Benzodiazepine dependence is a physical or emotional reliance on medications in the benzodiazepine class. These medications, introduced in the 1950s, can be very helpful for the management of anxiety, sleeplessness, and alcohol withdrawal. Patients who take them for an extended period of time may develop a dependence to the drugs, which necessitates careful withdrawal to prevent adverse reactions. Drug abuse can also include the use of benzodiazepines, although usually they are a secondary drug rather than the drug of choice.
Physically, symptoms of dependence can emerge within as little as two weeks on benzodiazepines, and sometimes patients who take short-acting medications may experience problems between doses. As the body gets accustomed to the medication, patients can experience pain, anxiety, and insomnia when they don’t get their regular dose, warning signs of benzodiazepine dependence. Tolerance can also develop, requiring a higher dose to have the same effect. Concerns about physical benzodiazepine dependence lead many practitioners to prescribe the medications for short periods of time only, and to monitor patients closely for signs of complications.
Emotional dependence can also arise. The patient may start to become worried or anxious about stopping the medication, which may contribute to difficulty stopping. In discussions with medical providers, patients may express fears about getting to sleep or controlling anxiety without benzodiazepines. This can develop into addiction, where the patient may spend more time actively seeking prescriptions, and could experience social disruption like trouble connecting with family members because of the addiction.
Medical practitioners are aware that benzodiazepine dependence is a known risk when prescribing these medications. Guidelines for how and when these medications should be recommended have been revised to address this concern; practitioners may only advise them when a patient doesn’t respond to other treatments and experiences disabling symptoms. They also offer them for short periods of time only to help stabilize patients while developing a safe long-term plan. Some practitioners may have a letter they give to patients with information on benzodiazepine dependence and safe use of the medications.
Patients who need to take these drugs for longer periods can develop physical dependence even with careful use, and shouldn’t be afraid to discuss it with medical providers. When it is time to stop the medication, they can slowly reduce the dosage over time to give the body time to adjust. Another drug may be recommended as a bridge to allow the patient to transition from the benzodiazepine more smoothly and comfortable. People with a history of dependence and problems with benzodiazepines should make practitioners aware of this, as it may be an indicator that they shouldn’t take benzodiazepines again.
