Benzodiazepine Misuse and Addiction: Symptoms, Risks, and Recovery

Side Effects of Benzodiazepines

Benzos have been hugely popular for decades because of their fast-acting calming effects. But a growing body of research points to some seriously concerning side effects. Pharmacology researchers warn that benzodiazepines’ “side effects and toxicity⁶ can result in morbidity and mortality for some patients,” and that “For any patient taking a [benzo], the prescribing physician must carefully evaluate the risks and benefits, and higher-risk patients require careful considerations.” 

Short-Term Effects

In the short term, side effects of benzos include drowsiness, dizziness, respiratory depression, and impaired coordination. These are why benzodiazepines come with warnings not to drive or operate heavy machinery. Other common side effects include confusion, blurry vision, and trouble concentrating.

Long-Term Effects

When used for extended periods, benzodiazepines have more serious effects.⁷ Long-term users often experience cognitive impairment, emotional numbness (also known as emotional blunting), and memory issues. Benzos slow down brain function, making it harder to think clearly, concentrate, and remember things. Over half of the participants in the CU Anschutz study reported symptoms lasting over a year: 

• Low energy
• Trouble focusing
• Memory loss
• Anxiety
• Insomnia
• Sensitivity to light and sounds
• Digestive problems
• Symptoms triggered by food and drink
• Muscle weakness 
• Body pain

“Particularly alarming,” the study adds, “these symptoms were often reported as new and distinct from the symptoms for which benzodiazepines were originally prescribed.” That is, the benzos themselves created conditions where none existed before.

Long-term benzo use can also have toxic side effects, including “impaired liver and/or kidney function”⁸ due to their accumulation in the body.

Memory Impairment and Cognitive Issues

Prolonged benzo use is linked to significant memory problems. Some people have difficulty forming new memories, and others may struggle with remembering things they once knew well. This is especially true for episodic memory, and even more so for people who drink heavily while taking benzos. Many people also find it harder to concentrate.

It’s possible to experience side effects of benzos even when taking them as prescribed.⁹ One study reports that “specific deficits in visuospatial ability and sustained attention have also been described in patients who have taken therapeutic doses of benzodiazepines regularly for longer than one year.” 

Emotional Blunting and Psychomotor Effects

Many people who take benzos long-term find that it numbs their emotions, making it harder to feel the range of feelings that colors human life—a term some behavioral scientists call “emotional anesthesia.” While feeling less emotion might sound like a relief for someone who often experiences them intensely, it also means they’re missing opportunities to learn healthy skills like processing and regulation. 

Interestingly, there is evidence that high-dose benzo use can increase depression:¹⁰ 

Some evidence indicates that higher benzodiazepine dosages are associated with an increased risk of depression and that reducing the dosage or discontinuing therapy may resolve the depressive symptoms. 

Benzos also slow psychomotor functions, which affects physical coordination and reaction time.

Benzodiazepine Addiction and Misuse

Risk Factors for Addiction

Benzos generally pose a high addiction risk. According to the AFP Journal,

The risk of developing physical dependence to benzodiazepines is high; 15% to 40% of long-term users report severe withdrawal symptoms after cessation.¹¹

Several risk factors make someone more likely to misuse benzos and develop an addiction. These might include: 

• Taking benzos for a longer time 
• Having a history of substance abuse 
• Dealing with mental health issues like depression or anxiety

Using benzos in higher doses than prescribed, or mixing them with other substances like alcohol or opioids, further increases addiction risk.

Tolerance Development

As the body gets used to benzodiazepines, it requires higher doses to feel the same effects. This is known as tolerance. Over time, someone who initially takes a low dose to manage an anxiety disorder may need much more to feel calm or relaxed. This can quickly spiral into dependence, where the body needs the drug to function normally.

Psychological Factors

Benzodiazepine misuse and addiction are often linked to psychological factors like stress, trauma, and other untreated mental health concerns. Some people turn to benzos to self-medicate, hoping to ease symptoms like anxiety, depression, or panic attacks. But while they may provide temporary relief, they don’t address the root causes of mental health conditions—and eventually, they only make things worse.

Co-Occurring Disorders

A lot of people who misuse benzodiazepines have co-occurring mental health disorders like depression, PTSD, or bipolar disorder. Living with these challenges can drive someone to use benzos to self-medicate or escape their feelings—whether or not they recognize the addiction risk. Co-occurring disorders are complex conditions. If this is a concern for you, look for a specialized treatment program that can treat addiction and mental health at the same time.

