Over the last several decades, people have begun abusing their medications more and more by taking them in the wrong dosages or combining them with a controlled substance such as recreational drugs or alcohol. What people often don’t realize while abusing their medications is that damage can occur towards your body in ways that cannot be repaired and this type of damage can possibly lead to death. Often, people who struggle with these problems need to be put in a rehabilitation center to make sure their body can get on track again and not go through terrible withdrawal periods. 

One form of medication people tend to misuse is called “benzodiazepines,” which is an antidepressant and a form of opioid. The main reason this form of medication is abused is because when it is taken in the wrong dosage, snorted, smoked, or combined with alcohol or recreational drugs, the person experiences a euphoric high like no other they have ever experienced. They are very addictive medications and can sometimes be as addictive as heroin or cocaine and come with severe and deadly side effects when they are misused. Any benzodiazepine that is taken alongside of alcohol or other drugs, prescribed or recreational, can put you at a higher risk of hospitalization and even death. 

Benzodiazepines are used to treat depression, anxiety, and insomnia and the common prescriptions are Lorazepam, Diazepam, and Valium which are initially prescribed at a low dosage in the beginning, of 0.5mg, and later prescribed as high as 12mg per day depending on the patient and their disorder. Lorazepam, generically known as “Ativan,” is a form of benzodiazepine that is prescribed to patients in standard dosages of 0.5mg or 1.0mg in the beginning and can be taken multiple times per day to treat anxiety, depression, and insomnia (Bui 464). The most common side effects that can occur from taking Lorazepam medication is sedation, potential for abuse, memory impairment, and interdose rebound anxiety, which is where the patient’s anxiety disorder becomes worse rather than better (Bui 466). Lorazepam is not the only medication in this category or the only one that causes these side effects; others include Xanax, Klonopin, Valium, and Serax. One of the main effects occurs when the medication is combined with controlled substances, specifically recreational drugs and alcohol, and the outcome of these combinations can be fatal or they can cause the patient’s current disorder to worsen. 

The side effects of this class of medication are very severe. While taking it, individuals have shown a rapid onset of more unfavorable side effects and addiction towards it. Patients have also shown many signs that alcohol negatively affects their person when the two are combined, becoming problematic (Bui 469). Often patients with current co-morbid alcohol abuse and alcohol dependency problems report that the combination of benzodiazepine and alcohol worsened their symptoms of anxiety, depression, or insomnia whereas the medication is supposed to help them (Bui 471). In 2016, Doctor Winckel published an article that discusses the effects alcohol had on a 28-year-old female while she was taking a benzodiazepine for depression. She began to experience memory impairment and unconsciousness after a few alcoholic beverages at a party and she eventually passed out (Winckel). The next morning when the woman awoke, she realized the night before she had been sexually assaulted after losing consciousness at the party and went straight to her doctor with the news and to get help (Winckel). Although this is a severe case, it is a prime example of what can occur when alcohol is consumed while taking a strong medication such as a benzodiazepine. 

Although younger generations suffer from this addiction, it is a problem with older generations as well. Surprisingly, the abuse of benzodiazepines is more popular among middle-aged and older adults than teenagers and young adults (Youdin 129). Youdin concluded that this is because the estimated generation of adults who are abusing or will begin abusing this medication were born during the “baby boomer” era and thus creating a new era called “the gray tsunami” through high rates of medication abuse. It is predicted that by the year 2030, there will approximately be 72.1 million adults either misusing or abusing psychoactive substances such as benzodiazepine and opioids (Youdin 129). The overall cause of benzodiazepine dependency problem with these adults is due to their history of exposure and experience with psychoactive drugs and other disorders through the course of their lifetime as well as the exposure and past experiences with alcohol and cannabis (Youdin 130). A college professor Youdin interviewed was a 73-years-old man named Gary. He was prescribed Diazepam for insomnia. He was prescribed to take a single 5.0mg tablet before bed each night. After a few weeks, he noticed the mediation was not working as well, as his body was becoming used to it, so he began to take two 5.0mg pills a night instead of the one he was prescribed, which resulted in him running out 64 days before the date that his doctor was allowing him to refill his prescription (Youdin 131). Gary decided to consult two new doctors and simultaneously have his three separate doctors prescribing the same medication for him so that he would have more to avoid running out. In the end, Gary was taking 40mg of Diazepam a day and becoming very addicted. Before he began his benzodiazepine prescription he was addicted to and had a history of abusing Methaqualone, also known as Quaaludes, and he suffered severely from his abuse of medications (Youdin 132). This is an example that explains how easily it can be to get addicted to a medication as strong as a benzodiazepine. Another person Youdin interviewed was Ruth, who was an 82-year-old retired receptionist who had been smoking cannabis since she was a teenager and has combined it with her benzodiazepine prescription. When Ruth’s husband died from a heroin overdose and she became a single parent, she became very stressed and her insomnia to worsen. She claimed that smoking marijuana helped her sleep better at night and helped to control her sleep disorder (Youdin 135).  Overtime, her insomnia and anxiety became worse and she developed severe anxiety, which is one of the effects of cannabis usage while on benzodiazepine (Youdin 135). Other substances can cause the side effects of benzodiazepines to worsen when they are improperly mixed together. 

