- Effects of Benzodiazepines on the Brain
- What Happens When You Combine Sedatives and Alcohol
- Treatments for Mixing Alcohol with Sedatives like Xanax and Ativan
- Associated Social and Mental Health Problems
Effects of Alcohol on the Brain
Drinking too much alcohol can lead to abnormally slowed breathing and can impair brain regions responsible for judgment, speech and vision.
It also decreases the excitatory effects of glutamate-- a neurotransmitter that contributes to normal respiratory functions and therefore, can cause respiratory depression.
Effects of Benzodiazepines on the Brain
Benzodiazepines also exert sedative effects by interacting with the GABA receptor to upregulate inhibitory neurotransmission--albeit at a site of action distinct from that of alcohol.
- Intense drowsiness or confusion.
- Slurred speech.
As a result, it becomes increasingly less effective at mediating a normal level of inhibitory signaling.
What Happens When You Combine Sedatives and Alcohol
Because both sedatives and alcohol are central nervous system depressants, using them together can cause excessive sedation and respiratory depression.
- Cognitive delays further reduce response time, thus increasing the risk of having accidents (e.g., falling, car accidents).
How Common is Combining Benzodiazepines and Alcohol
Alcohol & Sedative Deaths
SAMHSA's Drug Abuse Warning Network (DAWN) found that alcohol use was linked to just over 27% of all emergency department visits necessitated by benzodiazepine abuse, and to 21% of all deaths linked to this form of substance abuse in 2010.
The majority of sedative and alcohol-related deaths were due to suppressed respiration.
Why Do Some Users Combine Sedatives with Alcohol
1. People are often prescribed benzodiazepines to counteract the anxiety that may be associated with conditions such as cancer or chronic pain.
- Alcohol may be consumed in combination with sedatives to further mask the pain, especially if an individual has started to develop a tolerance to the sedatives.
2. In addition, people struggling with alcohol addiction tend to suffer from insomnia and anxiety, and experiencing these conditions may motivate them to take sedatives as well.
- Extreme sedation is accompanied by a dramatic reduction in the perception of pain or anxiety, and this is often the goal when sedatives are mixed with alcohol.
3. Some individuals also start taking prescription drugs in order to get high or experience feelings of euphoria, thinking that this would be safer than taking illicit drugs.
4. Often times withdrawal symptoms make it difficult for individuals to discontinue the abuse of either drug, and the development of withdrawal may further motivate a person's continued attempts at self-medication with alcohol or sedatives.
Treatments for Mixing Alcohol with Sedatives like Xanax and Ativan
One of the main impediments to treating concurrent alcohol and benzodiazepine abuse is the evaluation of associated mental health issues, that may have contributed to the development of poly-drug use behaviors.
Adverse outcomes further complicate treatment; when drug abuse and psychiatric disorders co-exist, patients tend struggle to:
The most critical factor in the treatment of concurrent benzodiazepine and alcohol abuse is detoxification; a process by which the body is physiologically weaned off a drug of abuse.
- Suicidal ideation that may end in self-harm.
- Severe confusion.
- Respiratory depression.
Due to these effects, abrupt discontinuation from benzodiazepines and alcohol is not recommended.
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The rate of withdrawal and symptom alleviation differ greatly depending on individual case characteristics. A gradual tapering schedule has shown positive results.
- A long-acting benzodiazepine is administered at decreasing doses and administered based on the progression of symptoms.
Due to the need to monitor symptoms (that fluctuate markedly) and alter treatment accordingly, detoxification cannot be conducted without medical support.
The severity of withdrawal from benzodiazepines has been linked to high neuroticism, lack of social support and lower quality of life--all of which have been associated with an increased severity of alcohol dependence.
Therefore, the importance of a uniform environment-without the possibility of accessing either drug- cannot be emphasized enough.
Additional therapy for this type of concurrent abuse entails the use of non-central nervous system depressants such as lower-toxicity antidepressants, atypical antipsychotics, or buspirone instead of benzodiazepines.
Impulse and emotional control, as well as distress tolerance is also taught through CBT--improving these skills has shown to positively influence drug-seeking behavior and decisions.
One of the most important aspects of CBT is the use of sessions where patients are presented with scenarios that trigger cravings and may lead to relapse.
- Learning how to combat these situations effectively is extremely beneficial in long-term recovery.
Additionally, some patients may find themselves in situations in which they require medical therapy for illnesses sustained as a result of depressant abuse (e.g. respiratory distress) as well as treatment for substance abuse.
These may be found in hospital stay-type care or in a facility which offers both. This is known as inpatient care.
Associated Social and Mental Health Problems
- Persistent disorientation and confusion.
- Learning and memory problems.
- Speech impairments.
- Major depression.
- Persistent anxiety.
- Try to borrow or steal sedatives from others.
- Forge prescriptions.
- Experience serious financial problems as a result of the expense associated with buying alcohol and sedatives.
As long-term substance abuse changes the way neurotransmitters such as glutamate and GABA respond to stimulation, mental impairments may become chronic problems that make it hard for individuals to display proper social functioning without effective substance abuse treatment.
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