Anti-anxiety medications or benzodiazepines are prescription only drugs that are used for the short-term treatment of severe anxiety and sleep disturbances, or specific medical conditions such as epilepsy and cerebral palsy. While they are therapeutically useful, benzodiazepines are a dangerous group of drugs because they are highly addictive, and when taken in high doses and or mixed with alcohol and other drugs, can cause an overdose and or death.
'Of the 1,865 drug induced deaths in 2019, the most common substance present was a benzodiazepine (43%). Between 2009 and 2018, the number of deaths where benzodiazepines were present rose by 70%.' — Australian Government, Australian Institute of Health and Welfare
Benzodiazepine (pronounced benzo-dye-assa-peen) should only be prescribed and used for short periods of time because it is possible to develop a tolerance very quickly and/or become dependent after as little as two weeks' regular use (e.g. daily).
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Dependence is when a person needs to use a drug to feel well.
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Tolerance is the need to increase the amount of drug used to get the same effect.
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Withdrawal is the process of quitting or cutting back on drug use. The body may experience a physical and/or psychological reaction as it gets used to functioning without the drug.
People who have become dependent on benzodiazepines (benzos) may experience long term effects such as increased risk of injury from falls and accidents, chronic headaches and stomach aches, fatigue or drowsiness, loss of sexual interest or function, skin rashes, increased hunger and weight gain, depression and memory and concentration problems.
Quitting benzos suddenly without careful medical supervision can lead to some of the most serious, and in rare cases fatal, and or prolonged withdrawal symptoms, compared with other addictive drugs.
What are Benzodiazepines?
Benzos temporarily depress or slow down the central nervous system. There are approximately 30 different types of benzos prescribed in Australia, with varied potency and length of effect. Benzos can take anywhere from 15to 40 mins to take effect, with 2 hours to reach maximal concentration in the brain. The effects can also last from a few hours to a few days, depending on the dose and type of benzo used. It is therefore important to carefully monitor your use to avoid overdose, specifically wait to reach 'peak effect' or maximal concentration before considering re-dosage.
The following list includes the generic names of different types of benzodiazepine pills or tablets, along with several brand names each may be sold under:
- Diazepam - Valium, Ducene, Antenex, Valpam
- Temazepam - Normison, Temaze, Temtabs
- Alprazolam - Xanax, Kalma, Alprax
- Oxazepam - Serepax, Murelax, Alepam
- Nitrazepam - Mogadon, Alodorm
- Lorazepam - Ativan
- Flunitrazepam - Rohypnol, Hypnodorm
- Bromazepam - Lexotan
- Clonazepam - Rivotril, Paxam
- Clobazam - Frisium
Note: Xanax and Rohypnol are no longer legitimately sold in Australia, any products with this appearance are illicit.
If you are prescribed one of the above benzodiazepines, be sure to talk through the risks with your doctor or pharmacist, including any other drugs you may be taking and lifestyle factors to ensure you can take them safely.
Counterfeit or fake benzos
Benzos are also used illegally as recreational drugs. They could be illegally obtained pharmaceutical benzos or counterfeit or fake.
Some of the names both counterfeit or illegally obtained pharmaceutical benzos go by on the street and in popular culture are: xans, xannies, xanny (in reference to the brand name Xanax), downers, rowies roofies (Rohypnol), serries (Serepax), moggies (Mogadon), vals or V (Valium), normies (Normison), downers, tranks (as in tranquillisers) and sleepers (sleeping tablets / pills).
In the past few years there has been an increase in the prevalence of counterfeit benzos, especially alprazolam products found in Australia. As with many counterfeit drugs, when analysed the fake alprazolam were found to be poorly manufactured and the ingredients and amounts or dose varied a lot from one tablet to the next, even within the same batch.
Check the latest
Counterfeit Alprazolam drug warning and all the latest Public drug warnings at
yourroom.health.nsw.gov.au/a-z-of-drugs/Pages/drug-warnings and
nuaa.org.au/drug-alerts.
Do not take alprazolam you suspect to be counterfeit. Products not purchased at pharmacies come with higher risk of overdose and serious or fatal health consequences. Get help immediately if you or someone else have taken any of these tablets and feel unwell.
Benzo-related emergency
Taking large amounts of benzos, returning to benzo use after a period of stopping or quitting and mixing benzos with other drugs that slow down the body (e.g. alcohol, sleeping pills, cannabis or opioids such as heroin, methadone, fentanyl), can put you at an increased risk of overdose and harm.
Like opioids, benzos are depressants that slow down the workings of the brain and the central nervous system. Overdose can happen whether someone is using illegal or pharmaceutical benzos prescribed by a doctor, especially where they are not used as prescribed.
Signs of overdose:
- person is unable to be roused or woken (even if they are snoring)
- very slow breathing
- heavy snoring or gasping
- slow heartbeat
- cold clammy skin
- lips may appear bluish
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 on Triple Zero (000).
If the person has been mixing benzodiazepines with other drugs, tell the Ambulance paramedic exactly what they have taken.
Quitting benzos
Not all people who ever use benzos become dependent. However, it is very easy to become dependent on benzos and it can happen within two to four weeks. Withdrawal symptoms may be challenging and can start within 24 hours of stopping. People who are dependent on benzos may find it hard to stop or cut down because of these withdrawal symptoms.
Talk with your doctor or alcohol and other drug specialist about how to gradually reduce and stop your benzo use. Getting help can assist you with managing the severity of withdrawal symptoms.
'Any patient who has taken a benzodiazepine for longer than 3–4 weeks is likely to have withdrawal symptoms if the drug is ceased abruptly' —
NPS MedicineWise
Withdrawal symptoms include:
- disturbed sleep
- feeling nervous or tense
- being confused or depressed
- panicking 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 (e.g. noises seem louder than usual)
- shaking, convulsions, seizures
- pain, stiffness or muscle aches or spasms
- flu-like symptoms
- heavier menstrual bleeding and breast pain for women
- 'pins and needles' in the limbs
- ringing in the ears, blurred vision
People who stop using suddenly after regular use are at risk of very serious and potentially fatal withdrawal symptoms, such as seizures. Therefore, it is important to seek medical advice about how to withdraw gradually. Talk to your GP / doctor about your benzo use or contact the Alcohol and Drug Information Service (ADIS) on 1800 250 015 for advice and referrals to dedicated treatment services.
Discover more about the effects of Benzodiazepines and where to get help at
A-Z of Drugs | Benzodiazepines.
For free and confidential advice 24/7 call the Alcohol and Drug Information Service (ADIS) on 1800 250 015. Counsellors are available to provide information, referrals, crisis counselling and support. Or start a
Web Chat with an ADIS counsellor online Monday to Friday, 8.30am – 5pm. ADIS can also provide up-to-date information about service availability in your area during the COVID-19 pandemic.
