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Benzodiazepines can be addictive and induce dependence even at low doses, with 23% becoming addicted within 3 months of use. Benzodiazepine addiction is considered a public health problem. Approximately 68.5% of prescriptions of benzodiazepines originate from local health centers, with psychiatry and general hospitals accounting for 10% each.
Benzodiazepine use disorder (BUD), also called misuse or abuse, [1] is the use of benzodiazepines without a prescription and/or for recreational purposes, which poses risks of dependence, withdrawal and other long-term effects. [2] [3] Benzodiazepines are one of the more common prescription drugs used recreationally.
Long-term use of benzodiazepines can induce perceptual disturbances and depersonalization in some people, even in those taking a stable daily dosage, and it can also become a protracted withdrawal feature of the benzodiazepine withdrawal syndrome. [54] In addition, chronic use of benzodiazepines is a risk factor for blepharospasm. [55]
Benzodiazepine withdrawal syndrome (BZD withdrawal) is the cluster of signs and symptoms that may emerge when a person who has been taking benzodiazepines as prescribed develops a physical dependence on them and then reduces the dose or stops taking them without a safe taper schedule.
There is some evidence that a prior history of CNS depressant dependence (e.g. alcohol) increases the risk of dependence on benzodiazepines. Tolerance to drugs is commonly believed to be due to receptor down-regulation ; however, there is very limited evidence to support this, and this hypothesis comes from animal studies using very high doses.
Notably, benzodiazepines addiction often occurs as a result of polydrug abuse, most commonly with opioids. [24] Medically supervised detoxification remains the first-line treatment for benzodiazepines addiction. [54] The use of other medication to aid withdrawal has not been well-developed. [55]