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What are Benzodiazepines? | Chemistry, Use Cases, Dosage & Side Effects

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Benzodiazepines are extremely popular prescription drugs, with an estimated worldwide annual usage of over 70 million. Benzodiazepines are a family of drugs that are commonly used to treat anxiety and insomnia. 

These medications work by stimulating the release of a neurotransmitter called gamma-aminobutyric acid (GABA). GABA helps regulate the activity of nerve cells in the brain and reduces anxiety, stress, and fear. 

While they can be effective in managing certain conditions, benzodiazepines can also have serious side effects if not taken properly. In this blog post, we’ll take a look at what benzodiazepines are, how they’re used, their dosage guidelines, and possible side effects. 

Chemical Composition 

Legal Status 


Benzene ring and diazepine ring Schedule IV of 

the Controlled Substances Act

ATC code: N05BA

Benzodiazepines High-Level Fact Sheet

We will start by explaining the chemical composition of benzodiazepines, their legal status in the USA, and the common trade names.

Benzodiazepines Chemical Composition

Benzodiazepines are a class of drugs that act upon the neurotransmitter gamma-aminobutyric acid in the brain to produce a calming, sedative effect. 

In terms of chemical composition, benzodiazepines vary depending on the specific compound but typically consist of a fusion between a benzene ring and a diazepine ring, which together form the core structure for all benzodiazepine derivatives. 

Different substitutions and functional groups can be added at different positions along the diazepine ring to create variations between different benzodiazepines, each with its own efficacy, duration of action, and side effects. 

Benzodiazepines Legal Status 

The legal status of benzodiazepines in the United States is a complex issue. These medications, which are used to treat anxiety and insomnia among other conditions, are considered controlled substances due to their potential for abuse and addiction. 

As a result, Benzodiazepines are considered Schedule IV drugs under the Controlled Substances Act, meaning that their sale or possession without a prescription can be highly punishable by law. 

They are legal to use with a prescription from a medical doctor and may be dispensed by pharmacists for registered patients. Patients must also provide proof of valid identification before obtaining any of these medications from pharmacies.

Benzodiazepines Clinical Data

Benzodiazepines are classified under sedatives and antidepressants that work by increasing the effect of a neurotransmitter known as gamma-aminobutyric acid (GABA). GABA is a chemical messenger in the brain that helps regulate nerve cell communication in areas involved with fear and anxiety. By increasing its activity, benzodiazepines help reduce feelings of fear or anxiety. 

Commonly prescribed benzodiazepines include diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin) and temazepam (Restoril). Other names for benzodiazepines include benzos and downers.

Benzodiazepines Use Cases:

Benzodiazepines are a type of drug used to treat a variety of medical conditions. They work by calming the nervous system and helping to reduce anxiety. While they are commonly prescribed to treat panic disorders, they can also be used in other scenarios. 

Let’s explore the use cases for benzodiazepines and see how these drugs can help individuals dealing with certain medical issues. 


Benzodiazepines have been around since the 1960s and have been proven effective in treating a wide variety of conditions including:

Anxiety Disorders 

Benzodiazepines are commonly prescribed to treat anxiety disorders such as panic disorder, generalized anxiety disorder, phobias, and post-traumatic stress disorder. These medications work quickly to reduce symptoms such as racing thoughts, restlessness, and difficulty concentrating. 

However, they should only be used short-term—generally no more than 4 weeks—as long-term use can lead to tolerance and addiction


Benzodiazepines are also commonly prescribed to treat insomnia and other sleep problems. These medications help induce sleep by slowing down activity in the brain which makes it easier for people with sleep difficulties to fall asleep and stay asleep for longer periods of time compared to people who do not take benzodiazepines. 

Again, these medications should only be used short-term as long-term use can result in tolerance and dependence. 

Seizures & Muscle Spasms 

Benzodiazepines may also be prescribed for managing seizures or muscle spasms caused by neurological disorders such as multiple sclerosis or cerebral palsy. In these cases, benzodiazepines can help stop seizures or reduce the frequency of them occurring over time. 

They may also help reduce muscle spasms by making muscles relax more easily which can help improve mobility in those who suffer from chronic muscle spasms due to neurological disorders. 

