Benzodiazepines are a class of medications that slow down activity in your brain and nervous system. They’re most often used for treating anxiety and related mental health conditions, as well as brain-related conditions like seizures. These medications are tightly regulated and are only available with a prescription.
Benzodiazepines are medications that make your nervous system less active. The decrease in nervous system activity makes these medications helpful for a variety of symptoms and conditions.
Many countries, including the U.S., classify benzodiazepines (sometimes known by the slang term “benzos”) as controlled substances. That means you need a prescription to get them. It’s illegal to have or obtain them (depending on the laws where you are) if you don’t have a prescription.
IMPORTANT: Benzodiazepines are controlled because they can have dangerous effects, especially when misused. They can also be habit-forming. Because of these factors, healthcare providers use benzodiazepines cautiously. If your nervous system’s activity drops too low, it can have dangerous or even deadly effects.
Your nervous system uses chemical and electrical signals to send and relay messages throughout your body. The chemical signals, known as neurotransmitters, can attach to cells with the right receptors. Neurotransmitters and receptors work much like your car keys. Neurotransmitters (your car key) can only fit into the right receptor (your car ignition). If it fits, the neurotransmitter can activate a process within the cell (starting your car).
Benzodiazepines tell your brain to release a neurotransmitter, gamma-aminobutyric acid (GABA). This neurotransmitter has a specific job: It makes your nervous system less active. The slowed activity can have the following effects:
There are two main ways that experts classify benzodiazepines:
The strength and duration of action of benzodiazepines are important in what conditions they treat. Short-term or emergency conditions usually merit the use of stronger, short-acting benzodiazepines. Chronic, non-emergency conditions are usually treatable with lower-strength, longer-acting benzodiazepines.
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These medications treat conditions based on which effect they cause. While there are separate types because they have different primary effects, there’s a lot of overlap between them. For example, most benzodiazepines have a sedative effect in addition to their primary effect.
A few medications mimic the hypnotic effects and work similarly to benzodiazepines, but they aren't the same. Experts call these nonbenzodiazepines. These drugs also activate the same receptors as benzodiazepines and cause GABA release. Because of how they work, these drugs are most effective in treating insomnia and related sleep disorders. They include:
Yes, benzodiazepines are commonly prescribed and see widespread use. In a 12-month period spanning 2014 and 2015, experts estimate that at least 30.5 million people in the U.S. took benzodiazepines prescribed by a healthcare provider.
The most common benzodiazepines approved in the United States include (but aren’t limited to):
Many benzodiazepines aren’t approved for use in the United States. Some of these have approval in other countries, and some don’t have approval anywhere.
One benzodiazepine that’s noteworthy — even though it’s not approved (and illegal) in the United States — is flunitrazepam. This drug is best known as Rohypnol (or by the slang term “roofies”), and it’s infamous for its use as a “date rape” drug. As a result, flunitrazepam is a well-studied drug in the U.S. (and in many places worldwide). Healthcare providers can test for it and treat people under its influence (see below under “What are the disadvantages, side effects and complications that are possible with benzodiazepines?”).
Benzodiazepines have several advantages:
Benzodiazepines are useful and effective, but some risks come along with them, including:
There are many reasons you shouldn’t take benzodiazepines. These include:
You shouldn’t drink alcohol if you’re taking benzodiazepines. Alcohol can interact with these drugs, causing dangerous side effects or complications. There may be other circumstances where you shouldn’t take benzodiazepines with certain foods or beverages. Your healthcare provider can answer questions about whether to change what you eat or drink while taking these medications.
Because benzodiazepines have a higher risk for misuse and can be habit-forming, healthcare providers tend to prescribe them cautiously. They may prescribe them only for use as needed, not daily, and they may prescribe lower doses or pick benzodiazepines that aren’t as strong. Your healthcare provider can explain their recommendations for your treatment, including the timeline for which treatments you receive and why.
Your healthcare provider will likely recommend that you don’t work or drive right after you start taking benzodiazepines. You may be able to work or drive after you start taking them, depending on how these drugs affect you, the dose you take, how long the drugs last and other factors.
Before you drive, go back to work, use heavy tools and machinery, or participate in other potentially dangerous activities, talk to your healthcare provider. They can guide you on what you can do to take your medications as prescribed and stay safe at the same time.
Your healthcare provider will schedule follow-up visits after prescribing benzodiazepines. It’s important to go to these visits as recommended. In some areas, providers can’t prescribe these medications without first seeing you for a follow-up visit. Your healthcare provider can tell you more about the laws surrounding prescribing these medications and the recommended schedule for you to return for a follow-up visit.
Yes, benzodiazepines can be habit-forming. Taking these medications exactly as prescribed makes that unlikely, but it’s still possible. Your healthcare provider can tell you more about what you can do to avoid dependence on these drugs or developing benzodiazepine use disorder.
Yes, withdrawal is a possible complication of misusing benzodiazepines. Unfortunately, it’s also possible with long-term use of these drugs even when you take them as prescribed. If you have concerns about dependence and withdrawal from benzodiazepines, your healthcare provider can help you plan the timeline for your treatment. They can also recommend switching you to longer-acting benzodiazepines, which are less likely to cause withdrawal symptoms.
According to a study from 2016, the most prescribed benzodiazepines are:
Together, these four drugs make up 99% of benzodiazepine prescriptions.
IMPORTANT: Because of the risk of misuse, overdose or other dangerous events related to benzodiazepines, it’s essential that you take steps to protect yourself and others. The most important things you can do include:
Benzodiazepines can pose a threat without you ever knowing it. Taking precautions is one of the best ways to protect yourself from unknowingly taking these drugs.
A “spiked” drink, meaning one with a drug added to it without your knowledge, is a threat to anyone, regardless of sex or gender. It’s also important to remember that you may not be able to taste a difference in a spiked drink.
The following precautions can help anyone avoid unintentionally consuming a drugged drink:
A note from Cleveland Clinic
Benzodiazepines are among the most commonly prescribed medications. They’re an important means of treating many conditions, ranging from mental health disorders to brain-related diseases. While these medications can treat many conditions and help millions, they’re not without risks. If your healthcare provider prescribes one of these medications, don’t hesitate to ask for guidance, and take the medications exactly as prescribed. That way, you can benefit from these medications and reduce the risk of problems along the way.
Last reviewed by a Cleveland Clinic medical professional on 01/03/2023.
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