A 40-Year History of Benzos in a Nutshell
Back in 1975 – when benzodiazepines (or benzos) were widely touted as a wonder drug for anything from chronic anxiety to mild stress, 103 million prescriptions were issued for them in the U.S. in that year alone.1 The following year, David Knott, a physician at the University of Tennessee, voiced strong concern about short-term memory loss among such patients, warning: “I am very convinced that Valium, Librium and other drugs of that class cause damage to the brain. I have seen damage to the cerebral cortex that I believe is due to the use of these drugs, and I am beginning to wonder if the damage is permanent.”
Two years later in Britain, Malcolm Lader, an expert on benzos at London’s Institute of Psychiatry, called them “the opium of the masses” because of Britain’s very high prescribing rates, a pattern that correlates with that in the U.S.
“We knew from the start,” Lader explained on the 2002 Discovery Channel documentary In Pills We Trust, “that patients taking markedly increased doses could get dependent. But we thought only addictive personalities could become dependent and that true addiction was unusual. We got that wrong! What we didn’t know – but know now – is that even people taking therapeutic doses can become dependent.”
In 1989, renowned anxiety specialist Isaac Marks drew yet more attention to “serious adverse effects” of the drug that only “become apparent later,” he asserted – long after most clinical trials had stopped tracking the patients.
Even back in 1983, Robert Whitaker noted a “striking deterioration in personal care and social interactions” in long-term benzo users. Continuing his work, he reported in 2007 that “French researchers surveyed 4,425 long-term benzo users and found that 75 percent were ‘markedly ill to extremely ill,’ with a great majority of the patients experiencing significant depressive episodes and generalized anxiety disorder, often with marked severity and disability.”
In the early 1990s, after years of being hounded by reported clinical research, Upjohn finally admitted: “Certain adverse clinical events, some life-threatening, are a direct consequence of physical dependence to Xanax (Upjohn’s benzo product). These include a spectrum of withdrawal symptoms; the most important is seizure. Studies of patients with panic disorder showed a higher rate of rebound and withdrawal symptoms with Xanax. Other symptoms – such as anxiety and insomnia – were frequently reported during discontinuation.”
What Is Today’s Verdict on Benzos?
So, where does all of this leave us? From Australia to Nepal to Britain to the U.S., continues Psychology Today, benzos are recognized as fueling powerful cravings among drug addicts. That’s less surprising, perhaps, when one hears that Professor Lader declared, in a 1999 interview, “It is more difficult to withdraw people from benzos than it is from heroin. The dependency is so ingrained and the withdrawal symptoms are so intolerable that people have a great deal of problem coming off benzos. The other aspect is that, in the case of heroin, withdrawal is usually over in about a week. With benzos, a proportion of patients go on to long-term withdrawal, and they have very unpleasant symptoms for month after month. Some of the studies can document people still having symptoms ten years after stopping use of benzos.”
Given the troubling, well-documented history on benzos, adds Psychology Today, responsibility dictates a strong note of caution. Patients who are concerned about the drugs’ adverse effects should NOT terminate their treatment abruptly, but should instead taper their dose carefully and very gradually, over a course of several months under medical supervision, to ensure their own safety.
Benzos and the Brain: Users Get Hooked on Neurons’ Sweet Silence
We know a great deal about the short-term effects of Xanax and other benzodiazepine medications on the brain.2 By blocking gamma receptors in the brain, these medications hyperpolarize neurons (i.e. brain cells). When hyperpolarized, neurons don’t fire as often, which works to lessen the brain activity that induces feelings of anxiety and fear. When the volume from these brain areas are turned down, people feel calmer and are less likely to become fearful, agitated or anxious. Unlike antidepressants, which take days or weeks to turn down brain anxiety, benzos produce immediate relief.
While benzos are very effective in silencing the neuron noise, they have two major drawbacks. First, over time the brain adjusts to their activity, so that if they are stopped suddenly, brain activity can overshoot normal. When this happens, people show withdrawal symptoms, such as high blood pressure, shaking and intense anxiety. When severe, benzos withdrawal can even produce death.
A second drawback is that the danger of addiction to these agents is further increased by the fact that they work so quickly. Bad anxiety is probably the single most miserable emotional state humans can experience. It is truly a living hell. For people who struggle with anxiety, the fact that benzos work so fast greatly increases the risk for developing psychological dependence – or, addiction.
Many drugs alter neurotransmission (neuron activity) by increasing or decreasing the quantity of receptors stimulated.3 Benzos, however, enhance receiving cells’ responses when the neurotransmitter gamma-aminobutyric acid (GABA) attaches to their receptors. Benzos’ relaxation effects result from this increased sensitivity to GABA’s inhibitory impact on cellular activity.
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1 Lane, Christopher, Ph.D.,“Brain Damage from Benzodiazepines: The Troubling Fact, Risks, and History of Minor Tranquilizers,” Psychology Today , www.psychologytoday.com/blog/side-effects/201011/brain-damage-benzodiazepines-the-troubling-facts-risks-and-history-minor , (November 18, 2010).
2 Raison, Charles, M.D., “What Are the Long-Term Brain Effects of Xanax,” CNN, http://www.cnn.com/2010/HEALTH/expert.q.a/03/23/xanax.long.term.use.raison/index.html?hpt=Mid (March 23, 2010).
3 “Impact of Drugs on Neurotransmission,” National Institute on Drug Abuse (NIDA), www.drugabuse.gov/news-events/nida-notes/2007/10/impacts-drugs-neurotransmission , (October 1, 2007).