Seizure Disorders

Benzodiazepines are one of the most effective treatments for seizures. These medications can reduce the frequency and intensity of seizure symptoms, providing seizure sufferers with much-needed relief. 

Benzodiazepines impact the central nervous system, calming overactive neurons that cause seizures to occur. They can provide many users with mild sedative effects which tend to be helpful when dealing with unbearable symptoms associated with muscle jerks, spasms, and overall discomfort caused by seizures.  

Alcohol Withdrawal

Benzodiazepines are often the first line of defense when treating individuals suffering from alcohol withdrawal. The sedative effects of this type of drug can help to alleviate physical symptoms, such as trembling and seizures, as well as psychological symptoms like anxiety, agitation and irritability. 

This can be instrumental in assisting those with alcohol dependence to manage their withdrawal and is often used alongside other therapies and treatments to ensure that their overall health is improved. 

Benzodiazepines can provide short-term relief for alcohol withdrawal but should always be taken under the supervision of a medical professional, who can assess the need for the medication and monitor its effects.

Bipolar Disorder

Benzodiazepines are a type of medication that can be helpful in treating symptoms of bipolar disorder. They can help reduce anxiety, agitation, and mania, as well as improve sleep. While taking benzodiazepines is not a permanent fix for bipolar disorder and it’s important to follow your doctor’s recommendations for use, they offer an effective way to temporarily manage the intensity of moods and other symptoms associated with the condition. 

A typical treatment strategy is to take them during manic phases when necessary and then discontinue their use once their desired effects have been achieved. The ability for these drugs to control the volatility of mood swings can give people with bipolar disorder support in managing their own mental health.

Performance Enhancement:

Benzodiazepines are a type of drug that have become commonly used by athletes to enhance their performance in competitive sports. In particular, they often use benzodiazepines to make themselves appear more relaxed and collected during intense situations, as well as to reduce anxiety associated with competition. 

Furthermore, the effects of benzodiazepines can also lead to improved focus and reactions times for athletes, allowing them to perform better under demanding circumstances. Unfortunately, these uses of benzodiazepines come with many potential issues ranging from dependency to side effects such as dizziness or confusion during competition. It is important to weigh the pros and cons carefully before using this medication for performance enhancement purposes.


In terms of their recreational use, benzodiazepines are often used to induce relaxation or sedation. These drugs can produce feelings of euphoria or intoxication which may result in users taking higher doses than prescribed or engaging in dangerous activities while under the influence. 

In recreational settings, these drugs can produce an intoxication that is sedating and euphoric. Although this might sound enjoyable, it is important to understand the risks associated with recreational benzodiazepine use. 

People using benzodiazepines recreationally may develop physical dependence if they repeatedly use high doses of the drug which can result in experiencing withdrawal when they stop using it. 

Benzodiazepines have become increasingly popular as recreational drugs among opioid addicts as a means to enhance the feeling of high from the opiates such as cocaine and heroin.

Types of Benzodiazepines:

There are almost 50 types of benzodiazepines available on the market, each with its own unique set of properties and indications. But here we will take a look at the 6 most commonly recommended types of benzodiazepines.


Also known as Xanax, is a short-acting benzodiazepine that works within minutes and has a half-life of 12 hours. It is typically prescribed to treat anxiety disorders, panic attacks and depression. Alprazolam is available in tablet form with dosages ranging from 0.25 mg to 3 mg. 


Otherwise known as Klonopin is a long-acting benzodiazepine used for treating epileptic seizures, panic disorder and sleep disturbances caused by among other things hyperactivity or emotional stress. 

It has a half-life of between 20 – 50 hours depending on metabolism rate, age and gender. Clonazepam tablets are usually provided in doses from 0.5mg up to 2 mg.. 


Commonly known as Ativan is another intermediate-acting benzodiazepine with an elimination half-life between 12 -18 hours depending on metabolism rate, age and gender of the user. 

It is widely used for treating both acute anxiety symptoms as well as chronic ones such as generalized anxiety disorder (GAD), seizure, and insomnia. Lorazepam can come in either pill or injectable form with dosages starting at 0.5mg up to 2 or 5mg per pill depending on strength.

