Benzodiazepine abuse consequences

The personal and social consequences of benzodiazepine abuse have not, to date, been extensively studied. A few seminal studies have shown, however, that use and abuse of the benzodiazepines carry the possibilities of impaired decision-making, decreased learning skills, released aggression, and an impaired ability to empathize, all of which can have profound effects on an individual s educational, social, and workplace environments. 

The problems of benzodiazepine abuse have been known about for a long time. Nevertheless, the extent of the abuse of these substances and the consequences of their pharmacodynamic interactions with other drugs and medicaments are often underestimated. Consequently, the problems of determining these substances and their derivatives in urine accurately and with good sensitivity are not appreciated to an equal extent by all analysts or by all who submit samples to them. 

The clinical consequences of the currently used benzodiazepines range from sedation, muscle relaxation, seizure reduction, anxiolysis, and hypnosis. Clearly, it would be highly desirable to be able to separate some of these effects. In addition, it would be useful to reduce other undesirable consequences such as development of tolerance and dependence, abuse, synergistic interaction with ethanol, and memory impairment (for a comprehensive review see [22]). Animal models for some of the aforementioned conditions, in combination with transgenic mouse technology, have recently led to a deeper understanding of the contribution some of the individual a subunits make to these behaviors. 

Before the introduction of the benzodiazepines, a number of drugs from different chemical and pharmacological classes were used in the treatment of anxiety and insomnia. However, these drugs are more toxic and produce more serious side effects than do the benzodiazepines. Many also have signihcant abuse potential. Consequently, most of these compounds are no longer widely used. These drugs include the barbiturates (e.g., pentobarbital, amobarbital), carbamates (e.g., meprobamate), piperidinediones (e.g., glutethimide), and alcohols (e.g., ethchlorvynol). 

Woods JH, Katz JL, and Winger G. Benzodiazepines Use, abuse and consequences. Pharmacol Rev 1992 44 151-347. 

The abuse of benzodiazepine hypnotics (for example, Temazepam, Triazolam) by injection of the crushed tablets is of increasing concern, and these drugs can be used to lace supplies of street heroin and consequently they have a black market value. General prescribing habits need to be maintained to ensure some control of the abuse. 

When taken alone, benzodiazepines have a relatively good safety record. Even when taken in overdose quantities alone these drugs rarely cause serious consequences. Unfortunately, however, when benzodiazepines are being abused, they may be used in combination with other drugs or alcohol, and it is these combinations that... 

Temazepam is a benzodiazepine that was until recently the most popular hypnotic in the form of a soft gel liquid-filled capsule but, being readily injected, it was widely also abused and the formulation was withdrawn. Temazepam is now classed as a controlled drug it is available as a tablet, with a much longer absorption time and duration of action making daytime hangover effect more likely. Consequently it is much less often prescribed. 

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