Benzodiazepines
{Benzos, Blues, BZDs, Tranks, Z-Bars, Downers}
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FAQs
Benzos are used in medicine; does it mean they are safe?
Benzos are medically approved drugs, primarily used to treat anxiety and insomnia. However, outside of these indications and without the supervision of a medical professional, a multitude of things can go wrong. Benzos have good safety profiles but remain very addictive, and can be very harmful when mixed with other drugs.
Do benzos have a cross tolerance with alcohol?
Cross tolerance between alcohol and benzos is generally assumed but not well documented in humans (25). The evidence is clear in animal studies. Even though alcohol and benzos act on different sites on GABA receptors, they still act on the same receptor. Theoretically, up or down regulation of the receptor due to any drug use will affect the response to both drugs.
Is there cross tolerance between benzos?
Yes, all benzos have cross-tolerance, meaning that taking one will after your tolerance of others 26.
Will taking benzos help me to come down from stimulants?
Just like having a coffee after alcohol does not make you anymore sober, benzos only mask the effects of stimulants, they do not counteract them. While this might give you a false sense of sobriety, it has been shown that mixing benzos and stimulants affected driving ability more strongly than either alone 27.
Does taking benzos with psychedelics reduce the risk of having bad trips?
Anecdotal reports suggest that taking a low dose of benzos before a psychedelic trip lessens the chances of experiencing a bad trip. This does however impair their ability to remember the trip. Benzos are also commonly used to alleviate an ongoing bad trip.
Useful links
The erowid forum has an extensive curation of reported experiences from users spanning a large variety of topics including bad experiences and mixing with other drugs. Check it out here.
References
1 Dassanayake, T., Michie, P., Carter, G. and Jones, A. (2011). Effects of Benzodiazepines, Antidepressants and Opioids on Driving. Drug Safety, 34(2), pp.125-156. DOI: 10.2165/11539050-000000000-00000.
2 Canada, H. (2018). Benzodiazepines - Canada.ca.
3 Benzo.org.uk. (2012). Benzodiazepines: How They Work & How to Withdraw.
4 Cooper, S. (1989). Benzodiazepines and appetite: Recent pre-clinical advances and their clinical implications. Human Psychopharmacology: Clinical and Experimental, 4(2), pp.81-89. DOI: 10.1002/hup.470040203.
5 Hojer, J., Baehrendtz, S. and Gustafsson, L. (1989). Benzodiazepine poisoning: experience of 702 admissions to an intensive care unit during a 14-year period. Journal of Internal Medicine, 226(2), pp.117-122. DOI: 10.1111/j.1365-2796.1989.tb01365.x.
6 Partanen, T., Vikatmaa, P., Tukiainen, E., Lepäntalo, M. and Vuola, J. (2009). Outcome after Injections of Crushed Tablets in Intravenous Drug Abusers in the Helsinki University Central Hospital. European Journal of Vascular and Endovascular Surgery, 37(6), pp.704-711. DOI: doi.org/10.1016/j.ejvs.2009.01.016.
7 Starcevic, B. and Sicaja, M. (2007). Dual intoxication with diazepam and amphetamine: This drug interaction probably potentiates myocardial ischemia. Medical Hypotheses, 69(2), pp.377-380. DOI: 10.1016/j.mehy.2006.12.033.
8 Mattila, M.J. and Nuotto E. (1983). Caffeine and theophylline counteract diazepam effects in man. Medical Biology, 61(6), pp.337-43.
9 Emmanouil, D. and Quock, R. (2007). Advances in Understanding the Actions of Nitrous Oxide. Anesthesia Progress, 54(1), pp.9-18. DOI: 10.2344/0003-3006(2007)54[9:AIUTAO]2.0.CO;2.
10 Jones, J., Mogali, S. and Comer, S. (2012). Polydrug abuse: A review of opioid and benzodiazepine combination use. Drug and Alcohol Dependence, 125(1-2), pp.8-18. DOI: 10.1016/j.drugalcdep.2012.07.004.
11 Kroboth P.D., Smith R.B., Stoehr G.P. and Juhl R.P. (1985). Pharmacodynamic evaluation of the benzodiazepine-oral contraceptive interaction. Clinical pharmacology and therapeutics, 38(5), pp.525-32.
