What is the True Addictive Potential of Benzodiazepines?

In all areas of medicine, you must balance the risks and benefits of medication management. Sometimes those risks are the long-term addictive potential of a medication. In this video we try to answer the question, what is the true addictive potential of benzodiazepines.
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All content is created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider. If you think you have a medical emergency, call your doctor, go to the emergency department, or call 911. We do not endorse any specific treatment, tests, or procedures. Reliance on this information is solely at your own risk.

[@danabeaver8852]

Thank you for taking your time to explain things to us!

[@ShrinksInSneakers]

No problem thanks for watching and commenting, please spread the word about the Chanel

[@katrinamenzies9398]

Heather Ashton manual ( look it up)

[@BeingBetter]

Just leaving a comment to boost your place in the algorithm

[@ShrinksInSneakers]

Always appreciate your comments, I'll have a new video on nutrition soon

[@charleswomack2166]

What about barbiturates?😊 I know that they are rarely prescribed, but nonetheless in my own personal experiences from ordering them from shady Russian online pharmacies that these have a "feel good" component to them.

[@ShrinksInSneakers]

I don't use many barbiturate other than as anesthesia for ECT and possibly phenobarbital for alcohol withdrawal. They have largely fell out of favor these days. I appreciate the comment

[@charleswomack2166]

And remember, there is a subtle difference between addiction and physical dependance. If I were to take benzodiazepenes for 1 full year every day I would become addicted to them after 3 or 4 days, but becoming physically dependent upon them would take a few months. This is because I am a recovering alcoholic/opioid user! And I take Vyvanse daily and have zero issues with becoming addicted to them. Why? I will never know. Each person is different I suppose.

[@ShrinksInSneakers]

Vyvanse is a good option as it's a pro-drug meaning it must be metabolized to the active medication making abuse less likely. It's also long acting which is another way to prevent addiction. Rapid increases in blood levels of drug activating the reward pathway. I appreciate you sharing your story here glad to hear things are working out

[@marthaokelley9360]

I am 67 and if I didn't have lorazepam I could not live. I have been SEVERELY emotional abuse from my ex-husband, our daughter and my own sister....all severely CRUEL people. I have HORRIBLE flashbacks, nightmares and extreme sadness....because my heart has been so severely broken.

[@BrianSmith-lo3mj]

I like the fact that you used the "coffee analogy" It wasn't a very good analogy because you're comparing apples with oranges, but it made me realize what the main problem is with Benzos are. It is the availability, or more specifically ... the lack of availability. If the DEA made coffee or caffeine a "controlled substance" then it would be a much larger problem than Benzos. I'm not saying that people should have unlimited access to them, but they should be treated like the Pseudoephedrine was treated back in 2004 when it was placed onto a monitoring program and turned it into a Class II medication.

[@timothyayers8596]

Good video. I think that we need to be careful here. The comparison to opioids create a kind of knee jerk reaction. What’s important is that benzodiazepines have only mild (if any) effects on the reward pathway in the brain. I hypothesise that people “like” the stress reliving and hypnotic effects of these drugs. This is way different than opioids where the reward pathway lights up like the Fourth of July. This class of drugs needs care but should be on the table for treatment. Especially for those with acute and serious anxiety. They are the most effective drugs in this case.

[@kadhijasanders]

Hi Dr Rossi, could you please answer my question? I take clonazepam 2mg ( not daily two to three times a week max, and mostly during the day) for GAD, during the day, clonazepam makes me feel calm, "in the moment" but if taken at night it makes me extremely agitated, euphoric, energetic, full of life, I got the feeling that I can do anything and everything. Why does this happen? I have never experienced any type of drowsiness, tiredness none of that...

[@m.m.m.c.a.k.e]

Appreciate the research videos! Abuse potential nil, no history. Provides relief for dyspnea which happens up to a few times per day. W/o, require max dose fluticasone propionate/salmeterol and several uses of salbutamol daily. Failed amitriptyline, venlafaxine, duloxetine, escitalopram, sertraline. Mirtazapine will likely fail, not sure yet. Thoughts?

[@iKam1Kaz1]

Great videos today, I thought it would have maybe had a higher addictive potential though that may be due to the area I live in Australia where in recent years opioids and benzos have been more restricted in being prescribed to patients mainly due to different laws where doctors have even gotten in trouble for over prescribing though that's a different topic altogether.

