Two years ago, popular celebrity Lena Dunham shared her personal experience with benzodiazepines, otherwise known as benzos.  Although her doctor prescribed benzos to manage her anxiety, Dunham found that she was becoming dependent on them. So much so, in fact, that she was taking the medication about every day for three years. They are only supposed to be prescribed for weeks, at most.

Benzodiazepines are minor tranquilizers with sedative effects. Doctors often prescribe them to treat anxiety or panic disorder. Some benzodiazepines you might have heard of are Ativan, Valium, or Xanax. (Their generic versions, respectively, are Lorazepam, Diazepam, and Alprazolam).

Dunham’s particular benzodiazepine of choice was Klonopin (Clonazepam).

Taking a benzodiazepine boosts the dopamine levels in your brain, which induces a pleasant state of relaxation. Although they are supposed to be prescribed on a short-term basis, many people take them for months and even years. They simply don’t want to give up the calming effect the drug has in improving their daily functioning. Or, they don’t want to experience the unpleasant withdrawal effects one gets when stopping. Doctors are also prescribing them for longer than the published guidelines.

The problem is, the longer you use benzos, the more dependent you become, and the withdrawal symptoms get worse and worse.

Benzodiazepines Can Lead to Dependence and Addiction

Many people, especially older adults, become dependent on benzos because of the fact that they work very well for anxiety and insomnia issues. Since they induce muscle relaxation, these drugs help with sleep as well.

One reason why there may be less awareness or stigma around benzodiazepine dependence is that doctors prescribe these drugs so often. Also, the drug works fairly instantaneously, in contrast to other medications (like anti-depressant SSRIs). This is why doctors often prescribe benzos on an occasional, or as-needed basis. But it’s also why many people feel comfortable popping in a Valium before they go to sleep, or why someone with severe social anxiety may take a benzo to calm his nerves the morning before he delivers a work presentation in front of his boss. Or, a teen with severe flying anxiety might take a Xanax right before she gets on the plane, if she’s nervous about a cued panic attack. Most aren’t taking the medication to get high—rather to feel normal, to feel less nervous and maintain their social or work obligations.

In fact, at an event where Lena Dunham and her co-producer Jenni Konnor spoke (ironically, the topic of the speech was adolescent anxiety), Konnor remarked that she had taken half a Klonopin before the event to calm her down so she could give the presentation.

However, research shows that long-term benzodiazepine correlates with certain physical and mental health issues, such as depression, early onset of Alzheimer’s, memory issues, and even early death. It can also lead to addiction and substance abuse issues.

Benzos and Opioids: A Deadly Combination

For people who also take opioids, the combination of benzos and narcotics (or alcohol) is a dangerous mix. In fact, 30 percent of overdoses involving opioids also involve benzodiazepines. One study found that half of the veterans who died between 2004-2009 because of opioid-related overdoses were taking benzodiazepines at the same time.

Why would someone have reason to take both? For one thing, they may be prescribed both medications simultaneously. This is the case particularly with older adults. For example, someone might take Oxycodone, Vicodin, or other prescription opioid painkillers if they experienced a fall or had surgery. Then, later on, they might start on an anti-anxiety medication like Xanax if they start experiencing panic symptoms. (Veterans, and the elderly population, are especially prone to anxiety disorders, as well as to physical ailments). But taking both opioids and benzos concurrently may sedate a person so much that it can be life-threatening.

Or, if someone takes a benzo to smooth out a rough day at work, they may also take a drink for the same reason, not knowing the two can become deadly. And of course, teens may abuse the two drugs in recreational or social settings.

Benzos and Teens

According to research, there has been a huge increase in benzodiazepine use among adolescents—almost a three-fold increase over 10 years.

One in every ten American adolescents has tried benzodiazepines at least once in their life, according to one study that surveyed high school seniors in America. Among these 11,000 students, 7.5% of the teens were taking the drug without a doctor’s prescription. On the other hand, almost 5% were prescribed benzodiazepines for medical reasons.

However, even among the students whose doctors recommended benzos, more than half didn’t take the drug as directed. They took the benzo for longer than prescribed, or started taking the drug before their physician prescribed it to them.

Where do Teens get Benzos?

Apparently, most adolescents and teens who use benzos unprescribed actually get them from home–from their parents’ medicine cabinets. One study showed a strong association between unprescribed use of benzos by adolescents and by their parents (particularly the mother). The minority get them illegally—buying them from their peers or drug dealers, or getting them off the dark web.  This has led to an increase in Xanax addictions—one of the most popular benzos to abuse. (For reference: One Xanax pill is about 20 times stronger than a Valium.)

Again, it’s not only teens looking to get high. (Though there’s that, too; teens may abuse benzos by snorting them to achieve a greater effect.) Well-intentioned teens with symptoms of anxiety, who may even be clinically anxious, may try to self-medicate with benzos since they hear it’s an easy fix. However, this is drug abuse as well, since they are not using the medication under a doctor’s orders and supervision.

But since benzos are often found in the home, many teens who would never take heroin would easily take a Xanax or Klonopin, as an example. Besides, if their parents or grandparents are using them for therapeutic reasons, what could really be so bad?

Withdrawal From Benzos: Only Under a Medical Supervision

Teens can quickly become dependent or even addicted to benzodiazepines like Xanax. Their mood-enhancing effect is similar to that of opioids like heroin.

However, even if a teen is ready to stop using benzos, they can’t just stop cold-turkey on their own. Withdrawal symptoms from benzos are extremely painful and long-lasting. They include extreme aches, restlessness, extreme pain, even seizures. Due to the medical risks of withdrawal, any tapering or detox process must be medically supervised by a doctor.

If you are ready to stop using benzos, you must only do so under a doctor’s instruction and supervisions. Whether the withdrawal process is a taper or detox, it must be doctor-approved.

For teens with opioid and alcohol addiction, specific FDA-approved drugs and Medication-Assisted-Treatment (MAT) programs help ease the withdrawal symptoms. These do not exist with benzo withdrawal. For this reason, most teens enter a drug rehab treatment center specializing in benzodiazepine addiction. There, a physician can implement and maintain a tapering schedule (or detox process) and substitute it with safer, less risky medications if necessary. Teens will also learn skills to cope with their anxiety through dialectical behavior therapy, cognitive behavioral therapy, and mindfulness exercises.