12 D'Arcy P.F. (1986). Drug interactions with oral contraceptives. Drug Intelligence & Clinical Pharmacology, 20(5), pp.353-62.
13 Starcevic, B. and Sicaja, M. (2007). Dual intoxication with diazepam and amphetamine: This drug interaction probably potentiates myocardial ischemia. Medical Hypotheses, 69(2), pp.377-380. DOI: 10.1016/j.mehy.2006.12.033.
14 Parle, M. and Dhingra, D. (2003). Ascorbic Acid: a Promising Memory-Enhancer in Mice. Journal of Pharmacological Sciences, 93(2), pp.129-135. DOI: 10.1254/jphs.93.129.
15 Partanen, T., Vikatmaa, P., Tukiainen, E., Lepäntalo, M. and Vuola, J. (2009). Outcome after Injections of Crushed Tablets in Intravenous Drug Abusers in the Helsinki University Central Hospital. European Journal of Vascular and Endovascular Surgery, 37(6), pp.704-711. DOI: 10.1016/j.ejvs.2009.01.016.
16 Chen, J.P., Barron, C., Lin, K.M., and Chung, H. (2002). Prescribing medication for Asians with mental disorders. Western Journal of Medicine, 176(4), pp.271--275.
17 Volkow, N.D., Wang, G.J., Fowler, J.S., Hitzemann, R., Gatley, S.J., Dewey, S.S., Pappas, N. (1998). Enhanced sensitivity to benzodiazepines in active cocaine-abusing subjects: a PET study. American Journal of Psychiatry, 155(2), pp.200-6.
18 Verster, J. and Volkerts, E. (2006). Clinical Pharmacology, Clinical Efficacy, and Behavioral Toxicity of Alprazolam: A Review of the Literature. CNS Drug Reviews, 10(1), pp.45-76. DOI: 10.1111/j.1527-3458.2004.tb00003.x.
19 Haque, W., Watson, D.J., Bryant, S.G. (1990). Death following suspected alprazolam withdrawal seizures: a case report. Texas Medicine, 86(1), pp.44-7.
20 Barker, M., Greenwood, K., Jackson, M. and Crowe, S. (2004). Cognitive Effects of Long-Term Benzodiazepine Use. CNS Drugs, 18(1), pp.37-48. DOI: 10.2165/00023210-200418010-00004.
21 Takada, M., Fujimoto, M. and Hosomi, K. (2016). Association between Benzodiazepine Use and Dementia: Data Mining of Different Medical Databases. International Journal of Medical Sciences, 13(11), pp.825-834. DOI: 10.7150/ijms.16185.
22 Harnod, T., Wang, Y. and Kao, C. (2015). Association Between Benzodiazepine Use and Epilepsy Occurrence. Medicine, 94(37), p.e1571. DOI: 10.1097/md.0000000000001571.
23 Riss, J., Cloyd, J., Gates, J. and Collins, S. (2008). Benzodiazepines in epilepsy: pharmacology and pharmacokinetics. Acta Neurologica Scandinavica, 118(2), pp.69-86. DOI: 10.1111/j.1600-0404.2008.01004.x.
24 Kadoi, C., Hayasaka, S., Tsukamoto, E., Matsumoto, M., Hayasaka, Y. and Nagaki, Y. (2000). Bilateral Angle Closure Glaucoma and Visual Loss Precipitated by Antidepressant and Antianxiety Agents in a Patient with Depression. Ophthalmologica, 214(5), pp.360-361. DOI: 10.1159/000027521.
25 Begleiter, H. and Kissin, B. (1996). The Pharmacology of Alcohol and Alcohol Dependence. New York: Oxford University Press, p.128.
26 Ramsey-Williams, V., Wu, Y. and Rosenberg, H. (1994). Comparison of anticonvulsant tolerance, crosstolerance, and benzodiazepine receptor binding following chronic treatment with diazepam or midazolam. Pharmacology Biochemistry and Behavior, 48(3), pp.765-772. DOI: 10.1016/0091-3057(94)90344-1.
27 Høiseth, G., Andås, H., Bachs, L. and Mørland, J. (2014). Impairment due to amphetamines and benzodiazepines, alone and in combination. Drug and Alcohol Dependence, 145, pp.174-179. DOI: 10.1016/j.drugalcdep.2014.10.013.
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