Abuse of benzodiazepines
Abuse of benzodiazepines – dependence on sleeping, soothing and antidisturbing medicines from group of benzodiazepines. Meets rather often owing to prevalence of benzodiazepines. Can arise as at the uncontrolled use for the purpose of receiving pleasure, and at reception on medical indications. Symptoms remind alcoholic intoxication, the disorientation, an incoordination, garrulity, the muffled speech and decrease in a muscular tone is observed. At the constant long use dependence development is possible.
Abuse of benzodiazepines
Abuse of benzodiazepines – rather widespread dependence. Its distinctive feature is a large number of socially successful patients of middle and advanced age. Many patients suffering from dependence on benzodiazepines accepted or accept medicines of this group to destination of the psychiatrist or the psychotherapist. At the same time, dependence on benzodiazepines occurs also among youth, and also people abusing drugs and alcohol.
To benzodiazepines such expressed draft, as to barbiturates, alcohol or drugs does not develop. At the termination of the use there is a cancellation syndrome, however the main problems in case of dependence existence usually are side effects: drowsiness, slackness, decrease in mobility, reaction delay, anterograd amnesia etc. Because of reaction delay benzodiazepines can become the reason of car accidents and industrial accidents. At long reception peculiar personal changes are observed: ocherstvleniye, selfishness and tendency to violation of ethical standards. Experts in the field of narcology are engaged in treatment of dependence on benzodiazepines.
Benzodiazepines – big group of the medicines having somnolent, soothing and antidisturbing effect. Besides, benzodiazepines promote relaxation of muscles and interfere with developing of spasms. Medicines from group of benzodiazepines are appointed for elimination of physiological and psychological manifestations of concern. The concern is the difficult state which is followed by pathological manifestations from muscles (excessive tension, twitchings, spasms), vegetative symptomatology (heartbeat, the increased perspiration, rushes of blood, weight in a stomach etc.), vigilance (sleep disorders, special attention, concern), fears and disturbing presentiments.
In the last decades because of an intense rhythm of life and a large number of stresses the concern and the panic attacks became extremely widespread problem. Benzodiazepines were the safest medicines allowing to eliminate all above-mentioned manifestations of concern. They are malotoksichna, do not cause such expressed dependence as barbiturates or alcohol and at the same time in therapeutic doses do not provoke development of depression and motive frustration.
Benzodiazepines widely spread in the world in 50-60 years of the last century. Statistically, now they take the second place on use frequency after cardiovascular means. In many countries benzodiazepines can be bought without appointment of the doctor. Along with antidisturbing effect they have anti-convulsive effect therefore medicines of this group apply not only at stresses, sleeplessness, disturbing frustration and panic states, but also at some convulsive syndromes.
Development of dependence on benzodiazepines
Dependence usually results from continuous overdose or long regular reception of medicine. It seems to the patient that the therapeutic dose is not enough – and he over and over again exceeds a dose, hoping to get rid of unpleasant symptoms completely. Dependence on benzodiazepines arises more often at the constant use therefore in need of long reception medicines are appointed faltering courses. Some patients are afraid of return of symptoms and, despite recommendations of the doctor, continue to use medicines even during breaks.
Benzodiazepines are the symptomatic means which are eliminating alarm, but not influencing the reasons of its emergence. If during planned reception of benzodiazepines the patient did not manage to solve the problem which is a source of the increased uneasiness at medicine cancellation the concern arises again. It induces the patient to continue the medicine use even after specified by the psychotherapist or the psychiatrist of term. Dependence on benzodiazepines develops already 6-8 weeks later after regular reception. A cancellation syndrome in combination with return of alarm, fears, concern or sleep disorders stimulate the patient to the further use.
There is also other option – some patients initially accept benzodiazepines in attempt to reach euphoria. Sometimes such patients specially feign symptoms of some diseases to receive medicine according to the recipe of the doctor. In the large cities there is "a black market" of benzodiazepines. At uncontrolled reception of benzodiazepines considerable excess of a therapeutic dose is usually observed (sometimes – in hundreds of times). Rather often the combined dependence on benzodiazepines and other psychoactive agents arising in attempts to reach brighter euphoria meets or to eliminate an abstinence syndrome at reception of cocaine, opiates and alcohol.