[@ShrinksInSneakers]

Addiction and the potential for addiction are things we want to be mindful of. 15% is still significant, even 5-7% is significant. I think whenever we try to make a universal rule like “no benzos” or say there is no significant risk for addiction it’s not correct and we need to make sure our assessments are accurate. As always I appreciate the comment

[@iKam1Kaz1]

@@ShrinksInSneakers Ahh ok thanks for clearing that up :)

[@ShrinksInSneakers]

@@iKam1Kaz1 Appreciate the comments and questions, as always

[@andrewjames3908]

im more concerned that studies have linked them to cancer, which is not suprising as benzene is a carcinogen

[@ShrinksInSneakers]

These medications were never intended to be used long term. It seems like the risk established on meta analysis is directly correlated with length of time and dose of benzodiazepine used. In the short term there can be value to using these medications with minimal risk, but long term chronic use was never the purpose.

[@Psychiatube]

If you have a patient that has a documented history of some other substance use issues (ie. Alcohol UD, Meth UD etc.) does that warrant avoiding these potential medications in indicated conditions? Where do you think the line between pre-judgement and clinical heuristics come into play? Would this change if their previous harmful behaviour was something non-substance related like sex, gambling, or internet addiction? Great video as always!

[@ShrinksInSneakers]

I think you must be cautious in prescribing to people with a history of substance use disorder or current use. It’s always going to be on a case-by-case basis. Many factors go into the decision such as how long has the patient been sober, there is a significant difference between someone who is 20 years sober and someone who is 6 weeks sober. Also, is the person taking other medications such as opioid pain medication or methadone maintenance that can increase the risk of respiratory depression. I would start most patients that I’m worried about with a nonaddictive medication and psychotherapy first to see if you achieve a good response. In many cases it can be done without benzodiazepines, but we need to remain open to all treatment options. Hope this helps

[@garysimone4977]

@@ShrinksInSneakers Dr ,ya a good gut, but re benzo 2-4 wk max as directed

[@Mtree40]

As someone with multiple addictions I only dont abuse my klonopin because it ruins my high from other substances. That’s where the other 2/3rds of your missing data comes from.

[@moondogaudiojones1146]

No one talks about lorazepam. I need some info on these as I’ve been prescribed them for years. My new(ish) doctor wants me to stop and he wants to use the what I call the weening method. That’s fine. Anyway I’d like to know a bit more about this drug. I’m 70 and I don’t want to be addicted to anything. I never felt like I was til my doc told me about them. I couldn’t sleep because of anxiety and this was the most “natural” sleep helper ever. Melatonin and things like that never worked. Anyway your thoughts on this new venture I’ll be taking in a few months?

[@Cuinn837]

My doctor had me taper down my Lorazepam to about 1/2 the dose I had been taking for years. The withdrawal symptons from this wean were not all that bad. I had some muscle pain, but it wasn't unbearable. It is important that your doctor wean you slowly. Xanax and Klonopin are reportedly much, much harder to get off of. Compared to them, Lorazepam isn't all that bad a drug. Perhaps your doctor would be willing to wean you off some of it but still let you keep some. I am doing well on the 1/2 of Lorazepam that I have left.

[@katrinamenzies9398]

Benzodiazepines information coalition ( look it up)

[@katrinamenzies9398]

Dr Jennifer Leigh benzodiazepines ( look it up)

[@safy2363]

short time period Bzd is not harmful the problem w some pt who continue on it even after We advice to stopped it

[@ShrinksInSneakers]

Agreed, it's very difficult when you get a patient who has been on these medications for several years and the process of tapering can take months. Appreciate the comment

[@christophergros9884]

No doctor should have the right to make them come off after taking it for years. Find another doctor that will continue what works for you .

[@OfficialRogue]

@@christophergros9884 the thing is no one should be taking a benzo for years... they're made mainly to help with acute anxiety/crisis periods (panic attacks etc), other than that even SSRIs are a more appropriate long-term treatment for anxiety. One has to use a treatment that is more suited for long-term usage and not addictive (and horrible for your health), and only use a benzo in moments when you really need to.. so really a doctor that wants to help you come off them is looking out for you and your health more than one that will just blindly keep prescribing them. But obviously after years it wouldn't be a quick or easy process, and that should be taken into account to make it as easy and slow as needed.

