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Benzodiazepine Intervention

When a Benzodiazepine Intervention is Needed

The definition of a Benzodiazepine (Benzo) is “any of a class of synthetic, potentially addictive, tranquilizers and sleeping pills”. Essentially a neural suppressor, benzo’s act by slowing down the mental activity of the brain. Is is important to seek help from an interventionist due to the severity of this type of addiction.

The most common interventions that our interventionist perform are for , , Klonopin, Librium, Dalmane and are generally prescribed to handle stress, anxiety or sleeplessness. Benzo’s are considered by some to be one of the most dangerous classes of drugs because their withdrawal brings about delusional thinking, confusion, seizures and sometimes death. Interestingly enough, originally designed to handle panic attacks and anxiety, abuse of benzo’s can actually increase anxiety over time, creating a “need” in the user to take more and more of the drug to handle the anxiety. Which, of course, creates more anxiety over time…and a greater need for the drug. A diabolical trap.

Although the substance itself isn’t usually the true problem in terms of recovery, it is important to understand that each substance abused does require a different approach in terms of intervention. An intervention for Xanax, Valium, or Klonopin is handled differently than a standard intervention on an alcoholic. In dealing with a benzo addict we generally have four types of people needing a benzo intervention, each of which is dealt with in a different way.

Least Common Benzodiazepine Intervention

The least common of benzo interventions is on a “pure” benzo addict. A pure benzo addict is someone who solely uses benzo’s for their effect and rarely if ever, combines with any other substances. He doesn’t drink, doesn’t use any other drugs. His drug of choice is Benzo’s and that’s all he abuses. He may have initially had a legitimate reason (ie. anxiety, stress, etc), but now is completely dependent on them.

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Intervention on an Alcoholic Who Uses Benzos

The classic stereotype of an alcoholic-benzo addict would be the wife who has a few glasses of wine and a valium each night. Essentially, an alcoholic-benzo addict is someone who is an alcoholic but also combines benzo’s with alcohol for two reasons.

The first is for an increase in the effect of alcohol. Combining a neural suppressor (benzo’s) and a central nervous system depressant (alcohol) has a shotgun effect on the nervous system and exponentially increases the effect. Of course, the danger of combining different classes of drugs also exponentially increases the danger.

The second reason for one combines alcohol and benzo’s is as a way to handle the associated anxiety common to alcoholics. As a result of heavy drinking, many alcoholics begin to develop impaired sleep patterns, restlessness, and anxiety. Many seek counseling for the anxiety but are reluctant to acknowledge or admit the severity of the drinking to a therapist. As a result, they are prescribed benzo’s when in actuality, the solution lies in handling and eliminating the drinking problem.. This type of benzo intervention is more common than that of a “pure” benzo addict.

Intervention on a Methadone User Who Also Uses Benzos

A methadone-benzo addict is someone who, prior to methadone, abused other opiate-based drugs, including Heroin. As an attempt to handle the opiate addiction, they are then prescribed methadone. Essentially, the effect of methadone on an opiate user is to block the effects of opiates on the system, while at the same time providing a “high”. Because it is an opiate blocker, it is extremely difficult to “get high” on opiates while taking methadone. As a result, many methadone users than take benzos in addition to the methadone for an increased “high” or effect. Performing a benzo intervention on a methadone-benzo addict is more difficult because of the methadone involved. The methadone itself is the primary problem and in essence, must be confronted more heavily than the benzos.

Polysubstance-Benzo Addict

A polysubstance-benzo addict is someone who has become addicted to benzo’s due to the frequency of use but also takes many different substances. For example, someone who on a daily basis takes Xanax or Valium, but also “parties” with alcohol, cocaine or opiates. In other words, it would be hard to describe him as “benzo addict” because he abuses a large variety of substances and very likely may be addicted many of them.

The Benzo Intervention Itself

Essentially the primary difficulty in performing a benzo intervention is timing and response. For most benzo addict’s have a higher degree of associated anxiety due to the abuse of the drug and, as a result, can be very reactionary. Their ability to handle the stress of an intervention is much less than that of others, and the interventionist must use a higher degree of understanding and care. Essentially, if the benzo addict is currently under a large amount of benzo’s, the intervention will go much more smoothly than if he currently isn’t under the effects of the drug. A benzo addict without their drug can experience panic attacks, desire to flee, and a high degree of nervousness during the intervention. All of these things must be taken into consideration when performing a benzo intervention.

Commonly Abused Benzo’s

Short-acting benzodiazepines are generally used for patients with difficulty falling asleep but who don’t have daytime anxiety. Shorter-acting benzodiazepines used to manage insomnia include:

For Insomnia Only

  • estazolam (ProSom®)
  • flurazepam (Dalmane®)
  • temazepam (Restoril®)
  • triazolam (Halcion®)
  • Midazolam (Versed®)

Benzodiazepines with a longer duration of action are used to treat insomnia in patients who also have daytime anxiety.  These benzodiazepines include:

For Insomnia and Anxiety

  • alprazolam (Xanax®)
  • chlordiazepoxide (librium®)
  • clorazepate (Tranxene®)
  • diazepam (Valium®,
  • halazepam (Paxipam®),
  • lorazepam (Ativan®),
  • oxazepam (Serax®),
  • prazepam (Centrax®), and
  • quazepam (Doral®).
  • Clonazepam (Klonopin®), diazepam, and clorazepate are also used as anticonvulsants.

Essentially each benzo intervention is unique and after proper analysis and guidance, your intervention specialist will help you to determine when and what is the best approach.

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