Benzodiazepines

The effects of benzodiazepines depend on: 

• if the benzodiazepines are fake/counterfeit
• how many tablets and what strength you take
• how often/long you have been taking them
• your age, height and weight
• your general health
• your mood
• your past experience with benzodiazepines
• whether you use benzodiazepines on their own or with other drugs
• method of use. 

IMMEDIATE EFFECTS 

The effects of benzodiazepines may last from a few hours to a few days, depending on the dose and type of benzodiazepines you take. It is possible to be affected by benzodiazepines and not be aware. 

The immediate effects can include that you: 

• feel relaxed /reduced anxiety
• feel drowsy, sleepy or tired
• have no energy
• become confused or dizzy
• feel good
• have mood swings
• slur your words or stutter
• cannot judge distances or movement properly
• have blurred or double vision
• cannot remember things from just a short time ago
• do risky things that you would not normally do
• may impair your capacity as a parent/primary carer of children
• may impair judgement while driving 

If you take a very high dose of benzodiazepines and /or take it with alcohol or other drugs you can go into a coma or die. 

LONG TERM EFFECTS 

Benzodiazepines are highly addictive. If you use benzodiazepines often and for a long time (more than two to three weeks), you may:

• have increased risk of injury from falls and accidents
• have no energy or interest in doing every day activities
• be cranky 
• feel sick in the stomach 
• have dreams that make you feel bad 
• experience fatigue or drowsiness
• lose interest in sex, or your body won’t work properly during sex
• get skin rashes
• be more hungry and put on weight 
• have menstrual problems (women) 
• be depressed 
• experience unpleasant withdrawal effects 
• have memory and concentration problems 
• increased risk of having seizures. 

The way a person uses benzodiazepines can also cause problems: 

• Injecting benzodiazepines that are intended to be swallowed in tablet/capsule form can cause severe damage to veins, leading to loss of limbs from poor blood circulation, or to organ damage or stroke. 
• Using benzodiazepines at the same time as other central nervous system depressants (sedative drugs) – such as alcohol, opioids (like heroin, methadone or oxycodone) – is very dangerous. It can cause muscle damage, cause you to become unconscious, stop or slow your breathing, put you into a coma or cause you to die. 
• Injecting benzodiazepines with unsterile injecting equipment makes you more likely to get blood poisoning (septicaemia) and skin abscesses (sores with pus). 
• NEVER share fits (needles and syringes), spoons, water, filters, alcohol swabs or tourniquets. Sharing injecting equipment makes you more likely to contract blood borne viruses such as HIV, hepatitis Band C. In NSW, free sterile injecting equipment is available from Needle and Syringe Program (NSP) outlets and from selected pharmacists. Call the Alcohol and Drug Information Service (ADIS) for the nearest NSP outlet. 
• Tell your doctor about any other drugs you are taking so they can give you the right type and dose of benzodiazepines. This will help to prevent the risk of different drugs affecting each other in your body.

Benzodiazepines are depressants that slow down the workings of the brain and the central nervous system. They are used medically to reduce anxiety and to help people sleep. They should only be prescribed by a health professional for short periods of time as it is possible to become dependent on them after as little as two weeks regular (eg daily) use. (See ‘Tolerance and dependence’). 

Different types of benzodiazepines work in the body for different lengths of time. They come in the form of tablets or capsules and some are available for intravenous use in hospital and other medical settings. These are a very dangerous group of drugs when taken in high doses and/or mixed with alcohol and other drugs and can cause an overdose or death.

 Some people inject benzodiazepines and/or use them at the same time as they use heroin, alcohol or other drugs. Injecting benzodiazepines, which are intended to be swallowed in tablet/ capsule form, can also cause severe damage to veins, leading to loss of limbs from poor blood circulation, organ damage or stroke.

Using benzodiazepines at the same time as any other drug, including alcohol, can be dangerous. Mixing benzodiazepines with other drugs that slow down the body (eg alcohol, sleeping pills, cannabis, heroin and other opioids), can: 

• make it harder to think clearly 

• make it harder to properly control how you move 

• stop your breathing and cause death.

