Benzodiazepines have a sedating effect on your central nervous system. Therefore, they can cause similar side effects to those of alcohol. However, taking them together can worsen the side effects of each other. Mixing them may cause intense damage and dangerous symptoms.
Also, building all forms of dependency on a drug is very possible if they aren’t taken according to a doctor’s instructions.
What are the Side Effects of Mixing Alcohol and Benzodiazepines?
Alcohol and other drugs such as benzodiazepines have a collaborative depressant effect on the central nervous system. Possibly, a bigger problem is the fact that memory impairment is much more likely when these substances are combined. Long-term abuse or high doses of benzodiazepines can cause significantly diminished memory, mood swings, and changes in behavior.
Individuals who abuse these substances often discover that they have developed a tolerance to their effects. In other words, they have to take more to achieve the same high. Likewise, many people struggling with alcohol use disorder (AUD) may combine alcohol with their drugs. This helps them achieve the calm or euphoria they’re seeking, but the potentially dangerous side effects of both alcohol and benzodiazepines are more distinct when they are combined.
Furthermore, during periods of blackouts, an individual may take part in risky behavior such as driving a car, criminal behavior, and even suicidal thoughts and actions. Besides the physical damage of abusing drugs or alcohol, things are often said or done that are regretted later.
What Are Benzodiazepines?
Benzodiazepines also called “benzos,” are a class of medications that help reduce the symptoms of anxiety and depression. Cases of generalized anxiety disorder or depression don’t always need treatment with medications but a psychiatrist may decide that a prescription for an antidepressant is necessary. The most common antidepressants include selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs).
However, after being introduced to the public in the 1950s, benzodiazepines quickly became the drug of choice for treating anxiety disorders. It was thirty years before public health officials identified the dangers of benzodiazepine addiction. This class of drugs has a challenging number of side effects, even when prescribed by a doctor. Side effects include:
- Reduced coordination
- Drowsiness and fatigue
- Impaired cognitive function
- Slurred speech
Benzodiazepines are usually only prescribed for a short amount of time to lessen more intense anxiety cases. Benzos start acting quickly and for a shorter length of time. However, antidepressants like SSRIs and SNRIs can be taken indefinitely and will provide all-day relief.
Common benzodiazepines include:
Alcohol Use Disorder (AUD)
Dependence on alcohol is an increasing and extensive problem. The World Development Report discovered that alcohol-related disorders affect 5-10% of the world’s population each year. Additionally, it is responsible for about 2% of the global burden of disease. Alcohol dependence is also one of the most common psychiatric disorders and is second only to major depression.
Heavy drinkers who suddenly decrease their consumption of alcohol or completely abstain may experience alcohol withdrawal. Alcohol withdrawal syndrome (AWS) is one of the most common signs of alcohol dependence. AWS is a group of symptoms that occur in alcohol-dependent people after stopping or reducing heavy or long-term excessive alcohol use. Symptoms may vary from mild to severe.
The most common symptoms are:
- Mild to moderate tremors
- Night sweats
- Rapid heart rate
- Nausea and vomiting
Some people develop severe AWS which may include, among others:
- Delirium Tremens (DTs)
These symptoms happen because of the brain’s alcohol-induced imbalances, which results in excessive brain cell activity if the alcohol is withheld.
Can Benzos be Used to Treat Alcohol Withdrawal?
Benzodiazepines have the largest and the best evidence in the treatment of alcohol withdrawal. They are considered the first-choice medication for AWS because they are effective and usually safe when used for short amounts of time. Benzos treat withdrawal symptoms by imitating the effects of alcohol in the brain.
Benzodiazepines have a similar anti-anxiety effect on the brain as alcohol. This allows them to effectively replace the effects of alcohol in the brain and prevent alcohol withdrawal symptoms. After starting a benzodiazepine for AWS, the dose may be tapered off over time to wean off the medication and still prevent the withdrawal symptoms.
Deciding on the right treatment regimen is the responsibility of a healthcare provider and needs to be developed specifically for the individual. It should be based on:
- How much the individual typically drank
- The duration of alcohol use
- Other health conditions
- Amount of improvement after starting treatment
Abuse of benzodiazepines is probably more common than most people think. Abusing these drugs can have a negative impact on relationships, career, and mental and physical health. In the United States, they are some of the most commonly prescribed medications. And they are also commonly abused.
The abuse of benzodiazepines is partly related to the toxic effects they cause and their widespread availability. They can be chronically abused or taken to overdose, either intentionally or accidentally. When people without prescriptions obtain them and use them for their sedative effect, use turns into abuse. Serious illness and death seldom result from abuse of benzodiazepines alone. But, the combination of benzodiazepines and alcohol, in particular, can be dangerous and even deadly.
Still, people who have prescriptions may also misuse their medication. Getting prescriptions from different doctors (doctor shopping), taking too much and running out, and being focused on when to take the next dose may be signs of a problem.
What are Symptoms of Benzo Abuse?
High doses of benzodiazepines can cause serious side effects. Signs of acute toxicity or overdose may include:
- Blurry vision
- Loss of coordination
- Breathing problems
4 Common Drugs that Shouldn’t Be Mixed with Benzos
Opioids like OxyContin (oxycodone), morphine, and Hysingla ER (hydrocodone) or combination products that contain any of those drugs are painkillers are abused and are dangerous if combined with benzodiazepines. According to Dr. Katy LaLone, an assistant professor of psychiatry at Case Western Reserve University in Cleveland, combining benzos with other sedative medications, particularly opioids including heroin, can cause cardiorespiratory depression that puts patients at risk of overdose and death. In fact, opioids are involved in 75% of benzodiazepine-related deaths.
