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Benzodiazepine
Bits & Pieces
by Erowid
The "Bits & Pieces" section is intended for random snippets of information which don't fit
easily elsewhere and/or which have been newly added, but not yet carefully categorized.

  • Benzodiazepines used in Emergency Medicine + Humor
    Benzodiazepines are used extensively in emergency medicine, to manage seizures, to calm people down, to reduce dangers associated with excitotoxcity (stimulants, hyperactivity), and many other emergency medical presentations. There is a humorous quip from emergency department docs that "The only thing benzos don't treat is benzo overdose [or addiction]." Although this is humorously overstated, partially in a self-critical way that benzos are overused by emergency medical professionals, they are a class of substances that have a huge range of applications in crisis situations.

  • Regular use Leads to Tolerance and Increased Dosages
    Benzodiazepines are well known for causing rapid tolerance to their effects. Using benzodiazepines daily or even several times per week can cause users to require substantially increased amounts to achieve their desired effects.

  • Withdrawal Risks: Anxiety, Insomnia, Seizures, Death
    Regular use of benzodiazepines leads to phyiscal addiction (strong withdrawal effects upon cessation of use). Stopping or reducing dosages can lead to mild to severe anxiety, including panic attacks, insomnia, and extreme dysphoria (very bad mood).

    Stopping chronic use of benzodiazepines without tapering dosages down can lead to very dangerous physical complications. Case reports include seizures, psychotic behaviour, and even death:


  • Memory Problems : Anterograde Amnesia #
    Benzodiazepines are well known for causing memory encoding problems, so that from the time the effects begin until the substance is substantially metabolized and out of the blood stream, memories may be lost (new ones not encoded). Memory becomes blurred, untrustworthy, and time passage can be difficult to account for. Higher doses, mixing with alcohol or other sedatives, certain benzodiazepines, and individual sensitivies all set how strong the amnesia is.

    There has been some work to try to reduce the amnesic effects of benzodiazepines and a variety of different chemicals have been tried to block this effect. Some success has been noted with:
    • Ascorbic Acid (Vitamin C) : There is some preliminary evidence that high doses of Vitamin C may reduce or block benzodiazepine amnesia.
      • Parle M, Dhingra D. Ascorbic Acid : a promising memory-enhancer in mice. J PHarmacol Sci. 2003 Oct; 93(2):129-135. [PubMed Abstract]
    • Piracetam : Piracetam at high doses has been shown to reduce amnesic effects in several drugs, including benzodiazepines.
      • Pan JC, Zhang SS. [Antagonism of piracetam on the amnestic effect of diazepam in mice]. Yao Xue Xue Bao. 1996;31(2):91-4. [PubMed Abstract]
      • Lenegre A, Chermat R, Avril I, Steru L, Porsolt RD. Specificity of piracetam's anti-amnesic activity in three models of amnesia in the mouse. Pharmacol Biochem Behav. 1988 Mar;29(3):625-9. [ PubMed Abstract ]
    • Vinpocetine : Some evidence that vinpocetine may reduce amnesic effects of benzodiazepines.
      • Bhatti JZ, Hindmarch I. Vinpocetine effects on cognitive impairments produced by flunitrazepam. Int Clin Psychopharmacol. 1987 Oct;2(4):325-31. [ PubMed Abstract ]
      • Storm G, Oosterhuis B, Sollie FA, Visscher HW, Sommer W, Beitinger H, Jonkman JH. Lack of pharmacokinetic interaction between vinpocetine and oxazepam. Br J Clin Pharmacol. 1994 Aug;38(2):143-6. [ PubMed Abstract ] (note this did not show memory improvements)

  • Erowid's Benzo Rule #1: Careful! Do not take high doses with high-dose opioids or high-dose alcohol, especially if you are alone.#
    The best way to die with benzos on board is to be taking a lot of something else, too, and maybe the benzos make it so you forgot what else you took. Or maybe you're just trying to calm some bad side effects and now you're down the rabbit hole with opioids, alcohol, stims, and (of course) cannabis. Note that high-dose benzos and opioids are commonly used in surgery and other monitored medical procedures, where experts are monitoring a person's perfusion, heart rate, respiration rate, and blood oxygen levels. Benzos of all stripes also commonly show up on coroner's toxicology reports alongside opioids and alcohol. Careful.

  • Erowid's Benzo Rule #2a: Do not increase your dose over time.
    Because of the rapid tolerance most people experience when using benzodiazepines and related drugs, there is a tendency to gradually increase dose and/or frequency in order to try to achieve the same effect that one got at one's favorite effect level. Stick to your dose regimen and don't increase your dosage. Just don't. The primary problems associated with benzodiazepine use are from changes in dose or frequency (excluding the problem of potentially fatal results from combining high-dose benzo plus high-dose opioid).

  • Erowid's Benzo Rule #2b: If you need more, wait longer, take less.
    Do not increase your dose without it being a pre-planned target that you consult on with your doctor and/or partner before you do. If you need more, wait a little longer and take less than your normal dosage or the same amount: do not increase your per-dose amount. Add as a mantra that benzos confuse, blur, or blot out memories. You might not remember having taken the most recent dose. Wait longer, take less.