It is unusual to overdose on benzodiazepines alone – but if you use them with other drugs such as alcohol, heroin or methadone it is very easy to overdose and die. Signs of overdose are:

• p​erson is unable to be ‘roused’ or woken
• coma
• very slow breathing
• slow heartbeat
• cold clammy skin
• lips may appear bluish.

If someone overdoses, other people with them should:

• phone Triple Zero (000) to get an ambulance and tell the operator that the person has overdosed (the police will not come unless someone dies)
• stay with the person
• try not to panic
• try to keep the person awake – talk to them, use their name
• if the person is unconscious, put them on their side, in the recovery position. [use illustration]
• clear their airway, check their breathing
• do mouth-to-mouth resuscitation if they stop breathing.​

Please note: The take home naloxone program includes instructions for performing rescue breathing and chest compressions. Before doing so, refer to the National COVID-19 Clinical Evidence Taskforce guidance on basic life support for adults in the community during the COVID-19 pandemic (PDF).

If you can’t wake someone up or you are concerned that they may have sustained a head injury from a drug related fall – call an ambulance immediately – dial Triple Zero (000).

If the person has been mixing benzodiazepines with other drugs, tell the NSW Ambulance paramedic exactly what they have taken. Paramedics are there to help. Generally paramedics don’t involve the police unless there is danger to themselves or other people/children, someone dies, or a crime (such as violence or theft) has been committed.

Drink spiking is when a person deliberately adds benzodiazepines or another drug (eg.GHB,) to another person’s drink without their knowledge – this could make the person become intoxicated unexpectedly. Drinks are spiked for amusement, to facilitate sexual assault, rape or theft.

If your drink has been spiked:

• ask someone you trust to get you to a safe place
• ask your doctor to test for the presence of drugs which can be identified through urine or blood tests within 24 hours.

If you feel unwell or suspect that you have been sexually assaulted then call an ambulance or go to the nearest NSW Health Sexual Assault service or Emergency Department.

Drink spiking is serious and illegal. To prevent drink spiking, it may be best to watch your drink, avoid sharing drinks, buy/pour your own drink and don’t accept drinks from people you don’t know well or trust.

Anyone can develop tolerance to benzodiazepines or other drugs. Tolerance means that you must take more of the drug to feel the same effects you used to have with smaller amounts or lower doses. This may happen very quickly with benzodiazepines. 

Dependence on benzodiazepines means that these drugs take up a lot of your thoughts, emotions and activities. You spend a lot of time thinking about using benzodiazepines, looking for them, using them and getting over the effects of using them. 

You also find it difficult to stop using or control how much you use. Dependence can lead to a variety of health, money, legal, work and relationship problems.

Not all people who ever use benzodiazepines become dependent. But it is very easy to become dependent on benzodiazepines and it can happen within two to four weeks of daily/regular use.

People who are dependent on benzodiazepines find it very hard to stop using them or cut down because of withdrawal symptoms. It may be dangerous to suddenly stop using benzodiazepines. Seek medical advice about how to withdraw gradually if you have been using benzodiazepines in higher doses or for a prolonged period. 

Symptoms of withdrawal can include: 

• disturbed sleep 
• feeling nervous or tense 
• being confused or depressed 
• panicking, disturbed and feeling anxious 
• feeling afraid or thinking other people want to hurt you
• feeling distant or not connected with other people or things
• sharpened or changed senses (eg noises seem louder than usual)
• shaking
• convulsions
• pain, stiffness or muscle aches or spasms
• flu-like symptoms
• heavier menstrual bleeding and breast pain (women)
• ‘pins and needles’ in the limbs 
• ringing in the ears, blurred vision.

Benzodiazepines taken during pregnancy cross the cord to the unborn baby. High doses can cause the baby to be born with poor muscle tone, poor feeding ability, breathing problems, drowsiness and low body temperature. 

New babies of mothers who use benzodiazepines are more likely to be sick in the first few weeks of life and later have withdrawal symptoms. 

Do not stop using benzodiazepines abruptly. Tell your doctor, midwife or the health professional managing your pregnancy if you are using benzodiazepines. They will be able to help you care for your baby. 