Substance abuse while on a strong medication has always been an issue, although it was believed long ago that alcohol did not have any identified receptor sites and did not affect the brain, but rather effected the membranes of the brain’s neurons thus not affecting any medication consumption (Youdin 147). This has now proven to be false for many reasons. Often, people who suffer from an alcohol dependency problem are prescribed medications to help them quit drinking alcohol and aid in the withdrawal process of not drinking (Tank 646). The type of benzodiazepine that is often prescribed for alcohol withdrawal is Chlordiazepoxide, which is “longer acting and helps convert metabolites in the liver (Tank 646)” while Lorazepam can be prescribed for this, it is “shorter acting and has no active metabolites for the liver (Tank 647)” thus not helping the liver recover from the damage from excess alcohol consumption as other medications. While it may sound like a dead end giving an alcoholic a medication that can be fatal when combined with alcohol, it has been proven successful if it is not abused (Tank 650).

Although the benzodiazepine withdrawal process can be fatal if not done in the right manner, abusing the medication is also fatal. It is an abused drug to many people, young and old, to obtain a euphoric high. In Finland, a team of doctors under Dr. Häkkinen studied a panel of patients among the ages of 14 to 44 that all suffered severe fatal poisoning from abusing their prescription of Buprenorphine, a subtype of benzodiazepine, between 2000 and 2008. Finland is ranked higher in this lethal drug than most countries for the rate of benzodiazepine prescription abuses (Häkkinen 301). Buprenorphine is also used for treating anxiety, depression, and insomnia because it has many of the same chemical substances that Lorazepam has. Most of the patients Dr. Häkkinen observed either snorted or injected the medication and tested positive for other opioid addictions. In total, they observed 1,383 patients and 57% of these patients died from Buprenorphine combined with alcohol. Also, 10% of these deaths were immediate, 52% were delayed and often occurred during sleep, and the remaining 38% was unknown. The fatal poisoning that is caused from benzodiazepines is typically an accident and occurs most commonly in males during their late twenties (Häkkinen 309). 

People who suffer from a benzodiazepine dependency problem often need to go to a rehabilitation retreat or even go through Buprenorphine Therapy for maintenance treatments so their body does not shut down through the withdrawal process (Häkkinen 301). Through this process, the patient will be heavily watched by their doctors, often at a rehabilitation clinic or hospital, and their hormone levels are documented multiple times a day to ensure they are where they need to be until the patient is back to normal (Häkkinen 303). If patients were to take themselves off the medication with no help, it is very possible they could die because their body would not know how to act without the drug in its system and their cells would begin to deteriorate quickly. Symptoms that often occur from benzodiazepine withdrawal are severe depression, night sweats, impaired vision, severe pain, lack of appetite, and many others (Häkkinen 309). 

