Abuse, emerging with regular intake of drugs of the group of benzodiazepines leads to a drug (for abuse) dependency. These substances have the General structural similar chemical structure.
Each tool in this class of medications in varying degrees characterised by the following effects:
- sedative (calming tranquilizing);
- anxioliticeski (eliminating anxiety);
- muscle relaxant (eliminates excessive muscle tension, as striated and smooth muscles);
When consumed there is a peculiar mental state, akin to alcohol or barbituric intoxication. It is the reason why the host unnecessarily benzodiazepines the person tries again and again to achieve them. If the medication is not by prescription and without control, when exceeding a certain therapeutic time interval, there is a mental and physical addiction to the medication.
Note: emerging addictive (no expected effect from the usual doses) leads to reception of the increased amount of benzodiazepines.
General information about benzodiazepine
Classification of drugs of this series are fairly lengthy, but our goal is somewhat different – to consider the development of painful abuse of these funds. We only note that benzodiazepines are of three types: short, medium and long-acting.
History of occurrences of the first benzodiazepine – Chlordiazepoxide (Librium) begins with 1955 on the basis of the experimental work of L. Sternbach. 4 years later was synthesized following the drug Diazepam. Due to its positive influence of a new group of substances has been actively used in many areas of medicine. But to the 80-th years of XX century doctors seriously faced with the massive development of abuse of benzodiazepines. It became clear that medicines require special monitoring in the appointment. Despite the ongoing work of finding new medications that will not cause dependency, the problem remains on the same level.
List of benzodiazepines and standard dosing is given in the table below:
Narcotic effect of benzodiazepines is based on the quality of gamma-aminobutyric acid (GABA), enhancing its effect on neurons, leading to antianxiety and calming effects.
Use of benzodiazepines, particularly effects
Drugs prescribed for the treatment of mental disorders on the background of the abstinence syndrome in chronic alcoholism, for the prevention and mitigation of epileptic seizures, in practice, the treatment of neuroses. Especially, these drugs are effective to eliminate panic attacks, anxiety, sleep disorders.
It should be remembered that during pregnancy, lactation and in the elderly benzodiazepines have undesirable effect more often than other categories of people.
Paradoxical reaction, and side effects
In some cases, on a background of reception, instead of the expected result may occur:
- the frequency and strength of convulsive manifestations;
- attacks of aggression, malice, impulsivity;
- suicidal behaviors, severe depression;
- sexual disorders;
- problems memory, thinking;
- speech defects;
- pathological changes in the intestine, loss of appetite, toxic liver damage.
The development of dependence the abuse of benzodiazepines
Constant, uncontrolled abuse of drugs leads to a gradual development of addiction. The effect of therapy is reduced. This forces patients to increase the dose and frequency of medication. Continuous intake of benzodiazepines generates a mental craving and physical dependence.
Please note: to avoid mental complications, you should periodically stop taking her meds, replacing them with others, or nothing at all taking.
Patients should be aware that this group of substances can only eliminate the symptoms of ailments, but does not cure them. To get away from the disease, you should eliminate its cause. Therefore, it is very important to the main “causal” treatment, while the action of benzodiazepines.
The therapeutic timing of intake should not exceed 2-3 months. If you cannot resolve the cause of the main manifestations of the disease after cessation of treatment, patients will develop a syndrome of cancellation (return fears, insomnia, anxiety, etc.), and perhaps in a stronger form – the syndrome of a ricochet.
In untreated cases, patients quickly return to the main drug. Dependencies gradually increase.
In some cases using benzodiazepines people taking drugs, trying to get away from their influence, to alleviate drug withdrawal symptoms. Most often this ends with the formation of a new polynarcomania, and after the development of severe benzodiazepine dependence.
How does the abuse of benzodiazepines
For the effect of drugs of this series is typical:
- the feeling of complete sedation, drowsiness, loss of coordination, and slow movements;
- the onset in the body sensations of relaxation and well being.
- improved mood (but not its changes);
- periodic development of motor and unfocused activity;
- difficulty in perception of external stimuli, slowness of pereklyuchenii attention;
- reducing the overall speed of mental reactions.
Please note: the manifestation of benzodiazepine intoxication most of the signs resembles that in the barbiturates and alcohol.
