Benzodiazepine use disorder
Patients more likely to develop benzodiazepine use disorder may have a history of substance abuse, and may present with multiple symptoms and pharmacotherapies. Patients in treatment for other depressive disorders may be inclined to abuse benzodiazepine if it is used to treat adverse effects of antidepressants rather than for short-term use (2-4 weeks). Long-term use of benzodiazepines has been shown to increase tolerance.
Patients may stockpile prescription drugs, seek multiple prescriptions from multiple health care providers, acquire medications from other users, and exaggerate their pain or distress level to acquire longer, stronger doses.
The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM 5) classifies substance abuse from mild to severe depending on the number of criteria met. The criteria address signs of cravings, tolerance, loss of control, loss of interest in favorite activities, avoidance of responsibilities, and withdrawal symptoms upon abstinence.
Health care providers are advised against prescribing multiple drugs in this class. It is advisable to follow practice guidelines, avoid long-term use, or choose other medications, especially when prescribing to high-risk or older individuals. Risk factors for abuse include other drug or alcohol dependence, chronic pain, personality disorder, depressive disorder, sleep disorder, and certain neuromuscular disorders.
Adverse effects of benzodiazepine use include amnesia (memory loss), psychomotor impairment, ataxia, altered mental status, slurred speech, rebound anxiety, and withdrawal symptoms, drowsiness, lethargy, disturbed concentration, feeling "hungover", uncoordinated muscular movement, and hypotonia. These effects increase the likelihood of impaired driving, falls, and fractures.
Benzodiazepine overdose or poisoning can occur when ingested in a high dose alone or in combination with ethanol or other drugs. Toxicity can induce a state of excessive drowsiness, delirium, psychosis, seizures, stupor, or coma.
Related topic: Benzodiazepine Withdrawal Syndrome
F13.10 – Sedative, hypnotic or anxiolytic abuse, uncomplicated
428406005 – Benzodiazepine misuse