2. Insomnia Medication
Also known as “Z-drugs,” prescription drugs that treat insomnia have a similar action to benzodiazepines. These drugs include:
Patients are often prescribed benzos for anxiety and a Z-drug for insomnia, not realizing the drugs have similar actions. This is common for patients receiving prescriptions from more than one doctor. Combining these two drugs can cause episodes of amnesia (blackout spells) and leads to a quadruple risk of severe outcomes, such as visits to a hospital or jail.
3. Proton Pump Inhibitors (PPIs)
PPIs, such as:
- Protonix are used to treat acid reflux.
This increases the blood levels of benzodiazepines by interacting with the same liver enzymes meant to clear them from the body. Doing this can result in making the side effects of benzodiazepines worse. This includes:
- Impaired driving
4. Fluoroquinolone Antibiotics
Fluoroquinolone antibiotics compete for the same binding sites on nerve cells as benzodiazepines. This means that one drug blocks the effect of the other. In this example, the fluoroquinolones block the benzo from binding, bringing on acute withdrawal in people who are dependent on benzo. There have been reports of long-term benzodiazepine patients experiencing withdrawal symptoms after using these antibiotics.
Grapefruit and Herbal Interactions
Grapefruit and certain herbal supplements can also have notable interactions with some benzodiazepines. Some of the more common interactions include:
- John’s Wort
- Grapefruit and grapefruit juice
Can Benzodiazepine and Alcohol Addiction be Treated?
There are effective methods for overcoming benzo and alcohol addiction and never going back. Treatment begins with identifying the problem and seeking help.
Stopping the use of benzodiazepines and alcohol is extremely dangerous and should not be attempted without the professional supervision of a detox center. Symptoms of alcohol withdrawal, as mentioned previously, can be life-threatening. Similarly, suddenly stopping benzodiazepines can result in withdrawal symptoms which may include seizures.
If detox cured addiction, no one would ever relapse. Unfortunately, detox is meant to clear the toxins from the body to help prepare for a treatment program where the real work of overcoming addiction takes place. Typically there is a variety of treatment programs available so the individual is able to enter and exit at the appropriate level.
Inpatient Treatment for Substance Abuse
An individual with long-term or very heavy drug or alcohol use may need to enter treatment at a higher level of intensity, such as inpatient treatment for substance abuse. This is where they live at the treatment center with 24-hour medical supervision. This is also important for people who don’t have stable, drug-free housing.
Partial Hospitalization Program (PHP)
PHPs are intensive programs in which the individual spends all day at the treatment facility, but is able to return home in the evenings. These are appropriate for people who need a high level of care but have a stable support system at home.
Outpatient Treatment for Substance Abuse
Outpatient treatment for substance abuse requires varying times at the treatment facility. These programs offer more flexibility for individuals whose addiction is not as severe or long term and have stable home and work support networks. Programs include:
- Intensive Outpatient Program (IOP) – IOPs usually provide 3 days of treatment at the facility.
- Outpatient Program (OP) – A standard OP requires 1 or 2 days of treatment at the facility. Outpatient programs are frequently used as step-down programs for people who have completed a higher level of care.
Therapy and Counseling
While in a treatment program, individuals receive a variety of counseling and addiction treatment therapy services depending on their needs. Common therapy approaches include:
- Individual and Group Therapy
- Family Therapy Program
- Cognitive Behavioral Therapy (CBT)
- Holistic Therapy
By participating in therapy, individuals may begin to recognize the reasons for their substance abuse and learn skills to avoid relapse. Many people discover an underlying undiagnosed mental issue that may be the root of their problem with substances.
The Denial Issue
As long as a person stays in denial of their problem, it can be very difficult to make them recognize the negative effects of their behavior. While the addiction progresses, the adverse effects on the person’s physical and mental health become impossible to deny.
Why You Need Westwind Recovery®
Westwind Recovery® Center has been named “Best Los Angeles Treatment Center” in 2020 and 2021. From detox to sober living, we are dedicated professionals whose only job is to see you, or someone you love succeed. In addition to our individualized approach to substance abuse treatment, we offer specialized programs such as:
- LGBTQ substance abuse treatment to provide a safe and welcoming place to work on sobriety and help heal family relationships.
- Night Track program for people who work during the day and need to attend treatment at night.
- Alumni program that includes social events and sober activities to keep treatment graduates engaged and prevent relapse.
Contact us now and discover what Westwind can do for you, your family, and your future.
Dr. Deena is the Chief Clinical Officer of Westwind Recovery®, an award-winning outpatient treatment center in Los Angeles where she oversees the clinical and administrative program and treatment methods. Dr. Deena is a doctor of psychology and licensed clinical social worker since 1993. LCSW #20628. Originally from the East Coast, Dr. Deena has worked running treatment centers, worked as a therapist in psychiatric hospitals as well as school settings and currently has a thriving private practice in the LA area. Dr. Deena has appeared regularly on the Dr. Phil Show as an expert since 2003. She has also been featured on many other TV shows, podcasts and has contributed to written publications as well as podcasts.