Opioids have taken too many lives from Appalachian residents each year, including our daughters, sons, friends, parents, and loved ones. In Tennessee, the rate of fatal drug overdoses per 100,000 in 2021 was 56.6, which was over 20 higher than the national average. While we can speculate that these overdoses were from opioids, how many were from polysubstance use?
ReVIDA® Recovery shares knowledge about opioid use disorders and the dangers of mixing opioids with other substances. Today, we are discussing benzodiazepines and opioids, what happens when you mix them together, and the dangerous outcomes that can ensue.
Table of Contents
Mixing Benzos and Opioids: A Dangerous Combination?
Benzodiazepines are a type of medication considered to be a depressant. They are only available by prescription and are used to treat anxiety disorders, insomnia, seizures, and panic attacks. Even when taken as prescribed, benzos do pose a risk of developing dependence, which is why they are given at a doctor’s discretion.
Opioids are depressants prescribed for pain management for both short and long-term conditions. This includes major surgery, chronic conditions, and cancer patients. Though they do have medicinal purposes, opioids pose a risk of developing dependence, especially when taken illicitly.
When taken together, benzos and opioids can create serious side effects. One of the main risks is experiencing an accidental overdose. This is because both benzos and opioids are depressants, which slow the central nervous system and can stop breathing.
The Appeal Behind Mixing Benzodiazepines and Opioids
The appeal behind mixing benzodiazepines and opioids lies in the increase of certain effects. Opioids cause a rush of euphoria and pain relief while benzodiazepines cause a calming, sedative effect. When taken together, these effects are amplified. Some benzodiazepines such as Valium® (diazepam) have shown higher euphoric effects than other benzos such as Xanax® (alprazolam). This increases the appeal of mixing benzos and opioids, but it also increases the risks of dangerous interactions.
The Combined Effects of Benzos and Opioids
Both opioids and benzos come with their own slew of side effects. Common side effects of opioids include:
- Constipation
- Euphoria
- Nausea
- Slowed breathing
Side effects of benzodiazepines include:
- Confusion
- Unsteadiness
- Slurred speech
- Relaxation
Both benzos and opioids have overlapping effects as well, including dizziness, drowsiness, and breathing changes. These effects are often the ones that become amplified when benzos and opioids are taken together.
Benzos often cause behavioral changes including acting erratic and unpredictable. However, opioids increase the sedative effects of benzos as well. The person may engage in reckless acts such as driving under the influence, having sex with multiple partners, and taking more substances. Both benzos and opioids together can cause memory problems including complete loss of events that occurred. This can result in relationship problems, legal issues, and possible exposure to sexually transmitted diseases.
The Dangers of Mixing Benzodiazepines and Opioids: Are There Deadly Consequences?
All substances have side effects, and mixing them can cause dangerous interactions. For those taking these substances illicitly, dependence can form and quickly turn into polysubstance use disorder. As we mentioned above, both opioids and benzodiazepines can result in increased tolerance, dependence, and addiction.
Polysubstance Addiction and the Inherent Risks
Substance use disorders don’t form overnight, they come with prolonged, consistent use of the substance. Both opioids and benzodiazepines work in the brain by altering chemical interactions. Opioids bind to opioid receptors, activating the brain’s reward system. This occurs naturally from existing endorphins in the body that interact with the central nervous system. Opioids hijack this system, and eventually, the brain stops producing natural responses. When opioids are no longer present, the body sends signals that it needs more, triggering withdrawal.
Benzodiazepines can cause the same outcome. The medication affects GABA receptors and causes a release of dopamine, which is the reward chemical. Over time, benzos completely take over this system and can result in developing pathological behaviors and a physical need for the substance. Benzodiazepines become the only thing that makes the person feel good and also induce reckless behaviors. The person may not act like themselves when they are going through benzo withdrawal.
When two (or more) substance use disorders occur together, they can severely impact the person’s life. Their life will revolve around taking each substance to prevent benzo or opioid withdrawal. As the effects of each wear off, the person will continue to take more and continue the cycle of polysubstance use disorder.
Overdose Risk and the Dangerous Increases
Both benzodiazepines and opioids can cause overdoses on their own. Opioids slow the central nervous system and can result in breathing stopping altogether. When this happens, vital organs begin to lose oxygen, resulting in damage that may be irreversible.
Benzodiazepines also slow the central nervous system in a similar way and can cause the same organ damage. When opioids and benzodiazepines are mixed, the risk of an overdose increases. Both substances can dangerously slow the central nervous system. An overdose can happen even before the person realizes it. While Narcan® (naloxone) can reverse an opioid overdose, there are no over-the-counter medications to treat a benzodiazepine overdose. Overdoses are life-threatening situations and require medical attention as soon as possible.
Can You Stop Taking Opioids and Benzos Safely?
It is possible to stop taking benzos and opioids safely but it should be done so by a medical professional. Both benzodiazepines and opioids cause withdrawal symptoms. Withdrawal symptoms are uncomfortable and not typically life-threatening, but there can be complications with either substance.
Opioid withdrawal peaks around 48-72 hours after the last dose. During this time, symptoms will include joint pain, muscle tension, general unwellness, vomiting, and diarrhea can occur. Because of these symptoms, the person will experience strong cravings for opioids. The problem with this is the body has already begun losing tolerance. If the person returns to use during this time, the opioids may be too strong and cause an overdose. By entering a detox program, withdrawal symptoms and cravings will be managed in a safe environment.
Benzodiazepine withdrawal has more serious mental side effects than physical. Irritability, anxiety, and panic attacks can occur during the early stages of withdrawal. Benzos change behavior patterns and make them more impulsive. Entering withdrawal on your own will result in extreme cravings with behaviors that focus on obtaining more benzos. This can result in violent behavior toward loved ones that normally wouldn’t happen. This is why it is important to enter a detox for benzodiazepine withdrawal.
Attempting to stop both of these medications at the same time at home is ill-advised for these reasons. Detox facilities are equipped to handle polysubstance use and provide a safe space to begin the healing process. Once detox is complete, referral to a treatment program is always recommended.
Getting Treatment for Opioid Use Disorder in Tennessee
Opioid use disorder can turn your life upside-down, especially when engaging in polysubstance use like benzos. The good news is that opioid use disorder treatment is available and will help begin the journey toward recovery. Through outpatient therapy and Suboxone treatment, you will learn the skills needed to manage life stressors in a healthy way. The first step is always scary, but taking the leap to a new life will be the most rewarding you can do for yourself.
If you or someone you love is living with an opioid use disorder, treatment options are available. ReVIDA® Recovery offers medication-assisted treatment with Suboxone as well as outpatient therapy. While these options address the root causes of your addiction, you will also have access to our substance use care coordinators who will help with housing, jobs, food assistance, and more. Call us today at 423-631-0432 to learn more about our program offerings.
Reclaim your life.