It is generally risky to take any drug while breastfeeding without medical advice. 

Taking benzodiazepines or buprenorphine while on methadone makes neonatal abstinence (withdrawal) more severe for babies. 

Using benzodiazepines without a prescription from a doctor, or keeping, selling or giving them to someone else is illegal. If you are caught you could face substantial fines and penalties including a prison sentence.

Benzodiazepines slow down the workings of your brain and your body, so they may make you drive dangerously. Any dose of benzodiazepines may affect your driving, and if you have any concerns, consult your doctor. You should not drive if you have not taken benzodiazepines before, are on a large dose or have recently increased your dose.

It is illegal to drive under the influence of drugs, including benzodiazepines. Penalties include losing your licence, a fine and/or jail. Anyone under the influence of drugs who kills or injures another person while driving can be sentenced to a term in prison.

The table below shows some of the different generic and brand names of oral benzodiazepines. 

Narcotics Anonymous Australia, a non profit organisation aiming to support people to abstain from drugs.​

www.reconnexion.org.au provides counselling, telephone support and information services (1300 273 266) to address the challenges of anxiety, stress, depression and benzodiazepine (tranquillisers and sleeping pills) dependency and related conditions.

For free and confidential advice about alcohol and other drugs 24 hours, 7 days a week, call the National Alcohol and Other Drugs Hotline 1800 250 015.

It will automatically direct you to the Alcohol and Drug Service in the state or territory you are calling from. 

Other support services

• nuaa.org.au NSW U​sers and AIDS Association (NUAA) is a peak drug user organisation in NSW providing harm reduction information and blood borne virus prevention peer education.
  

  Nepean Youth Drug and Alcohol Service (NYDAS) works within a holistic model of care to address a range of issues for young people (12 -20 years) of age related to their alcohol and other drug use. Call (02) 4734 2129 or (02) 4734 1333.

• Poisons Information Centre is a  24/7 call centre service to NSW and after hours call centre across Australia. Call 13 11 26

• ahmrc.org.au for Aboriginal community controlled health services across NSW. Go to Members/ Members regional map/ Member services or Member websites.

• alcohol.gov.au provides information about related health issues and Australian government policy. 

• druginfo.adf.org.au for facts and resources on alcohol and other drugs and the prevention of related harm.

• druginfo.sl.nsw.gov.au State Library of New South Wales provides up to date information for public libraries in NSW.

• headspace.org.au for mental health and wellbeing support, information and services for young people (12-25 years) and their family and friends.

• kidshelp.com.au is a free, 24 hour counselling service for young people aged 5-25 years. Counselling is offered by web, email or call 1800 55 1800.
  

• au.reachout.com ReachOut is an Australian online youth mental health service with a mobile-friendly site and forums where you can access help, information and support.

• shil.nsw.gov.au for free and confidential sexual health support and information.

• smartrecoveryaustralia.com.au Smart Recovery is a voluntary self-help group that assists people in recovering from alcohol, drug use and other addictive behaviours.

• Visit tafensw.edu.au for help with education, career development or personal matters. Students can contact a local TAFE / university counsellor. Follow the links to student services, careers and counselling.

• youthaction.org.au Youth Action is the peak organisation for young people in NSW. Use the search option to access a directory of NSW youth services.

• youthsolutions.com.au for services for young people 12 – 25 years of age and the community including prevention and health promotion, drug and alcohol education, community programs and referral. You can also call (02) 4628 2319. [provides services to young people in Macarthur & Wingecarribee].

When someone uses or misuses substances, it can affect everyone around them. This site offers a variety of resources for friends and families concerned about their loved ones. Support services are available specifically to help people supporting others with substance use or misuse. There are also tips for talking with kids about alcohol and other drugs (part 1 and part 2). ACON provides support specifically for LGBTQ+ families through Pivot Point.

Informational resources are available in 27 languages. This includes videos providing information about where and how to get help for yourself or someone you care about.

General resources include:
Information and support for family and carers

Managing aggression, alcohol and drug use in the home: A guide for those concerned about children 5-12 years

Coping with aggression, alcohol and drug use in the home - A guide for teenagers

A parents' guide to drug slang