Benzodiazepines are a group of drugs called minor tranquillisers, often known as 'benzos'. These drugs are prescribed by a doctor to help people with anxiety or sleep problems. There are about 30 different types (called the 'generic' names) of benzodiazepines. Each one of these generic name drugs may be sold under several different brand names - all the same drug, but made by different companies.

The list below shows some of the different generic and brand names of benzodiazepines.

• diazepam - Valium, Ducene, Antenex
• oxazepam - Serepax, Murelax, Alepam
• nitrazepam - Mogadon, Alodorm
• temazepam - Euhypnos, Normison, Temaze
• lorazepam - Ativan
• flunitrazepam - Rohypnol, Hypnodorm
• bromazepam - Lexotan
• clonazepam - Rivotril

Some slang names for benzodiazepines include 'benzos', 'rowies', 'serries', 'moggies', 'vals', 'V', 'normies'. Some people use benzodiazepines without a prescription from a doctor. This is illegal and can be very dangerous.

How are benzodiazepines used?

Benzodiazpines slow down the workings of the brain and the central nervous system. They are used medically to reduce anxiety, to help people sleep and to relax the body. They should only be prescribed for short periods of time because it is possible to become dependent on them after as little as four weeks' use as directed by a doctor (see 'dependence' later in this booklet).

Different types of benzos work in the body for different lengths of time.

They come in the form of tablets or capsules.

Sometimes people use benzos when they are not prescribed by a doctor, for the reasons above and for other reasons. Some people inject benzodiazepines and/or use them at the same time they use heroin, alcohol or other drugs. This can be very dangerous, causing overdose or death.

Injecting benzodiazepines that are intended to be swallowed in tablet/capsule form can also cause severe damage to veins, leading to loss of limbs from poor circulation, organ damage or stroke.

Effects of benzodiazepines

What benzodiazepines do to you depends on:

• how many tablets and what dose you take
• your height and weight
• your general health
• your mood
• your past experience with benzodiazepines
• whether you use benzos on their own or with other drugs
• whether you use alone or with others, at home or at a party etc.
• route of administration.

Immediate effects

The effects of benzodiazepines may last from a few hours to a few days, depending on the dose and type of benzo you take. The immediate effects can include that you:

• feel relaxed
• feel drowsy, sleepy or tired
• have no energy
• become confused or dizzy
• feel really good
• have mood swings
• slur your words or stutter
• can't judge distances or movement properly
• have blurred or double vision
• can't remember things from just a short time ago.

If you take a very high dose of benzodiazepines with other drugs you can go into a coma or die.

Long term effects

If you use benzodiazepines often for a long time you may:

• have no energy or interest in doing normal things
• be cranky
• feel sick in the stomach
• have headaches
• have dreams that make you feel bad
• lose interest in sex, or your body won't work properly during sex
• get skin rashes
• be more hungry and put on weight
• if you are a woman, you may have menstrual problems
• be depressed.

The way a person uses benzodiazepines can also cause some problems:

• Injecting benzodiazepines that are intended to be swallowed in tablet/capsule form can also cause severe damage to veins, leading to loss of limbs from poor circulation, organ damage or stroke
• Using benzodiazepines at the same time as other central nervous system depressants - such as alcohol, heroin, methadone, or some prescribed drugs - is very dangerous. It can cause you to lose consciousness, stop breathing, fall into a coma or die.
• Injecting benzodiazepines with used or dirty injecting equipment makes you more likely to get infected with HIV, hepatitis B or C, get blood poisoning (septicaemia) and skin abscesses. So that you don't get these problems, DO NOT SHARE fits (needles and syringes), spoons, water, filters, alcohol swabs or tourniquets.
• When you are getting benzodiazepines from a doctor, tell them about any other drugs you are taking so they can give you the right dose. This will help to prevent the risk of different drugs affecting each other in your body.

Tolerence and dependence

Anyone can develop a 'tolerance' to benzodiazepines or other drugs. Tolerance means that you must take more of the drug to feel the same effects you used to have with smaller amounts or lower doses. This may happen very quickly with benzodiazepines.

'Dependence' on benzodiazepines means that it takes up a lot of your thoughts, emotions and activities. You spend a lot of time thinking about using benzodiazepines, looking for them, using them and getting over the effects of using them. You also find it difficult to stop using or control how much you use. Dependence can lead to a variety of health, money, legal, work and relationship problems.

Not all people who ever use benzodiazepines become dependent. But it is very easy to become dependent on benzos, it can happen within four weeks.

Withdrawal

People who are dependent on benzodiazepines find it very hard to stop using them or cut down because of withdrawal symptoms. Suddenly stopping using benzodiazepines can be dangerous. You should get help and withdraw gradually if you have been using benzos regularly or using high doses of them.

Symptoms of withdrawal can include:

• convulsions
• disturbed sleep
• feeling nervous or tense
• being confused or depressed
• feeling afraid or thinking other people want to hurt you
• panicking and feeling anxious
• feeling distant or not connected with other people or things
• sharpened or changed senses (e.g. noises seem louder than usual)
• shaking
• pain, stiffness or muscle aches or spasms
• flu-like symptoms
• heavier menstrual bleeding and breast pain in women.

Overdose

It is unusual to overdose on benzodiazepines alone - but if you use them with other drugs such as alcohol, heroin or methadone it is very easy to overdose and die. Symptoms of overdose are:

• person is unable to be 'roused' or woken
• coma
• very slow breathing
• slow heartbeat
• cold clammy skin
• lips may appear a 'bluish' colour.

If someone overdoses, other people with them should:

• phone 000 to get an ambulance and tell the operator that the person has overdosed (the police will not come unless someone dies)
• stay with the person
• try not to panic
• try to keep the person awake - walk them around, talk to them, use their name
• if the person is unconscious, put them on their side, in the 'recovery' position
• clear their airway, check their breathing
• do mouth-to-mouth resuscitation if they stop breathing
• if the person is 'on the nod' and looks like they may overdose, walk them around and keep talking to them.

Benzodiazepines and pregnancy

Using benzodiazepines when you are pregnant can affect both the mother and the unborn child. Babies can also have problems after they are born.

New babies of mothers who use benzodiazepines are more likely to:

• be sick in the first few weeks of life and later
• have withdrawal symptoms when they are born (because they are no longer getting benzodiazepines from the mother's blood supply).