

Warning Signs of Benzodiazepine Abuse

Benzodiazepine abuse is widespread due to the high number of prescriptions in the United States. The National Institute on Drug Abuse (NIDA) reports that about 30% of opioid overdoses in the US involve benzodiazepines and that one in eight Americans use benzos. Furthermore, misuse of benzos accounts for roughly seventeen percent of benzodiazepine usage. As a result, further studies show the highest demographic using benzos is adults eighteen to twenty-five years, but significant numbers of seniors aged fifty through sixty-four are using it. 

Misuse and benzodiazepine abuse can be dangerous as it might lead to overdose, which could jeopardize the ability to breathe. In addition, long-term use may indicate that addiction might need to be addressed. Mixing benzos with other opioids or alcohol could have extreme adverse results and even death. Finally, abuse of these drugs could cause cognitive and physical impairments that could lead to accidents, sexual assault, and impaired driving.

Benzodiazepine Withdrawal

Medically monitored detox is suggested for the initial treatment step for addiction to benzodiazepines. After a long time of usage, the body is challenged with withdrawal, and if the user suddenly stops taking benzos, there can be adverse consequences, such as seizures. Withdrawal symptoms can vary, depending upon which of the three types of benzodiazepines are being used, length of use, and dosage. 

Withdrawal symptoms can vary to include any of the following and last from a few weeks to a year:

• Headaches, anxiety, or irritability
• Twitching or muscle aches
• Dizziness and tremors
• Nausea, vomiting, stomach pains
• Bizarre dreams, difficulty sleeping, fatigue
• Poor concentration
• Irritability Altered perception, heightening of senses
• Delusions, hallucinations, and paranoia
• Seizures

Find More Information on Treatment for Benzodiazepine Abuse in Georgia

For those who are affected by benzodiazepine abuse and are seeking more information, the Retreat of Atlanta offers experienced treatment providers to answer your questions. Offering a peaceful setting to begin a journey of recovery, we provide a variety of options for treatment. Our several locations are available to discuss our process of assessment, medical detox, and further treatment options. Contact us to find more information concerning the options we extend.