Aside from combing benzodiazepines with alcohol, many people have resorted to smoking, injecting, and even snorting the medication and combining this with alcohol consumption. This is not for medical reasons, but for them to obtain a euphoric high which they have not been able to get from other drugs. The most common abused benzodiazepine is Lorazepam, as many people believe that snorting it and consuming alcohol will intensify the effects of the drug on their person’s brain. When someone abuses this drug, the side effects are very severe and can include: impaired coordination, irritability, loss of inhibitions, memory loss, and harmful behaviors on themselves as well as on others (NIAAA 2016). It is never safe to drink while being prescribed Lorazepam, as the side effects of the medication alone are hard enough on the person. Common side effects the medication cause is dizziness, shortness of breath, drowsiness, impaired coordination, loss of consciousness, and violent outbursts (NIAAA 2016). Not only does Lorazepam cause these side effects, but Ativan and Valium have been proven to cause the same problems, if not worse. To someone who wants to get very high from a medication, this might sound like a good high to have, to forget things and fall asleep or be uncoordinated, but it is very, very fatal and damages your body significantly every single time.

In an interview with Carla Hartford, she explained that while on the medication she felt as if her ADHD problem would worsen every day, severe loss of appetite would occur, weight loss, and Carla would often not leave the house, let alone her bed, for an entire day or more. One of the major problems Carla had was making plans one day, fully committed to them, and then feeling too overwhelmed later to actually go and thus canceling them. The worse side effects were shown when she would have as small as a single standard drink of alcohol. She mentioned having black outs and episodes that would not occur sober or not on the medication alone. One example of this was at a family dinner for her anniversary, Carla began yelling at the dinner table and throwing pieces of food at her husband, daughter, and friend and around the restaurant. When the people came to sing “happy anniversary” to her and her husband, she kept asking what was going on and even after was still confused as to why it happened. The next day she was shown multiple videos of that night and it made her totally appalled as she remembered nothing. Other small instances would be that she began to think she was being watched all the time and that people were talking about her, as paranoia is one of the most common side effect of Lorazepam while other instances she would not remember important dates such as her daughters’ or grandchildren’s birthdays.

Carla Hartford is my mother and she has struggled with this problem for many years now. She does not have an alcohol dependency problem, but rather a benzodiazepine dependency problem. She has been prescribed benzodiazepines for fourteen years now and began taking Lorazepam nine years ago when her OB/GYN prescribed her one pill per day at 1.0mg. Over time, her doctors began to up the dosage and up the number of pills she was required to take per day and until a few months ago she took four pills per day at 1.0mg equaling 4.0mg per day of a very strong medication. Her benzodiazepine dependency problem was heightened when she would consume alcohol even as little as a single glass of wine or a twelve ounce beer – an amount that will not harm the normal drinker. While on Lorazepam, she experienced violent fits, irrational behavior, uncontrollable crying, severe paranoia, insomnia, forgetfulness, as well as a feeling of not belonging along with severe depression. Through the help of my family, friends and our family doctor it has gotten significantly better within the last year as my mother realized she had a problem. My mom, within the last few months, has successfully been taken off her prescription of Lorazepam that she has been prescribed for the last nine years and is in the process of being taken off benzodiazepines all together, although it is a long and tough process. Our family doctor began by taking away her higher prescription of Lorazepam and changing the dosage to 0.5mg and lessening the number of pills she had to take every two weeks until it was only one half of a pill. Then she was put on Valium and her doctor is going through the same process with it since it takes a long time to be taken off benzodiazepines all together. By the end of May my mother will be totally clean from all benzodiazepines! I began this research in hopes that I could give it to my mother to prove to her that she needed to be taken off her medication, as of now she is totally off it and instead I am going to give it to her and my other family members to make them more knowledgeable on the medication.

As a conclusion, yes combining benzodiazepines with a controlled substance lead to negative behaviors such as violence, worsened anxiety, depression, and even death. It can be a very difficult obstacle to be taken off of a prescription for benzodiazepines, even if it has been a long-term addiction. Some advice would be that no matter how difficult it can be to quit these drugs, it will be over with time. An addiction problem with benzodiazepines can often look like a problem with an alcoholic or a recreational drug user, but before deciding what sort of addiction it can be, ask a doctor so that you do not diagnose the patient with the wrong addiction. It is more prominently abused in the older generations of our people and it changes a person entirely from who they once were. It is time that this medication is not abused by anyone anymore and doctors begin to minimize the amount of opioid type prescriptions written. 