[@katrinamenzies9398]

Dr Jennifer Leigh (

[@tyrel-fg7zf]

Ashtion Manuel not addiction

[@celinejohnston3694]

What is going on with flurazepam/dalman? Is it discontinued?.

[@timothyayers8596]

Dalmane is back on the Market as of November 2023. There’s only one manufacturer so it’s not super easy to get. Your pharmacy will need to order it.

[@desdigitallyextractedstere761]

Very addictive. I've been on a Benzo since I was 17 years old. The doctor started me on Librium, then Valium, then Xanax, and now Clonazopam. I'm now 67 years old. I'm now prescribed 1 mg of Clonazopam 2 times a day. I usually take 1/2 of the pill, .5 mg during the day and 1 mg at night. My psychiatrist is just going to leave it as it is because it's been 50 years. I never abused them and always took the dose that was prescribed. It seems I didn't build up a tolerance because I've cut one of my daily doses in half. The .5 mg dose does make me drowsy and I usually have to nap for an hour after I take the .5 mg. The Benzos are the best medication for anxiety, but not for depression. Benzos can make one feel depressed. For depression I've been taking Buprion and Dextramethoraphan which is a fantastic combination for depression. For a good night's sleep, I take 50 mg of Quitiapine (Seroquel) Anyway, back to the Benzo; they are extremely difficult to stop and the withdrawal is hell especially from Xanax. Benzodiazapines can cause liver inflammation and I take NAC and Milk Thistle every day and that keeps my liver enzymes normal. To sum it all up, I wouldn't start taking one unless it's absolutely necessary. I would try an SSRI first.

[@edwarddunphy3099]

Is 2 mg Klonopin stronger than 10 mg valium

[@ShrinksInSneakers]

yes much stronger, for every 1 mg of clonazepam it's equivalent to 20 mg of valium. Hope this helps if you haven't subscribed to the channel please do and spread the word about what we are doing here.

[@gareth3857]

Nothing wrong with a good benzo

[@user-mm1pf4km2f]

It erases your memory

[@edsykes9779]

Not a lot of data? How is there not a lot of data, yet they are prescribed hundreds of thousands? Appropriate and in appropriate according to “if the patient has an addictive past”. You can become physically and worse mentally addicted to benzodiazepines within less that a month. Even on a low dose. So, that alone is enough DATA to where any dr should know that it’s in appropriate to prescribe a month long script. Which btw is your typical script. One script a lifetime of hell. Genetically prone to addiction. How would you find out someone is addicted to coke or heroin? As for opiods prescribed by drs then taken away after they become addicted then people near forced to go to heroin which now seems to be fentanyl. And now there is a “opioid pandemic”? No there is a medical pandemic. Benzodiazepines should be prescribed to someone for a flight if they have a sincere fear of flying, or if they recently are grieving to loosing a loved one but only for maybe at most a week long script. Anxiety, restlessness, insomnia, dizziness nausea, headaches, and potentially fatal seizers. Why don’t you just say the term, (all of which are paradoxical reactions) AKATHISIA. AKATHISIA. These terms for akathisia are to minimize the true effects of extent and knowledge of the people who are attacked by these poisons. Seizures are the most concerning for yourself and drs? It’s the least common, and drs tend to disinform akathisia. I notice you haven’t mentioned it not one time in this video. Where is the data for that? And why is it not a concern? Or informed of to the patient before they are prescribed benzos, or ssris, etc? U want to know about the patients back ground, yet you don’t want to inform them of their potential future if they take these poisons? You are spreading dis information, and minimizing the dangers of this mess. This is more dangerous than cocaine and methamphetamine. I don’t even have akathisia, but I think it may be in my back ground waiting to come out any time I am unable to get my dr to prescribe me what I have been taking AS DIRECTED 6mg day for ten plus years. I don’t have a history of substance abuse, or do I now? Drs orders. Drs are the substance abusers. Gaslighting people, killing people, addicting people, I can go on. Need licenses taken away if you ask me. This is bullshit. Will you reply? I would guess not. However l, I do hope you do.

[@BrianSmith-lo3mj]

Q: Will he reply? A: Hell no!, because you're throwing the FACTS out there, and we all know that the truth hurts.