#benzodiazepines
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What Do Benzos Do, Exactly? What Are They Used For?
Benzodiazepines act as a central nervous system depressant. That has a multitude of different effects, and honestly, they’re a uniquely useful class of drug.
They can be used to treat muscle spasms, anxiety, and sleep disorders. They can keep a patient sedated both in the short term or the long term. Some of them can even stop seizures.
One of the benefits—and terrifying side effects—of benzos are their ability to keep the brain from forming memories. This makes them extremely useful for procedural sedation, for people like me who may need things like dental surgery but want to be blissfully memory-free of the process. However, this leads to another use of benzos as, well, date-rape drugs.
Want to learn more? Read on, fair human!
(trigger warning: pharmacology of date rape drugs mentioned. No images or descriptions of sexual assault occur. One bit about dentistry and consent.)
Benzos: An Abbreviated List
Because there are an awful lot of these drugs on the market, I’m going to keep it relatively short, and list only the most common benzodiazepines available. Different meds are used for different things and come in different forms, so I’ll list that too!
Oh, and as for abbreviations: PO = oral (usually a pill, but sometimes a liquid suspension for kids); IM = intramuscular (a shot in the arm, leg or buttock), IN = Intranasal (can be administered up the nose), IV = intravenous. Anxiolysis means “breaking up anxiety”, or reducing it.
diazepam (Valium): PO / IV. Used for muscle relaxation, stopping active seizures, anxiolysis, as a sleep aid (short term). Limited use for sedating violent patients because an IV must be in place. In babies, diazepam can also be given per rectum (up the butt) to stop seizures.
lorazepam (Ativan): PO / IV / IM. Long acting. Used for stopping active seizures, anxiolysis, sedation of violent patients. Falling out of favor for seizure and chemical restraint because of its long-lasting effects (up to 8 hours).
midazolam (Versed): PO / IV / IM / IN. Very powerful sedative effects. Used for stopping seizures, sedation of violent patients, and sedation in the ICU / OR. This medication is very commonly used in ICUs because of this, and is the first-line choice for stopping seizures in patients without IVs in place.
alprazolam (Xanax): PO only. Primarily used for anxioslysis. Highly addictive.
triazolam (Halcion): PO only. Primarily used for procedural sedation and anxiolysis.
clonazepam (KlonidineKlonopinthanks anon!): PO only. Primarily used for anxiolysis and as a newer, less-addictive alternative to alprazolam.
I will say this: as a provider who works in the emergency and intensive/critical care setting, if I had to only ever have one benzo on hand, I would take midazolam and never look back.
What Does It Feel Like To Be On A Benzo?
Characters under the effects of benzodiazepines may feel drowsy, dizzy, “dopey”, “loopy”, like their limbs are very heavy, like their eyelids are heavy. They may also feel giddy. Benzos suppress inhibitions, so people may be an interesting combination of silly and drowsy.
Under a strong enough dose, benzos can cause characters to fall asleep.
Memories of time while on a benzo, particularly one with strong amnestic effects like triazolam or midazolam, can be blurry. Characters may remember one or two key events during a period of sedation, or they may simply not remember it at all.
I had triazolam three times for dental procedures. The first time I didn’t remember anything, the second time I remembered stressful events (but I don’t remember feeling stressed), and the third time I remembered nothing again.
However, the first time I was apparently still extremely anxious, to the point of crying and asking for my wife. (I’m an EXTREMELY nervous dental patient. I had my trust massively violated by a dentist as a kid, by which I mean, if you ask a kid if it’s okay to keep drilling, and she says NO, you fucking stop, you piece of shit, balloon gloves don’t replace consent.)
Ahem. Sorry.
Are There Side Effects?
There can be. Benzodiazepines often cause dizziness, drowsiness, foggy thinking, weakness, an unsteady gait (stumbly walk).
It’s more rare, but they can cause disorientation, depression, sleep disturbances, and memory impairment.
When a character has a paradoxical reaction, even though they’ve been given a stimulant, they may become moreexcited, agitated, and aggressive.
Also, any benzo given in high enough doses can be enough to trigger respiratory depression or even apnea (lack of spontaneous breathing).
All of these side effects are potentiated (made stronger and more likely) when benzos are taken while the person has also been drinking alcohol.
Are Benzos Addictive?
They can be. Those who take them every day can become physically dependent on them, dependent those who stop taking them suddenly can have seizures, nausea, vomiting, body aches, anxiety, double vision, profuse sweating, and more. This can happen with a sudden discontinuation or even a dose reduction.
Severe symptoms can include seizures, delirium, psychosis, and hallucinations. Seizures can be fatal if not treated.
Why Do Benzos Stop Seizures?
GABA receptors, the same receptors that benzodiazepines hit, are CNS depressants. That means they can reduce overall activity, such as the uncontrolled activity of a seizure.
However, the longer a seizure goes on, the more GABA receptors are inactivated, which is why patients who’ve been seizing for >10 minutes may not respond to benzos, and may need another class of drug. This condition of prolonged seizure activity, by the way, is called status epilepticus.
You Mentioned Date Rape Drugs?
Yes.
This is the downside of a class of drugs like benzos, that have both sedation, inhibition lowering, and amnestic effects. Some asshole is going to use it incorrectly. Some asshole is going to abuse it.
And that is absolutely awful. The way our society, or at least American society, handles sexual assault is atrocious, much less when it comes to those involving alcohol and drugs, whether the victim willingly ingested them or not.
That kind of abuse of something designed to be therapeutic gets me really steamed.
However, benzos help millions of people worldwide each year. Without them the odds of stopping ongoing seizures would be very slim. And millions of people have anxiety that is eased with a low dose of benzodiazepine. Two of them are in my family.
And even if we got rid of all the benzos in all the world…. assholes would find a way.
Assholesalways find a way.
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And thanks for reading :)
xoxo, Aunt Scripty
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i relapsed in some habits i thought i kicked and im FURIOUS at myself
Slow Me Down
Kurwa
Ostatnie chwile względnego spokoju
3 kg benzo
All this bud and xans and no one to share them with. Welp guess I’ll sleep until next week. I miss you…
I have thirty pills.
“This is a ROUND WHITE PILL with (LOGO) 35 printed on the front”
It should have been ten.
See, what you’re missing here is that it all started with the birth of time:
From discrepancies in the fluid universe, tiny things joined by chance,
and it was by chance that together they then recruited their own tiny things.
And as the string of accidents grew inumerable spiderwebbing universes from each of its gnarled twigs,
Only one twined into a rope; the only one to come to fruition.
This is the rope that put those thirty pills in the bottle clearly labeled “2 MG, QTY: 10 EA.”
The first deviation from a uniform sheet of spacetime
Is the most recent common ancestor of all happenings thereafter. Including the fact that now
I have thirty pills.