Symptoms of abuse of benzodiazepines
Symptoms of benzodiazepinovy intoxication remind an intoxication picture barbiturates. At reception of the majority of medicines there is a drowsiness, block, an incoordination and relaxation of muscles. Unmotivated physical activity, raising of mood, unstable mood, fussiness and not purposeful activity is sometimes observed. These manifestations are followed by reduction of clearness of perception, difficulty when switching attention and reduction in the rate of reactions.
At survey patients remind the people who are in a condition of strong alcoholic intoxication. They reel when standing and walking, miss in attempt to take in a hand some subject etc. The speech is not legible. Perseveration – persuasive repetitions of words or phrases, numerous reproduction of movements, repetition of emotions and feelings are observed. Pupils are expanded, skin pale, language with a whitish raid. Dryness of mucous membranes comes to light. The tone of muscles is lowered. In several hours after reception intoxication turns into the expressed weakness and slackness. Quite often the patient falls asleep. Residual effects of benzodiazepines completely disappear within a day.
At constant reception of benzodiazepines tolerance increases, achievement of a condition of euphoria requires increase in a dose. An incoordination of movements and a static ataxy become less expressed. Other effects remain, at the same time lengthening of the period of post-effects – slackness and weakness to which depression and indifference is added is noted. There can be a tearfulness and irritability. At reception of high doses violations of consciousness and the episodes of excitement which are followed by hallucinations are possible. Occasionally the psychoses reminding deliriya develop. The overdose is followed by the progressing consciousness violations, deterioration in activity of respiratory, cardiovascular and urinary systems.
The abstinence syndrome is shown by a complex of somatonevrologichesky and mental violations. Tachycardia, a lowering of arterial pressure, the increased perspiration, a tremor of fingers of hands which are unsharply expressed an incoordination of movements, pallor of integuments, expansion of pupils, horizontal and dispepsichesky frustration is observed. Temperature increase, a headache and dizzinesses is possible. Change of a mental and emotional state is shown by depression, fatigue, a dysphoria, internal tension, sleeplessness, nightmares, uneasiness and concern. Sometimes there is depersonalization.
Abstinency duration at the termination of the use of medicines usually makes 2-3 weeks. Sometimes separate displays of an abstinence syndrome remain within several months. In the period of abstinency some patients have convulsive attacks. Psychoses with consciousness violations, the expressed concern, decrease in mood, paranoid frustration, hallucinations and depersonalization are possible.
Long abuse of benzodiazepines can become the reason of a peculiar frustration of the personality. Memory is broken, the intelligence suffers, impoverishment of a mimicry is noted, the face of the patient reminds a mask. The movements and the speech are slowed down. The selfish behavior, tendency to violation of ethical standards, roughness, cruelty and callousness in relation to people around is characteristic. Decrease in working capacity, bad shipping of intellectual and physical activities is noted.
Treatment and the forecast at abuse of benzodiazepines
Depending on expressiveness of symptomatology treatment can be performed in out-patient conditions, in the conditions of narcological or psychiatric office. At a small experience of the use single cancellation of psychoactive means is possible. At long reception and the expressed abstinence syndrome medicine or is cancelled gradually, smoothly reducing a dose, or replace with other medicine from the same group, and then also reduce a dose. Treatment is carried out against the background of individual or group psychotherapy. The patient is in the subsequent under observation of the narcologist.
The forecast at dependence on benzodiazepines rather favorable. Noticeable defect of the personality owing to the use of medicines develops only at a small amount of patients, in other cases after cancellation of benzodiazepines gradual disappearance of symptoms and full or almost complete recovery is observed. As well as at other dependences, an important component of successful treatment is desire of the patient to refuse abuse of psychoactive agent.