On the other hand, injectable solutions range from 2 or 4 mg/2ml vials up to 10 ml/10mg vials for more severe cases requiring more immediate relief of symptoms like panic attacks or severe insomnia episodes due to high levels of stress or trauma events like PTSD related flashbacks. 


A long acting benzodiazepine commonly known as Valium is usually prescribed for treating muscle spasms due to neurological issues such as multiple sclerosis (MS) or spinal cord injury (SCI).

The half-life of Diazepam is  20-100 hours and often comes in pills starting from 2mg to 10 mg. 


Oxazepam, also known as Serax, is a benzodiazepine drug used to treat anxiety and alcohol withdrawal symptoms. It is available for oral administration in tablet form ranging from 10 mg to 50 mg, though the usual recommended dosage for adults is 15 mg to 30 mg per day. 

The drug’s half life is approximately 5-15 hours which means it takes this long before the body has metabolized half of the dose taken. It is important to note that Oxazepam’s long half life increases the risk of overdosing, so patient monitoring and frequent adjustments in doses by a doctor are necessary when taking this medication.


Chlordiazepoxide is a benzodiazepine drug, often referred to by its trade name Librium. It is most commonly prescribed to treat moderate to severe anxiety and alcohol withdrawal symptoms. 

Patients can choose from 25, 10 or 5 mg capsules of chlordiazepoxide depending on their doctor’s recommendation. Doctors usually begin treatment with the lowest dose and increase it incrementally based on the patient’s response to treatment. 

The average recommended amount for an adult is 20 – 40 mg per day taken in divided doses spread out over several times throughout the day. Chlordiazepoxide is a long-acting drug with a half-life of between 30-100 hours.

Benzodiazepines Side Effects:

Benzodiazepines are a class of drugs commonly prescribed to treat anxiety, panic attacks, insomnia, and other mental health issues. While these medications can be effective in treating these conditions, they can also have a variety of side effects.

Common Side Effects on Benzodiazepines:

The most common side effect associated with taking benzodiazepines is drowsiness. This is because benzodiazepines slow down your central nervous system, making it difficult to concentrate or stay alert while taking them. 

Other common side effects include confusion, headaches, nausea, dizziness, impaired coordination and balance problems. Some people may also experience changes in their appetite or sex drive while using benzodiazepine medications. 

Serious Side Effects on Benzodiazepines: 

In rare cases, taking benzodiazepines can lead to more serious side effects such as difficulty breathing (respiratory depression) or an irregular heartbeat. These symptoms should be reported to a doctor immediately if they occur while taking these medications. 

Additionally, benzodiazepines can cause memory loss and confusion when taken in high doses or for long periods of time. Some users also report depression or suicidal thoughts as well as paradoxical reactions such as aggression and agitation. 

It is important to talk to your doctor about any potential risks before starting a new medication regimen.  

Benzodiazepines Long Term Effects:

Along with the short-term side effects mentioned above, there are potential long-term effects associated with taking benzodiazepine medications as well. Abusing these drugs over an extended period of time can lead to physical dependence on the drug which can cause severe withdrawal symptoms when the drug is stopped abruptly. 

Additionally, long-term use of benzodiazepine medications has been linked to depression and cognitive impairment due to decreased brain activity caused by the drug’s sedative properties.  

Benzodiazepines Addiction: 

Benzodiazepines are a type of powerful prescription drugs commonly used to reduce anxiety and treat insomnia. However, with prolonged use, some individuals can develop an addiction to them. 

This kind of addiction is notorious for forming quickly and easily, as the body develops a tolerance to it faster than most other substances. Symptoms of benzodiazepine addiction include cravings, continuing to take the drug despite knowledge of its harmful consequences, spending significant time and energy trying to get more regularly prescribed doses, and increased doses over time in order to feel the same effect. 

Furthermore, the withdrawal symptoms associated with benzo addiction can be intense and even life-threatening without professional medical assistance. Anyone who believes they may be struggling with a benzo addiction should seek help from a doctor or treatment center immediately for benzodiazepines addiction treatment.

