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What Is the Difference between Prescription Opiates & Benzodiazepines?

Different prescription pill bottles of opiates and benzodiazepinesPrescription medications are designed to help people overcome very serious medical or psychiatric problems that they may not be able to handle on their own without pharmacological support. They are made to help, but in some cases, they can cause harm. That is the case with both benzodiazepines and opiates. Both are available via prescription, and both can cause harm. There are, however, big differences between these drugs.

All about Opioids

Opioids are prescription medications that are designed to help people cope with pain. They do not physically block a pain signal, but they boost a signal of pleasure deep within the brain. When pleasure signals are high, pain signals are easier to ignore or live with. People who use these medications appropriately may be able to live with pain, where they may not have been able to do so without the medications.

Painkillers are remarkably common, as are addictions to these drugs. According to the National Institute on Drug Abuse (NIDA), an estimated 2.1 million people in the United States were addicted to painkillers in 2012. Many of these people came to addictions after abusing medications they were prescribed for pain. Others came to addictions due to borrowing or grabbing medications that belonged to others.

There are many different opioids available, according to NIDA, including:

  • Vicodin
  • OxyContin
  • Percocet
  • Kadian
  • Avinza
  • Codeine

Each drug comes with different dosing instructions and different risks, but they all work by tinkering the brain’s pleasure signals. They all also come with a significant risk of overdose. Medscape reports that people who take too much of an opioid can slip into a coma-like state in which breathing rates and heart rates slow down to a crawl. With prompt medical attention, this is a process that can be reversed. There are medications that can render opioids inactive, and if they are applied in time, people can make a full recovery from an overdose. But, if those medications are not applied in time, a severe overdose can be fatal.

Recovering from an opioid addiction involves medical detox. Those same medications that can stop an overdose can be used to block cravings for opioids, and they can soothe cravings while the brain heals. Even people who do not go through medical detox can get sober. The withdrawal process can be uncomfortable, as it causes flu-like symptoms, but it is rarely life-threatening. In about a week, those symptoms go away.

Therapy follows medical detox or at-home detox. With therapeutic support, people who have an opioid addiction can recover fully.

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All about Benzodiazepines

These prescription medications are used to assist people struggling with mental illnesses, including anxiety disorders. They work by slowing down electrical activity inside the cells of the brain, which can keep an electrical storm of anxiety from taking hold. People who take these medications might be accustomed to living with storms of anxiety on a regular basis. With medications, they may not feel those storms.

Remarkably common are Benzodiazepine prescriptions. According to research by the National Institutes of Health, 1 person in 20, ages 18-80, received a benzodiazepine prescription in 2008. Doctors who felt their patients needed these medications had several different brand name drugs to choose from, including:

Benzodiazepines are classified based on their strength and longevity. Some drugs hit a user hard, and they go away quickly. Those drugs are ideal for someone in the midst of a panic attack, but those drugs can also be quite addictive as they change reality very quickly and go away very quickly. Other drugs take longer to hit, but they last a longer period of time. These drugs can also cause harm, but they tend to be a little safer, from an addiction perspective.

Overall, according to a study in American Family Physician, benzodiazepines are considered safe. Even if people take too many of them all at once, they rarely if ever cause an overdose. They drugs can be powerful, but when taken alone, they do not seem capable of causing a person’s immediate death.

However, benzodiazepines can be quite dangerous during the recovery period. That slowing of electrical activity can seem like a new normal for a brain long exposed to drugs, and when the brain’s electricity returns to a normal level, it can spark a storm of activity. That could cause a person to experience seizures, and those seizures can be damaging to the brain.

Severe withdrawal symptoms can cause death, but they can also block the recovery process. As an article in Current Opinion in Psychiatry points out, people who experience the first inkling of a difficult side effect during withdrawal may opt to return to drug use, rather than allowing the withdrawal to continue. They may refuse to try to get clean in the future. To them, the process might not seem safe.

Clinicians can help by moving addicted people to a new type of benzodiazepines. If people are taking fast-acting drugs, they can be moved to long-lasting versions. Those drug versions can be progressively tapered until they are no longer strong and powerful. In time, with a slow taper, people can get clean without experiencing a life-threatening problem.

Then, therapy can be used to help people understand their drug cravings and come to a better and healthier future. Those therapy programs are often measured in months, not days, and most people who complete them still need the help of support groups to stay clean, but they can be remarkably helpful.

mixed opiates tablets and benzodiazepines tabletsThe Bottom Line

Medications can work wonders when they are used as prescribed, but medications can also do an intense amount of harm when they are abused. That is why it is vital for people who are abusing medications to get help with their addictions. That help could be lifesaving, and it is right around the corner. If you are abusing drugs, ask for help. You can recover. You deserve to recover, and the help to do so is available.

Infographic of the opiate overdose epidemic
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