Benzodiazepines and opioids are prescription medications that have depressant effects on the nervous system but are used for different medical purposes. While benzodiazepines are prescribed to relieve anxiety, seizures, and insomnia, among other conditions, opioids are used for pain management.
Mixing benzodiazepines and opioids is a form of polydrug abuse that can have catastrophic consequences. In the most severe cases, this drug combination can lead to death.
Keep reading to learn more about benzodiazepine and opioid drug interactions, better understand opioid dependence, and discover the revolutionary ANR approach to treating it.
What Are Benzodiazepines, and How Do They Work?
Colloquially known as benzos, benzodiazepines are a class of central nervous system (CNS) depressant drugs prescribed for a range of conditions, such as:
- Anxiety
- Seizures
- Insomnia
- Panic disorder
- Muscle spasms
Benzodiazepines work by enhancing the gamma-aminobutyric acid (GABA) neurotransmitter upon binding to the GABA A receptor. This neurotransmitter sends calming messages to the brain, leading to hypnotic, sedative, relaxing, and anticonvulsant effects. While these drugs treat the symptoms of anxiety, insomnia, and other conditions, they do not address their root causes.
Most benzodiazepines are classified as Schedule IV controlled substances, meaning they have a relatively low risk for abuse and dependence. Nonetheless, it’s not uncommon for people to develop tolerance and benzodiazepine dependence.
According to researchers from the University Hospital of Zürich, as many as 30–45% of chronically treated patients develop “low-dose dependence,” characterized by withdrawal symptoms that appear upon drug discontinuation. For this reason, benzodiazepines are only generally recommended for short-term treatment.
Types of Benzodiazepines
There are three types of benzodiazepines:
- Long-acting, such as diazepam (Valium®) and clonazepam (Klonopin®)
- Short-acting (e.g., midazolam (Versed®) and triazolam (Halcion®)
- Intermediate-acting, like alprazolam (Xanax®)
Short-acting benzodiazepines like Halcion® have a shorter half-life than long-acting ones like Valium®. In other words, it takes less time for your body to process and eliminate short-acting benzodiazepines. However, these types of benzodiazepines are more likely to cause withdrawal symptoms.
What Are Opioids, and How Do They Work?
Opioids are a class of drugs that act on the CNS to relieve pain. They are typically prescribed for moderate-to-severe pain management when milder painkillers cannot be used or aren’t potent enough.
Opioids work by interacting with the opioid receptors located throughout the CNS. They disrupt the transmission of pain signals between the body and the brain by binding to these receptors, thereby altering pain perception.
However, repeated opioid exposure gradually alters brain chemistry. Specifically, it decreases endorphin production while increasing the production of more opioid receptors, leading to tolerance and opioid dependence. As such, anyone who takes opioids for a prolonged time risks becoming dependent, including those who carefully follow their doctor’s instructions.
Furthermore, these potent pain medications also trigger sudden dopamine release, inducing intense euphoria and relaxation. Given that people are intrinsically wired to repeat dopamine-boosting behaviors, these rewarding effects add to the addictive potential of opioids.
Due to the high potential for abuse, dependence, and opioid addiction, most drugs belonging to this class are treated as Schedule II controlled substances. Therefore, they can only be obtained by prescription.
Types of Opioids
The main types of opioids are:
- Natural (e.g., morphine and codeine). Also known as opiates, natural opioids are extracted directly from the opium poppy plant.
- Synthetic, such as fentanyl and tramadol. Synthetic opioids mimic the effects of opiates but are fully human-made.
- Semi-synthetic (oxycodone, hydrocodone, etc.). These are produced in laboratories from natural opioids.
All opioids, regardless of how they’re derived, can lead to dependence and addiction, especially if taken for a prolonged time or abused.
Now that we’ve covered the basics, let’s examine the risks of combining benzodiazepines and opioids.
The Risks and Dangers of Combining Benzodiazepines and Opioids
The main dangers of combining benzodiazepines and opioids are the increased risk of respiratory depression, overdose, and serious side effects.
