Anxiety disorders are increasing gaining recognition in recent years for the debilitating effects they can have on individuals, families, and workplace productivity. Affecting over 40 million Americans, anxiety disorders are the most common form of mental illness in the United States. However, the drugs recognized as the best pharmacological treatment for anxiety disorders, benzodiazepines like Xanax, Valium, and Klonopin, present doctors with an additional problem. The misuse and abuse of these drugs can create a dangerous physical dependency that has led to an alarming 300% increase in patients checking into drug treatment facilities to treat dependence on the medication originally prescribed to help improve their lives.
The Rise of Anxiety
As we have adapted from a hunter-gatherer species to a life of relative safety inside homes that protect us from the dangers of weather, animals, and other humans, our adaptive processes have failed to keep pace with the results of human ingenuity. The vestige of our primitive brains that once alerted our ancestors to the threat posed by a wolfpack outside their campsite has gone from life-saving to the arbiter of a life-crippling problem, anxiety.
No Easy Solution
While most anxiety disorders have been linked to hyperactivity of the the primitive “fear center” of the brain known as the amygdala, the factors contributing to the onset of anxiety disorders are a myriad of genetic and developmental factors, combined with the life experiences of the individual. With such wide-ranging contributing factors, understanding the mechanics of anxiety disorders has proven incredibly difficult, as has the development of an effective treatment for the condition. All of these problems appeared to be solved by the development of Librium and its immediate descendent, Valium.
“Mother’s Little Helper”
Valium, which is also known by its generic name diazepam, was one of the first “blockbuster” drugs that brought the idea of pharmaceutical solutions into homes across the United States. Marketed mainly as a way to “reduce psychic tension” in middle-class, stay-at-home mothers, the drug became a cultural icon and was the focus of a hit song by the Rolling Stones. However, warning signs about the dangers of this first widely-used benzodiazepine medication started to appear early after the global demand skyrocketed. In the 1975 Vogue story “Danger Ahead! Valium – The Pill You Love Can Turn on You,” the public was alerted to the potential of the drug to cause a “far worse addiction than heroin.”
What Are Benzodiazepines?
Before delving further into the potential risks of benzodiazepine misuse and abuse, let’s look at the drugs included in this class. The chart below includes the most commonly prescribed benzodiazepines used to treat anxiety. The drugs are listed alphabetically by generic name, with common brand names in parentheses.
- Alprazolam (Xanax)
- Chlordiazepoxide (Librium)
- Clonazepam (Klonopin)
- Diazepam (Valium)
- Flunitrazepam (Rohypnol)
- Lorazepam (Ativan)
- Oxazepam (Serax)
Dangers of Benzodiazepines
The addictive mechanism of benzodiazepines operates in a biochemically similar way to the mechanism used by other addictive drugs like opiates and cannabis. By increasing the amount of dopamine released in the “reward center” of the brain, long-term use of the drugs can cause changes in the structure of a person’s brain, resulting in both increased tolerance and addiction.
Additionally, the drugs produce additional physical dependencies that manifest themselves in a condition known as benzodiazepine withdrawal syndrome. A patient who abruptly quits taking the medication can experience any of the following symptoms:
- sleep disturbances
- increased anxiety
- panic attacks
- memory problems
- inability to concentrate
- heart palpitations
- vision changes
- suicidal ideations
For these reasons, people using or abusing benzodiazepines are encouraged to seek professional help when stopping the medication.
Helpful vs Harmful
Given the potential harm of benzodiazepines described above, one may ask why these drugs are prescribed at all. However, the proper usage of benzodiazepines, as directed by a physician, is clinically-proven to be the best available pharmaceutical method for the treatment of severe anxiety disorders. When combined with a proper exercise regimen and cognitive behavioral therapy, many patients are able to overcome their anxiety disorders and learn to cope with their affliction without the use of a daily benzodiazepine prescription. Most dangers lie in the misuse or outright abuse of these medications. While these drugs are effective at reducing anxiety and tension, everyone should take note of the FDA-required warning label that was placed on all advertisements for Valium in 1980:
Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic drug.
Do You Suspect That You Are Addicted or A Loved One May Be?
If you are concerned about someone close to you being addicted to benzodiazepines, you would likely benefit from speaking to a trained expert at an inpatient treatment facility about that person’s condition. Some signs that this expert will likely ask about include:
- Difficulty controlling use
- Seeking multiple prescriptions or “doctor shopping”
- Other “drug seeking behavior”
- Concurrent use of other addictive drugs, like alcohol
- Preference to drug use over other activities
- Signs of withdrawal (described above)
Treatment for Addiction
Due to the volatile nature of benzodiazepine withdrawal, virtually all patients suffering from benzodiazepine addiction are required to stay at a licensed inpatient facility or a hospital for the detoxification process. Once the detox is complete, patients are expected to complete at least 30 days of treatment at an inpatient or outpatient treatment facility. Due to the nature of the addiction, many patients are better served by an inpatient facility, which offers a number of advantages for this early stage of recovery:
- Constant expert intervention
- Structured activities built into the entire day
- Providing and monitoring of healthy nutrition and exercise
- A community of others facing similar challenges
- Removal from outside triggers and drug-using friends
- An environment focused solely on recovery and developing healthy practices for the future
Klonopin, Ativan, Xanax and Valium are incredibly potent medications that must be used properly in order to be effective. Improper use or abuse of the drugs can quickly lead a person down a dangerous path. Therefore, one must remember to use these medications only as directed and discuss alternatives with your doctor if you are uncomfortable with the risks associated with the drugs. Finally, if you suspect that you may need help with benzodiazepine addiction or know of someone close to you who may be in need of help, do not hesitate to seek help from the proper resources.