Types of Drug Treatment for Benzodiazepines Addiction

Benzodiazepines are one of the most widely prescribed medications for anxiety and other psychological disorders. Unfortunately, they can be highly addictive and have a very high risk of misuse. 

Thankfully, there are a variety of treatments available to help those with addiction overcome their reliance on benzodiazepine drugs. The most effective type of rehabilitation typically combines medications to manage withdrawal symptoms and behavioral therapies to reduce cravings and address underlying mental health issues that may have contributed to the substance abuse in the first place.

Learning life skills like stress management, communication techniques and problem solving can also help give someone with benzodiazepine addiction the tools they need to live a drug-free life. 

Patients can either enroll in intensive inpatient treatment programs to partial hospitalization or opt for an intensive outpatient program or an outpatient rehab, based on their lifestyle and intensity of dependence.

Benzodiazepines Withdrawal:  

Benzodiazepines are a class of drugs commonly prescribed to treat a wide range of conditions, such as anxiety and insomnia. While these drugs can be beneficial for some people, many individuals that take them long-term become dependent on them. 

This leads to difficulties when they try to quit and can lead to withdrawal symptoms if use is stopped suddenly or reduced too quickly.  Benzodiazepine withdrawal is a complex process due to the fact that the brain must re-establish its own mechanisms for regulating hormones or neurotransmitters that have been suppressed due to using benzodiazepines over time.

Symptoms of benzodiazepine withdrawal can occur within hours after the last dose and may include anxiety, difficulty concentrating, depression, irritability, confusion, fatigue, headaches, muscle pain or stiffness, dizziness or lightheadedness, sleep disturbances such as insomnia or nightmares, trembling hands and feet and sweating.

It is important for individuals who decide to withdraw from benzodiazepines to be aware that although it may be difficult at times dealing with some uncomfortable physical and psychological side effects; it will eventually result in improved functioning in day-to-day life as your body returns back to its natural balance without relying on drugs. 

Commonly Seen Benzodiazepines Drug Combinations: 

While consuming Benzodiazepines, either for medical or recreational reasons, it is important to avoid mixing these with any other drug. Especially in recreational settings, benzodiazepines are commonly mixed with other drugs to enhance the euphoric feeling.

One of the most commonly seen benzodiazepines drug combinations is a combination of alcohol and benzodiazepines, which is often abused and can lead to serious health risks. Alcohol is a central nervous system depressant that enhances the effects of benzodiazepines, such as increased sedation, amnesia, confusion, and impaired motor coordination.  

It’s important to note that while this combination may produce pleasant sensations in the short-term that could be considered euphoric or pleasurable in the moment; it can become incredibly dangerous if taken over extended periods of time due to its strong dependence potential and high risk for addiction. 

Another common benzodiazepines drug combination is cocaine and benzodiazepines. This powerful stimulant and antidepressant combo has been shown to increase feelings of euphoria as well as intensify the effects of both substances leading to dangerously low blood pressure levels, slowed breathing rate and potentially lethal allergic reactions in some users who have a sensitivity to either drug individually or combined together. 

Benzodiazepines drugs are also often combined with Adderall. This combination is often taken to reduce anxiety or improve focus when studying for exams or doing any other form of intense cognitive work. 

While some users may feel improved concentration after taking this combination, others may experience extreme symptoms such as irregular breathing and increased heartbeat. People should be aware that taking these two drugs together can lead to an increased risk of developing depression or addiction issues down the line. 

Benzodiazepines Facts and Statistics:

In addition to treating anxiety and other mental health issues, benzodiazepines can also be used to control seizures in those with epilepsy. In some cases, they may be used as muscle relaxants or pre-anesthesia medications prior to certain surgeries. 

It is estimated that 1 out of every 10 people worldwide have taken some form of benzodiazepine at least once in their lifetime with the majority being women between 25-54 years old according to World Health Organization statistics from 2011-2018. 

The use of benzodiazepines has increased significantly in recent years due to growing concerns about stress and mental health issues across all age groups. The amount of benzodiazepine prescriptions written annually has been steadily increasing for years now.