On examination, the patient, the doctor draws attention to:
- unsteadiness when standing (especially in Romberg);
- the patient struggles to perform delicate operations (take pen, book);
- disertacija disorders – slurred, faltering speech, difficult pronunciation of sounds;
- the obsessive repetition of words, phrases, movements;
- emotional depletion, or Vice versa, inappropriate reactions (laughing, inadequate, sad, sadness);
- significant dilation of the pupils of the patient, pallor of the skin;
- the white coating on the tongue, dryness of the skin and mucous membranes;
- excessive relaxation of muscles, lose their tone, lethargy;
- reduced reflexes.
The phenomena gradually increase, the patient a few hours sleep. After awakening remains marked weakness and emotional “dullness”. Gradually, the symptoms go away.
Constant medication creates tolerance to the drug, increasing the tolerance (malajustment to conventional doses). The lack of the usual sensations forcing patients to constantly increase the dose. In the first place in the intoxication go mental changes, and problems incoordination reduced. Dose dependent benzodiazepines of people can be reused more than one time and per diem.
Withdrawal syndrome, benzodiazepine withdrawal
During abstinence growing painful sensations that require taking another dose. That is becoming increasingly obvious withdrawal syndrome. The patient is increasingly starting to look for a reason and the possibility of taking the drugs.
Have a dependent appears:
- severe pallor, lethargy, depression;
- irritability with kapriznaya and tearfulness, even in men;
- heart rate dramatically increases, the pressure decreases, the patient sweats profusely;
- fingers shaking;
- pupils dilate dramatically;
- severe depression;
- sleep disorders with terrible, often interrupting dreams;
In more severe cases there can be seizures, psychosis with hallucinatory experiences, suicidal thoughts and actions. Some patients develop depersonalization.
Please note: withdrawal may last about 2-3 weeks or more, depending on individual circumstances.
Eventually, for the abuse of benzodiazepines is complicated and psihopatizatsii personality disorders. Patients having severe memory problems, violations of intellectual capabilities, comes impoverishment of emotional coloring, a person acquires massovidnost. The person progresses egocentrism, moral distortions (the whole world owe him something). In the character traits manifested by rudeness and boorishness, indifference to others, cruelty. Mental stress are difficult. The ability for physical work is reduced.
Overdose if abuse of benzodiazepines
Overdose of benzodiazepines occur in rare cases. The toxic effect of these drugs is more common in the combined use of their drug, alcohol, opiate group, antidepressants tricyclic series.
Overdose is manifested:
- severe drowsiness, passing into stupor and coma;
- a drop in blood pressure;
- dysfunction of eyeballs with nystagmus (the pendulum movement);
- problems with speech;
- sphincter disorders;
- stop breathing and cardiac activities.
Substance abuse treatment benzodiazepines
Treatment of benzodiazepine dependence has a number of features. If the patient’s condition allows, then perform it in the outpatient setting. Severe cases, especially co-dependent, require a hospital.
The issue of termination of admission is considered individually. For the correct approach must consider many factors. The optimal solution would be simultaneous, a complete cessation of the medication. Although some drug use and a stepwise dose reduction. Practice shows that a sharp “break” the technique gives better results, even at high doses of benzodiazepines.
In the majority of patients on the background of the abolition of develop very severe depression, fear of death, loss of body weight, asthenia.
In this case, an experienced psychiatrist selects the required antidepressant. Recent years, very well established drug – Trittico. With the help of withdrawal syndrome wears off and is virtually painless. Usually enough for several months in order to eliminate all negative withdrawal symptoms. Trittico acts very gently and does not contain any harsh side effects.
After the withdrawal from the antidepressants have a long time to eliminate the effects of fatigue. For this purpose the most suitable nootropics. Pick them up depending on the dominant residual effects. Sometimes it takes nootropics with stimulant effect, sometimes with a calming effect. Receiving this group of drugs may need quite a long time, because after benzodiazepine dependence remains pronounced damage of the mental functions of the patient.
It is important to maintain the activity of the heart (optimally – Inflammation), and liver. Long-term use of benzodiazepines has expressed the load on the liver cells. Therefore, the use of hepatoprotectors in a short time eliminates the toxic effect. Of modern protective and cleansing toxins from the liver drugs it is possible to pay special attention to Hepalife, both in injection and capsule form.
Important role of psychotherapy. Methods of suggestion and persuasion, which is the main form of impact of this treatment method are applied both individually and in group options impact.
Hypnotherapy allows you to assign motivational goals based on the rejection of benzodiazepines.
After the end of treatment by psychiatrists-narcologists the baton of psychotherapy are psychologists. On their ability to stabilize the mental processes convalescent patient depends on the duration of remission.