The Problem With Benzodiazepines
In the treatment of alcoholism and addictions, anxiety is often a coexisting problem. Left untreated, chances for relapse are high. Awareness of this problem has led many dual diagnosis treatment centers to prescribe anti-anxiety pills (i.e., the benzodiazepines) to help ease the tension of anxious clients.
What are benzodiazepines?
“Benzodiazepines are a class of psychoactive drugs used to treat anxiety, insomnia, and a range of other conditions. They are one of the most widely prescribed medications in the U.S., particularly among elderly patients.”
Which drugs are benzodiazepines?
Some of the more common and popular benzodiazepines given for anxiety include:
- Diazepam aka Valium
- Clonazepam aka Klonopin
- Lorazepam aka Ativan
- Alprazolam aka Xanax
Common benzodiazepines given for sleep include:
- Estazolam aka Prosom
- Flurazepam aka Dalmane
- Lorazepam aka Ativan
- Temazepam aka Restoril
- Triazolam aka Halcion
Why Are Benzodiazepines Bad?
As a class of drugs, benzodiazepines are among the most addictive and difficult to stop using. They cause addiction in a way similar to opioids. The Physicians Desk Reference advises doctors to not leave their patients on these drugs for long. In the case of Ativan, “…for short term (up to 4 months) relief of the symptoms of anxiety.” The changes benzodiazepines do to the brain make them unsuitable for long-term use, yet some doctors leave their patients on them for a long time, sometimes years.
Because benzodiazepines are cross-tolerant with alcohol they are often prescribed as a buffer to ease the physical withdrawal from alcohol. In short-term situations, (several days) this presents no problem. Unfortunately, we have seen clients whose doctors have left them on benzodiazepines as a long-term strategy to help them quit drinking. This never ends well. Alcoholics would be better off staying with the alcohol, rather than trading booze for benzos.
One of the reason benzodiazepines are so dangerous is because they cause long lasting changes in brain architecture by distorting the pathway for normal GABA reception. GABA is the most abundant calming neurotransmitter in the brain. When benzodiazepines interact with GABA receptors, they inhibit the release of GABA into the synapses of dopaminergic neurons. This results in a lessening of GABA restraint on the dopaminergic neurons, which increases the release of dopamine. Abnormal spikes in dopamine levels has been implicated in almost all addictions. In time, as the body tries to compensate for these abnormal spikes, the addict is forced to use more of the drug to maintain the same effect.1
That’s how the National Institute on Drug Abuse presents the problem of addiction with benzodiazepines, but I believe they may be side-stepping a bigger issue. Recall the primary purpose of GABA is to regulate glutamate, the most abundant excitatory neuron in the brain. By curtailing the release of GABA through inhibitory interneurons, benzodiazepines influence a restructuring of the brain's architecture (over time) in a way that allows levels of glutamate to rise unregulated. Dr Blaylock calls excessive glutamate stimulation “excitotoxicity,” a very destructive effect on the brain. This would account for the high level of anxiety experienced by long-term benzodiazepine users, and sounds highly plausible to me.
After awhile the brain comes to depend on benzodiazepines to compensate for that distortion with higher dopamine stimulation. However, never lose sight of what benzodiazepines are: cheap imitations of the real chemical (GABA) the brain runs on. When the day comes that a benzodiazepine addict wants to pull back, or stop using, (and it comes for all users) guess what happens. If you guessed anxiety in hyper-drive, inability to sleep, ongoing fight/flight tension, you’re right. Not only that, but this torturous withdrawal goes on for months and months, sometimes years and years. It’s not nice to fool Mother Nature. Once you change the structure of the brain, getting it back can take a long time.
An Alternative To Benzodiazepines?
Hoffman LaRoche, the Valium manufacturer stated (after their patent expired), niacinamide is a brain constituent with benzodiazepine-like actions. I guess they wanted to glean maximum profits before revealing that a natural B vitamin could help reduce anxiety at a fraction of the cost, with no addictive properties, and without any side effects. But today doctors continue to prescribe benzodiazepine in cases where niacinamide can work just as well.
Sadly, pharmaceutical companies have such tremendous influence over medicine that many doctors believe only drugs (cheap imitations) can help mental disorders. Orthomolecular physicians know better, but orthomolecular doctors are hard to come by, and orthomolecular clinics focused on addictions and mental health disorders are even more rare.
At the Health Recovery Center, we actually run tests to help identify specific anomalies that produce anxiety, and use special combinations of the real chemicals of life (not drugs) to help ease the anxious brain.
1. NIDA Notes. National Institute on Drug Abuse volume 24, no 2, p7.