Effects of Mixing Benzodiazepines & Alcohol

1. Effects of Benzodiazepines on the Brain
2. What Happens When You Combine Sedatives and Alcohol
3. Treatments for Mixing Alcohol with Sedatives like Xanax and Ativan
4. Associated Social and Mental Health Problems
5. Sources

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.

When left unchecked, excitatory processes in the brain can elicit feelings of anxiety or panic in a tolerant user, unless more and more benzodiazepine is taken to counter it. If you or someone you love is currently suffering from co-abuse of benzodiazepine or alcohol, call 1-888-993-3112Who Answers? to find a treatment program that suits your needs.

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).

• 
  Both acute or chronic alcohol intake in combination with large amounts of sedatives can significantly increase sedation through a synergistic effect at both GABA and glutamate neurotransmitter sites in the brain--which may cause an individual to stop breathing or slip into a coma.

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:

• 

  • Maintain abstinence.
  • Use mental health services.
  • Avoid suicide-attempts.
  • Maintain employment and social relationships.

Medical

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.

Don't wait Hear from others on their journey through addiction and recovery Withdrawal & Detox

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.

Inpatient

• 
  An inpatient center offers access to medical professionals who can supervise detoxification; a critically important factor in the management of adverse withdrawal symptoms from concomitant benzodiazepine and alcohol dependence.

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.

Mixing alcohol and benzodiazepines can cause mental health problems that make it hard for individuals suffering from them to overcome the abuse without receiving closely monitored treatment, or specialized dual diagnosis approaches to effectively target both the substance abuse and mental health issues simultaneously. But specialized treatment programs are available, please call 1-888-993-3112Who Answers? to find treatment today.

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Outpatient

• 
  Alternatively, patients whose functional status has not been adversely affected may feel more competent to integrate outpatient care into their lives.

  • This involves making regular appointments at clinics or facilities at which they can access regular medical and/or psychological treatments.

Residential

• 
  Some patients may prefer to remain within a center for treatment, regardless of their health or functional status. These decisions may be affected by personal or abuse-specific (e.g. wishing to avoid the temptation to slide back into abuse patterns) reasons. Therefore, they may check into a residential facility to work at their treatment.

  • Residential options may extend beyond initial care for substance abuse problems. These options may include 'sober living' facilities, in which the client lives free of drug-abuse temptations or 'cues'.

Associated Social and Mental Health Problems

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.

Sources

1. Gudin JA, Mogali S, Jones JD, Comer SD. Risks, management, and monitoring of combination opioid, benzodiazepines, and/or alcohol use. Postgrad Med. 2013 Jul;125(4):115-30.
2. Parsons, OA. Alcohol abuse and alcoholism. In: Nixon, S.J., ed. Neuropsychology for Clinical Practice. Washington, DC: American Psychological Press, 1996. pp. 175-201.
3. Morgan, MY. Alcohol and nutrition. British Medical Bulletins 38:21-29, 1982.
4. Martin, PR, Singleton, CK, Hiller-Sturmh?fel, SH. The role of thiamine in alcoholic brain disease. Alcohol Research & Health 27(2):134-142, 2003.
5. Mendelson WB. Neuropharmacology of sleep induction by benzodiazepines. Neurobiology 16: 221, 1992.
6. Amrein R, Hetzel W, Harmann D, et al: Clinical pharmacology of flumazenil. Eur J Anaesthesiol 2:65, 1988.
7. Barker MJ, Greenwood KM, Jackson M, Crowe SF. Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis. Arch Clin Neuropsychol. 2004; 19(3):437-54.
8. Girre, C, Facy, F, Lagier, G, & Dally, S. Detection of blood benzodiazepines in injured people. Relationship with alcoholism. Drug and Alcohol Dependence 21(1):61-65, 1988.
9. Linnoila, M, Mattila, MJ, & Kitchell, BS. Drug interactions with alcohol. Drugs 18:299-311, 1979.
10. Medical Economics Data. Physicians' Desk Reference. Montvale, NJ: Medical Economics Data, 1993.
11. Sands, B.F.; Knapp, C.M.; & Ciraulo, D.A. Medical consequences of alcohol-drug interactions. Alcohol Health & Research World 17(4):316-320, 1993.
12. Forney, R.B., & Hughes, F.W. Meprobamate, ethanol or meprobamate-ethanol combinations on performance of human subjects under delayed autofeedback (DAF). Journal of Psychology 57:431-436, 1964.
13. The TEDS Report: Admissions Reporting Benzodiazepine and Narcotic Pain Reliever Abuse at Treatment Entry. Rockville, MD: Center for Behavioral Health Statistics and Quality; 2012. Substance Abuse and Mental Health Services Administration (SAMHSA).
14. Highlights of the 2010 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits. Rockville, MD: SAMHSA; 2012. Substance Abuse and Mental Health Services Administration (SAMHSA).
15. Drug Abuse Warning Network, 2011: Selected Tables of National Estimates of Drug-Related Emergency Department Visits. Rockville, MD: Center for Behavioral Health Statistics and Quality, SAMHSA; 2012. Substance Abuse and Mental Health Services Administration (SAMHSA).
16. Johnson E. Utah Drug Overdose Mortality: Findings From Interview With Family and Friends of Utah Residents Aged 13 and Older Who Died of a Drug Overdose Between October 26, 2008 and October 25, 2009. Salt Lake City, UT: Utah Department of Health; 2009.
17. Calcaterra S, Glanz J, Binswanger IA. National trends in pharmaceutical opioid related overdose deaths compared to other substance related overdose deaths: 1999-2009. Drug Alcohol Depend. 2013 Aug 1; 131(3):263-70.
18. Chen KW, Berger CC, Forde DP, D'Adamo C, Weintraub E, Gandhi D. Benzodiazepine use and misuse among patients in a methadone program. BMC psychiatry. 2011;11:90.
19. Shaivani R, Goldsmith J, Anthenelli RM. Alcoholism and psychiatric disorders: Diagnostic challenges. Alcohol Research and Health, 2002; 26(2):90-99.
20. Madras BK, Compton WM, Avula D, Stegbauer T, Stein JB, Clark HW. Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: comparison at intake and 6 months later. Drug Alcohol Depend. 2009 Jan 1; 99(1-3):280-95.
21. Jones JD, Mogali S, Comer SD. Polydrug abuse: a review of opioid and benzodiazepine combination use. Drug Alcohol Depend. 2012 Sep 1; 125(1-2):8-18.
22. Khong E, Sim MG, Hulse G. Benzodiazepine dependence. Aust Fam Physician. 2004 Nov; 33(11):923-6.
23. Otte C. Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues Clin Neurosci. 2011; 13(4):413-21.
24. Durham, R.C., Chambers, J.A., Power, K.G., Sharp, D.M., Macdonald, R.R., Major, K.A., Dow, M.G., Gumley, A.I. (2005). Long-term outcome of cognitive behaviour therapy clinical trials in central Scotland. Health Technol Assess. 2005; 9(42):1-174.
25. Jann M, Kennedy WK, Lopez G. Benzodiazepines: a major component in unintentional prescription drug overdoses with opioid analgesics. J Pharm Pract. 2014 Feb;27(1):5-16.