According to the National Institute on Drug Abuse, about 14 million prescriptions for benzodiazepines were written in 2013 in the United States alone. This was up from 10 million prescriptions written just four years earlier in 2009. 

In addition to prescription use of benzodiazepines increasing over time, so too has recreational use of these drugs without a prescription – especially among young adults aged 18-25 years old. 

Recreational use of benzodiazepines is dangerous because it increases the risk of overdose or drug interactions with alcohol or other substances. Deaths caused by benzodiazepines overdose have more than tripled since 2002 according to Centers for Disease Control data from 2017. 

Benzodiazepines History and Cultural Impact: 

Benzodiazepines were first developed in the 1950s by chemist Leo Sternbach of Hoffmann-La Roche. They were initially used to treat anxiety and insomnia, and then later as sedatives and anticonvulsants. 

Benzodiazepines became widely popular in the 1960s, with several famous cases of celebrities using them, including Elvis Presley, Marilyn Monroe, and John Belushi. In the 1970s, benzodiazepines began to receive negative press due to a rise in drug abuse. 

The most successful movie depicting benzodiazepine use was perhaps “The Panic in Needle Park” (1971) with stars Al Pacino and Kitty Winn. This film is about two heroin addicts living out their tumultuous lives on the streets of New York City. 

It is an unflinching portrayal of addiction with both characters frequently taking benzodiazepines for various ailments throughout the film. There were several famous personalities involved in the history of benzodiazepines as well. 

Dr. Gertrude Elion was responsible for developing many of the drugs currently used today including some benzodiazepines such as Lorazepam and Temazepam. Nobel Prize winner Professor Solomon Snyder was a pioneer in understanding how these drugs worked on the brain; he helped create better ways to make them more effective but also safer than previously available compounds like barbiturates or alcohol. 

Benzodiazepines have had a large cultural impact over the years too; they are often seen as symbols of escapism, recklessness, and rebellion which has been portrayed in various music videos from artists like Frank Sinatra (“Angel Eyes”), David Bowie (“Fame”), Pink Floyd (“Time”). 

In literature, authors such as Hunter S Thompson (Fear & Loathing in Las Vegas) or Charles Bukowski (Women) have made frequent references to taking benzodiazepines for various purposes ranging from relaxation to getting high. 

Despite their controversial past, benzodiazepines still remain important medications for many people worldwide who suffer from anxiety or other mood disorders for which there are few alternatives outside of counseling or psychotherapy. 

They are also increasingly being studied to better understand their effects on addiction recovery and posttraumatic stress disorder treatment. 

For now, it appears that these powerful drugs will continue to have a major influence on our culture due to their efficacy at treating a wide array of mental health issues while avoiding dangerous side-effects associated with other treatments like antipsychotics or opioids when taken responsibly under medical supervision.

Common Benzodiazepines

Here is a list of some commonly prescribed, approved benzodiazepines in the US:

  • Alprazolam (Xanax)
  • Chlordiazepoxide (Librium)
  • Clorazepate (Tranxene)
  • Clonazepam (Klonopin)
  • Lorazepam (Ativan)
  • Estazolam (Prosom)
  • Flurazepam (Dalmane)
  • Diazepam (Valium)
  • Midazolam (Versed)
  • Nayzilam
  • Seizalam
  • Onfi
  • Oxazepam (Serax)
  • Sympazan
  • Quazepam (Doral)
  • Temazepam (Restoril)
  • Triazolam (Halcion)

Bottom Line: Benzodiazepines in the United States 

Benzodiazepines, like any other medication, come with their own set of pros and cons. While these medications do have some risks associated with them—namely dependence when taken over long periods of time—they can provide relief from many uncomfortable symptoms that would otherwise be difficult to manage without medical intervention. 

If you’re considering trying benzodiazepines for any condition discussed above, it’s important that you speak with your doctor first about all potential benefits and risks so that you make an informed decision about your health care needs.


Warren Phillips

Warren is a Licensed Master Social Worker, who specializes in substance abuse and mental health treatment. Clinically, Warren has developed a therapeutic skillset that utilizes a strengths-based perspective, Twelve Step philosophies, Cognitive Behavioral Therapy and Motivational Interviewing.

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