Like alcohol, benzodiazepines are central nervous system depressants. Though the two drugs work differently to achieve similar effects, the combined effect of taking both alcohol with benzodiazepines can be dangerous and even fatal. Both alcohol and benzodiazepines fall under a category of drugs called central nervous system depressants.
Alcohol and benzodiazepines can have an adverse effect, especially when taken in combination or in higher than recommended doses leading to decreased breath rate, heart rate, increasing chances of accidents by reducing coordination, fine-motor control, and generating confusion or disorientation. Coma and death are also possible.
What Are Central Nervous System Depressants?
Central nervous system depressants reduce nerve cell activity in the brain and along the central nervous system. There are several drug types that generate this effect including benzodiazepines, barbiturates, and non-benzodiazepines medications including Ambien, Lunesta, and Sonata, used to treat sleep disorders.
These drug types work similarly in affecting the availability of the inhibitory neurotransmitter, gamma-aminobutyric acid (GABA), which reduces nerve cell activity. Gamma-aminobutyric acid is also a key neurotransmitter in our response to fear. When we are startled, nerve cell activity in the brain increases. This increase is part of our fight or flight response. In response to an increase in excitatory neurotransmission, GABA is released leading to the relaxation of smooth muscle fibers and a general feeling of calm.
Benzodiazepines work to enhance the effects of GABA and are a form of tranquilizer. Sold under some common brand names including Valium, Xanax, and Ativan, the drug has been used to treat anxiety, insomnia, and is sometimes prescribed as a muscle relaxer, among other uses.
Alcohol is also a central nervous system depressant and binds with GABA receptors to produce similar effects to drugs like benzodiazepines. In small doses, each of these drugs may have the effect of reducing anxiety or helping someone feel more relaxed. However, at higher doses, or when used in combination or abused, these drugs can have a significant combined inhibitory response, including reduced breaths per minute, slowing of the heart rate, affect coordination and reduce focus, and trouble thinking and making decisions. Overdose can prove fatal.
What Makes Abusing Alcohol And Benzodiazepines So Dangerous?
While it’s nice to feel relaxed, inducing too much GABA can be dangerous in two ways. First and most dangerous are the adverse health effects. Inhibiting the central nervous system of the body with drugs is like dialing down the control system on a car, then blindfolding the driver. Response time slows, breath and heart rate slow and can even stop, blood pressure is diminished, cognitive functioning is impaired, coordination is reduced, and it may be difficult for someone to speak without slurring. Another cause of death when alcohol is involved is aspiration and alcohol poisoning.
The second risk of combining alcohol and benzodiazepines is the increased risk of physical dependency on substances. Once you begin artificially increasing GABA, the body begins to respond to the increase by reducing the number of available receptor sites. This leads to a reduction in the desired effects of the drugs, perpetuating use of the substances.
When someone tries to stop taking the combination of alcohol and benzodiazepines, they face an unprecedented onslaught of neural activity which can heighten already troublesome anxiety, depression, or insomnia. These co-existing mental disorders may exist prior to abuse of the substances, or may result from the substance abuse.
Withdrawals From Combining Alcohol With Benzodiazepines
If a serious physical dependence on the combination of alcohol and benzodiazepines develops, withdrawal symptoms can be serious and require comprehensive care to manage. Withdrawal symptoms of both drugs may include severe headaches, insomnia, agitation, muscle rigidity, anxiety and panic attacks, shakiness, profuse sweating, confusion, gastrointestinal upset, changes in weight, and irregular heartbeats. Cravings for one or both drugs may be intense for the first few weeks and longer.
Withdrawals from Alcohol and Benzodiazepines Include:
- Severe headaches
- Severe insomnia or sleep disruptions
- Muscle rigidity
- Anxiety and panic attacks
- Profuse sweating
- Gastrointestinal upset
- Changes in weight
- Irregular heartbeats
- Severe cravings
Treating Alcohol And Benzodiazepine Addiction
Treating alcohol and benzodiazepine addiction must include a treatment plan to accurately assess both the severity of the addiction, as well as any co-occurring mental disorders underlying the addiction. It is critical that someone undergoing treatment for an addiction to alcohol and benzodiazepine receive evidence-based care, especially since withdrawals from both drugs can mimic severe psychiatric disorders, including bipolar disorder and schizophrenia. The severity of withdrawals on the psyche combined with the physical withdrawals from both alcohol and benzodiazepine, including seizures and depressed immunity, make finding a comprehensive treatment plan essential to an individual’s long-term recovery.
A comprehensive treatment plan may include the practical application of yoga, exercise, and even acupuncture to naturally re-stabilize GABA and reduce related withdrawal symptoms including insomnia and anxiety. Medical management of these withdrawals may be necessary in more severe cases.
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