Despite their differences, benzodiazepines and opioids are both centrally-acting drugs with depressant effects. Although they act on different receptors in the CNS, they slow down brain activity. Taking benzodiazepines and opioids together can enhance these effects, increasing the risk of extreme sedation, confusion, drowsiness, and respiratory depression.
Respiratory depression and opioid or benzodiazepine overdose are among the greatest risks associated with polydrug use involving benzodiazepines and opioids. This drug combination can dangerously suppress your breathing and heart rate, which may have fatal consequences without prompt medical intervention.
Nearly 14% of opioid overdose deaths that occurred in 2014 also involved benzodiazepines like Valium®, Xanax®, and Klonopin®.
Since mixing benzodiazepines and opioids can be extremely dangerous, the FDA generally advises against their concurrent use. In rare cases, however, healthcare professionals might have no other option but to prescribe benzodiazepines and opioids together. Such patients should be carefully monitored throughout the treatment.
If your doctor determines it’s appropriate for you to take opioids with benzodiazepines, follow their instructions strictly to reduce the risk of respiratory depression, overdose, and other adverse effects. You should also inform them about any side effects you experience while taking these drugs.
Seek medical attention immediately if you notice any signs of an opioid overdose, which may include:
- Constricted pupils
- Extreme confusion
- Severe drowsiness
- Decreased heart rate
- Slow, shallow breathing
- Discolored skin, lips, and fingernails
- Difficulty moving, talking, or staying awake
4 Long-Term Effects of Mixing Benzodiazepines and Opioids
Some long-term effects of mixing benzodiazepines and opioids may include cognitive impairment, organ damage, chronic respiratory issues, physical dependence and addiction.
Let’s break these down:
#1. Cognitive Impairment
Combining opioids with benzos can take a significant toll on your cognition, leading to slowed cognitive processing and memory problems. Those who mix benzodiazepines and opioids, especially repeatedly, risk developing drug-induced cognitive impairment, as both of these drugs can impair cognition and cause delirium. Taking them together further exacerbates these risks.
Not to mention, using benzodiazepines and opioids may impact your judgment and decision-making. This, coupled with the fact that these drugs also impair coordination, may increase the risk of accidents, falls, and injuries. Plus, this drug combination can cause breathing problems, potentially leading to brain damage caused by oxygen deprivation.
#2. Organ Damage
Benzodiazepines and opioids are primarily metabolized by the liver, with most types being excreted by the kidney. Prolonged use of either of these drugs may lead to renal and hepatic impairment, and mixing them increases these risks even more.
Combining benzodiazepines with opioids can also damage other organs, such as your heart. Since polydrug abuse considerably increases the risk of organ damage, you should never take these drugs in higher doses, more frequently, or for a longer period than prescribed.
#3. Respiratory Issues
Mixing benzodiazepines and opioids puts you at high risk of chronic respiratory issues, some of which—such as respiratory failure—may be life-threatening.
While anyone taking this drug combination can develop respiratory issues, those with pre-existing lung problems should be especially careful. A study by Jacques Baillargeon et al. found that concurrent benzodiazepine and opioid use is associated with increased adverse respiratory events in older adults with chronic obstructive pulmonary disease (COPD).
#4. Physical Dependence and Addiction
Physical dependence and addiction are among the greatest risks associated with opioids. Benzodiazepines, too, can cause dependence, especially with prolonged use and abuse. Unsurprisingly, taking these drugs together makes you more likely to become dependent on either of them.
On this note, let’s explore the signs of benzodiazepine and opioid dependence and abuse.
Signs and Symptoms of Benzodiazepine and Opioid Dependence and Abuse
The main signs and symptoms of benzodiazepine and opioid dependence are tolerance and withdrawal symptoms. When it comes to benzodiazepine and opioid abuse, keep in mind that you should always take these drugs as instructed; taking them in any other way is a form of polysubstance abuse, which is extremely dangerous.
If you take benzodiazepines or opioids for a prolonged time, your body and brain will become so accustomed to them that your original dose will lose its effectiveness. In other words, you will eventually need higher doses to achieve the same effects as before.
In the case of opioid use, this happens because repeated opioid exposure causes the brain to create more opioid receptors. Meanwhile, the exact mechanism behind benzodiazepine tolerance isn’t fully understood yet.
