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Short- and Long-Term Effects of Benzodiazepines

Benzodiazepines, commonly referred to as “benzos,” are a class of prescription drugs that function as central nervous system (CNS) depressants.1 Medical professionals prescribe benzodiazepines to treat a range of conditions, most commonly for anxiety disorders and panic disorders, but also for seizure disorders, insomnia and other sleep disorders, muscle spasms, and alcohol withdrawal.1

Benzodiazepines are widely prescribed in the United States. Valium (diazepam), Xanax (alprazolam), Ativan (lorazepam), Klonopin (clonazepam), and Restoril (temazepam) are the most prescribed and illicitly used benzodiazepines.2 Benzodiazepines are generally safe when taken as prescribed by a doctor, but even at therapeutic doses, they can result in tolerance and dependence, where withdrawal symptoms appear after a person stops taking them or significantly. According to the 2020 National Survey on Drug Use and Health, an estimated 4.8 million people in the U.S. aged 12 years or older misused benzodiazepines in the past year.3

This page details how benzodiazepines work, the short- and long-term effects, and how to get help if you or a loved one might be struggling with benzodiazepine misuse or addiction.

What Do Benzodiazepines Do to the Body?

Benzodiazepines work by stimulating receptors that act as binding sites for the body’s primary inhibitory neurotransmitter, gamma-aminobutyric acid (GABA).2 Taking benzodiazepines facilitates the binding of GABA at the receptors located throughout the CNS, leading to an increase in inhibitory tone.4 In other words, benzodiazepines can calm an otherwise overexcited CNS. When inhibitory tone is increased, CNS excitatory tone is decreased, leading to sedation and feelings of relaxation.2, 5

The Drug Enforcement Administration (DEA) classifies benzodiazepines as a Schedule IV substance, meaning that they have a lower potential for misuse than Schedule I-III substances.2, 6 However, benzodiazepine misuse is relatively common and data suggests that a person with any prescription for anxiety medication has 1.9 times greater odds of past-year benzodiazepine misuse and 2.6 times greater odds of a substance use disorder involving sedatives.7

Benzodiazepine tolerance and dependence can occur even when used as prescribed. Tolerance is a naturally occurring neuroadaptation where the brain is attempting to compensate for the constant presence of the drug which results in a person requiring more of a drug to experience the desired effects. With benzodiazepines, tolerance is a main driving factor of dependence.1 Abruptly stopping or trying to cut back on benzodiazepine use after a person develops a physiological dependence results in unpleasant and potentially harmful, even life-threatening, withdrawal symptoms.1, 4  Seizure is a particular concern associated with benzodiazepine withdrawal.1 Other withdrawal symptoms can include anxiety, agitation, hallucinations, insomnia, increased heart rate and blood pressure, shakiness, severe cravings, and more.8

Side Effects of Benzodiazepines

Benzodiazepines are generally safe when taken as prescribed by a medical professional for short periods, typically no longer than a few weeks.1, 4 All benzodiazepines have similar effects on the brain and body.4 The effects of benzodiazepines can vary based on factors such as dose, potency, half-life, and how long the drug is used.1, 4

Speaking to your doctor and thoroughly reading the drug label provided with your medication can provide a complete list of potential side effects that can occur with the specific benzodiazepine you are taking.

Some common side effects of benzodiazepines include:9

  • Drowsiness.
  • Confusion.
  • Dizziness.
  • Issues with memory and movement.
  • Poor concentration.
  • Slurred speech.
  • Reduced blood pressure.
  • Slowed breathing.

Elderly people who take benzodiazepines are at increased risk of experiencing psychomotor impairment, which can lead to falls that may cause serious causing femur or hip injuries. The elderly are also more likely to experience motor vehicle accidents as well as experience cognitive issues and memory problems resulting from benzodiazepine use.1, 4

Combining benzodiazepines with alcohol, opioids, or other benzodiazepines or sedatives can intensify the sedative effects and can result in life-threatening overdose, slowing or stopping a person’s breathing and heart rate.9

Signs of Benzodiazepine Addiction

Benzodiazepine addiction is clinically referred to as a sedative, hypnotic, or anxiolytic use disorder, a mental disorder that’s diagnosed based on meeting 2 or more criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):10

  • Taking benzodiazepines in higher amounts or for longer than planned.
  • Consistently wanting or unsuccessfully trying to cut back or stop using benzodiazepines.
  • Spending a lot of time getting, using, or recovering from the effects of benzodiazepines.
  • Experiencing strong cravings for benzodiazepines.
  • Failing to complete responsibilities at home, school, or work as a result of ongoing benzodiazepine use.
  • Inability to stop using benzodiazepines even when use has caused or worsened social or relationship issues.
  • Reducing or quitting hobbies or other recreational, social, or occupational activities because of benzodiazepine use.
  • Ongoing benzodiazepine use in situations that could be physically harmful, such as driving under the influence.
  • Continuing to use benzodiazepines even after knowing that it has caused or worsened ongoing physical or mental health problems.
  • Tolerance occurs, or needing a higher dose, or taking the drug more frequently, to feel the desired effects.
  • Experiencing withdrawal symptoms when use is cut down or stopped.

The last two criteria, tolerance and withdrawal symptoms, are not considered to be met when a person has a prescription for benzodiazepines or is otherwise using benzodiazepines under medical supervision.

Benzodiazepines are commonly misused in conjunction with other substances, such as alcohol, opioids, or other sedatives.2, 4 This can both increase the risk of experiencing harmful effects, including impaired motor skills, sensory perception, and ability to think clearly, as well as increase the risk for overdose, which can be fatal.1, 2  Of particular concern is combining benzodiazepines with opioids. In 2020, there were 12,290 fatal benzodiazepine-involved overdose deaths. Of those, 10,771 also involved an opioid, primarily fentanyl.11, 12

Getting Help

If you or someone you care about are struggling with benzodiazepine use, help is available. Benzodiazepine addiction treatment can help people stop using benzodiazepines and other substances to regain control of their life.

If you are ready to quit using benzodiazepines, you may benefit from medical detox, as withdrawal symptoms can be unpleasant and in some cases, life-threatening.8, 13 Medical detox can help you withdraw from substances as safely and as comfortably as possible and facilitate your transition into ongoing treatment.14

While there is no one-size-fits-all approach, treatment may include a combination of behavioral counseling, medication, co-occurring disorder evaluation and treatment, follow-up care, and more.13 Should your benzodiazepine misuse occur in conjunction with the use of other substances, treatment will address multiple addictions.13

Treatment may be available at a rehab center near you or out of state. You can learn more about treatment options by contacting your primary care physician (PHP) or a mental health practitioner. You can also contact American Addiction Centers (AAC) when you call . AAC is a leading provider of evidence-based treatment and can answer your questions about addiction, verify your insurance, and more.

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