Signs of Benzodiazepine Misuse

Behavioral Indicators

There are several behavioral signs that someone may be misusing benzos: 

• “Doctor shopping,” seeing multiple doctors to get prescriptions
• Taking higher doses than prescribed
• Acting secretively 
• Neglecting their responsibilities
• Withdrawing socially 

Physical Symptoms

Physical signs of benzodiazepine abuse include:

• Slurred speech
• Drowsiness
• Poor coordination
• Blurred vision 
• Headaches 
• Constantly feeling tired or “out of it” 

Psychological Manifestations

Psychologically, benzodiazepine misuse and addiction can cause: 

• Mood swings
• Paranoia
• Heightened anxiety
• Depression

It’s ironic, but the very drugs prescribed to reduce anxiety can, over time, make anxiety much worse. Benzos are known to cause rebound anxiety¹²—an increase in anxiety from stopping use. This is especially true if they’re used incorrectly.

Withdrawal Management

Understanding Withdrawal Symptoms

Benzodiazepine withdrawal can be severe and even dangerous. The National Institute on Drug Addiction describes benzodiazepine withdrawal syndrome:¹³

Physiological dependence on benzodiazepines is accompanied by a withdrawal syndrome which is typically characterized by sleep disturbance, irritability, increased tension and anxiety, panic attacks, hand tremor, sweating, difficulty in concentration, dry wretching and nausea, some weight loss, palpitations, headache, muscular pain and stiffness and a host of perceptual changes.

People usually notice rebound anxiety and insomnia within the first few days, followed by full withdrawals for up to 2 weeks. Withdrawal symptoms of benzodiazepines can last for far longer and usually require professional treatment. Because of the risks involved, it’s always important to detox from benzos under medical supervision.

Tapering Protocols

The safest way to come off benzodiazepines is by gradually tapering. This means slowly reducing the dose over time to minimize withdrawal symptoms. Going “cold turkey,” or stopping benzodiazepines abruptly, can be highly dangerous and is not recommended. A qualified professional should manage this process. 

How quickly you can taper off benzos¹⁴ depends on a variety of factors, says the Oregon Health Authority: 

There is no evidence for a one-size-fits-all approach to tapering benzodiazepines. The rate of taper will depend on the severity of withdrawal symptoms, which are influenced by several factors: the original dose, type, potency, duration of action and length of use of the benzodiazepine; the reason the benzodiazepine was originally prescribed; and the personality and individual vulnerability of the patient, their lifestyle, personal stresses and past experiences, and the degree of social support during the taper.

Tapering can take as little as 2 weeks or as long as a year or more. 

Medical Supervision and Support

Medical detox programs help you manage benzo withdrawal symptoms in a controlled, supervised environment. Doctors, nurses, and addiction-specialized therapists monitor your progress and provide support to make sure the withdrawal process is as safe and comfortable as possible. Some rehabs even have detox centers on-site, making it easy to transition directly into inpatient addiction treatment. 

Treatment Options

Medication-Assisted Treatment

In some cases, treatment specialists use medications to help manage withdrawal symptoms and cravings. Substitution or maintenance therapy¹⁵ can help people with more severe dependencies, or serious mental health concerns, taper off benzos without destabilizing themselves too severely. For long-term recovery, these treatments should be part of a comprehensive addiction treatment plan.

Psychotherapy

Therapy plays a huge role in long-term benzo addiction recovery. Cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) and other talk therapies can help you understand and change the thought patterns and behaviors that play a role in your addiction. Other approaches, like process groups and holistic treatments, offer additional avenues for working through addiction by accessing different parts of the brain. In general, psychotherapies teach long-term coping strategies that help you address the underlying reasons for addiction and prevent relapse in the future. 

Support Groups and Behavioral Therapies

Support groups offer a sense of community and shared experience that keep you on track through the challenges of recovery. These can include Narcotics Anonymous (NA), other 12-Step programs, or non-12-Step alternatives.

A Path to Recovery From Benzodiazepine Misuse

Benzodiazepine use disorder is a serious issue. But recovery is entirely possible with the right combination of medical support, therapy, and ongoing care. If you or someone you love is struggling with benzo addiction, get help as early as possible. Recognizing the signs of misuse and reaching out to a professional can make all the difference. 

Start exploring your benzodiazepine addiction treatment options today and discover why recovery is a journey worth taking.