However, researchers from Utrecht University suggest that it develops due to benzodiazepine-induced changes in the GABA A receptor, ionotropic glutamate receptors, and the neurosteroid system.
Furthermore, people with physical dependence experience uncomfortable benzodiazepine or opioid withdrawal symptoms upon drug cessation. Several withdrawal symptoms from these drugs, such as sleep disturbances, irritability, sweating, and nausea, overlap.
Concurrent benzodiazepine and opioid use may cause particularly severe withdrawals, increasing the risk of relapse, subsequent overdose, and death.
Importantly, untreated physical dependence can lead to addiction, which is marked by problematic drug use. Those addicted cannot stop taking the drugs, even when it destroys their life. For this reason, it’s crucial to seek professional help as soon as you recognize the signs of opioid dependency in yourself or a loved one.
Today, the best treatment for opioid addiction is ANR; this groundbreaking solution stands out from traditional methods in that it targets the neurobiological causes of opioid dependence.
ANR Opioid Dependence Treatment
Accelerated Neuro-Regulation (ANR) is an ultra-modern opioid dependence treatment developed by Dr. Andre Waismann. As the first and only method that addresses the underlying causes of opioid dependence, it has an unmatched success rate.
ANR approaches opioid dependence treatment from a medically, scientifically based perspective. It works by re-regulating the endorphin-receptor system while the patient is sedated. Put simply, ANR treatment restores the brain to its pre-dependence state, eradicating opioid dependence together with withdrawal symptoms.
Benefits of Undergoing ANR Treatment
Some of the main benefits of undergoing ANR treatment include:
- Patient safety. ANR is scientifically proven to be safe. To ensure patient safety throughout the procedure, it is only carried out in an ICU setting of fully accredited hospitals by a team of board-certified medical professionals.
- Long-lasting results. By targeting the root cause of opioid dependence rather than its symptoms, ANR facilitates lasting recovery. Once your nervous system is rebalanced, you’ll no longer suffer from cravings and other withdrawal symptoms, allowing you to forget about the fear of relapse.
- Short duration. With an average hospital stay of just 36 hours, ANR enables you to conquer opioid dependence within a matter of days, as patients can return home just a few days after hospitalization.
As of today, the ANR treatment has helped close to 25,000 people worldwide reclaim control of their lives.
Meet Jared, one of ANR patients whose inspiring story proves that it is never too late to seek help for opioid dependence:
Ready to return to an opioid-free life? Contact us today for a free, 100% confidential consultation!
Key Takeaways
Ultimately, you should only use benzodiazepines and opioids together if your healthcare provider determines there are no other alternatives.
If you have to take these medications, work closely with your doctor, let them know about any unwanted effects you experience while taking them, and look out for the signs of drug overdose.
Lastly, let’s summarize what we covered:
- Benzodiazepines are prescription drugs that reduce the symptoms of anxiety, sleep, and seizure disorders by acting on the GABA A receptor.
- Opioids are potent pain medications that reduce the perception of pain by interacting with opioid receptors.
- Mixing benzodiazepines and opioids substantially increases the risk of severe side effects, respiratory depression, overdose, prescription drug dependence, and more.
- ANR is a safe and highly effective treatment that can help you break free from opioid dependence within days.
Benzodiazepines and Opioids FAQ
Combining benzodiazepines and opioids is dangerous because both drugs act as CNS depressants. Therefore, taking them together exponentially increases the risk of respiratory depression, overdose, and other potentially life-threatening adverse events.
ANR treatment for opioid dependency works by modulating the endorphin-receptor system, thereby reversing the damage repeated opioid exposure causes to the nervous system. In doing so, this innovative treatment addresses the neurobiological causes of opioid dependence, negating the risk of ongoing withdrawal symptoms and relapse.
If you suspect a loved one is misusing benzodiazepines and opioids, encourage them to seek professional help for substance abuse and dependence. Mixing benzodiazepines and opioids can have detrimental—and even life-threatening—consequences. However, quitting these drugs without medical supervision can be extremely dangerous.
