What is the Strongest Benzodiazepine?
Benzodiazepines are some of the most frequently used and frequently prescribed prescription medications in the U.S. Each year millions of prescriptions are written by clinical providers for benzos such as Xanax and Klonopin. Benzos are also one of the only prescription medications that when abused or misused, can cause both physical dependency and the experience of withdrawal symptoms. These highly potent and highly habit-forming medications are designed for various levels of efficacy and potency. However, even at the lowest potency, they can become addictive and lead to a substance use disorder.
Benzos are typically central nervous system depressant medications used to produce calming and sedative effects for those who suffer from anxiety disorders, insomnia disorders and seizure disorders. When abused, it can lead to addiction and is often associated with a risk of suicide and suicidal thoughts and ideation.
How do Benzodiazepines work?
Benzos work by suppressing the central nervous system by increasing the effectiveness of the GABA neurotransmitters in the brain. This leads to reduced activity in the brain, which also slows down activity in the body. Common uses for benzos include anxiety disorders, panic disorders, insomnia and sleep disorders, seizure disorders, alcohol withdrawal and as a muscle relaxant. Unfortunately, benzos are also frequently used with other central nervous system depressant substances such as alcohol and opioids. The combination of this type of polydrug use will often lead to addiction and signs of overdose.
Some of the dangers of benzo abuse include:
- Short-term side effects include intense sedation
- Increased risk of dementia
- Severe or worsening withdrawal symptoms
- Drug dependence which is due to chronic drug use
- Drug addiction which leads to substance use disorder
- Overdose which can be intentional or accidental
- Increased risk of Alzheimer’s disease
- Increased risk of congenital disabilities
- Confusion
- Irregular heartbeat
- Vertigo
Benzos abuse is often associated with chronic use of drugs. When this occurs, it can even go as far as changing a person’s ability to feel emotions. The drug can profoundly impact those who struggle with managing intense or difficult emotions. This is referred to as emotional anesthesia. The severity of the effects of the benzos will depend on which benzos they are prescribed.
What are the different types of Benzodiazepines?
Are all benzos the same? Do they all have similar potency and efficacy? No. Despite varying potency, even the weakest benzos can increase the risks of developing dependency and addiction. The potency of benzos refers to the strength of the substance. The strength of the benzos will depend on the drug’s half-life, half-life dosage and if the user is also taking other drugs in combination with the benzos. The half-life of a drug is based on its intended use and can be determined by calculating how long it takes for the drug to take effect on the user.
Benzos with a short half-life and short-acting are felt more intensely by the user. They also have a quicker onset of effects, which occurs more rapidly, making the drug more attractive to recreational users and dealers. Most recreational users who abuse the drug look for highly potent and short-acting benzos because they provide a quick and intense impact.
High-potency benzos have a quicker onset and the user can immediately experience the effects of the drug. The higher the potency, the quicker the effects of sedation and calming will kick in.
Short-acting benzos take effect for a short amount of time. Long-acting benzos will last longer. Short-acting benzos are often prescribed to treat conditions such as sleep disorders. This helps a user fall asleep faster and stay asleep for longer without hindering their cycle when they wake up due to the short effective period. Long-acting benzos are often prescribed to treat conditions such as anxiety disorders. This is because it can take longer to treat conditions of anxiety and therefore users need a longer-lasting effect of the drug.
The combination of high potency and short-acting benzos are generally the most sought-after drug for recreational use and abuse because of their ability to produce an intense, rapid, yet short-lived high. This type of high is what causes a user to become addicted.
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So what is the strongest benzodiazepine? What is the weakest benzodiazepine?
- High potency and long-acting – clonazepam, brand name Klonopin
- High potency and short-acting – alprazolam, brand names Xanax, Ativan and Halcion
- Medium potency and intermediate-acting – clobazam, brand name Onfi
- Low potency and long-acting – chlordiazepoxide, brand name Librium and Valium
- Low potency and short-acting – diazepam, brand name Serax and temazepam, brand name Restoril
Both Xanax and Klonopin are considered to be some of the strongest benzos for treating conditions such as anxiety disorders and seizure disorders. Klonopin is listed by the DEA as a Schedule IV Controlled Substance and can remain in the body for as long as 50 hours depending on the dosage of the drug. Klonopin is also the only legal benzos in the United States that is high potency and long-acting with a slow onset of effects. This factor contributes to the delay in recovery from abuse of this drug because it can take a long time for the substance the leave the system once it has been taken.
Xanax is the only high-potency benzos that has been developed into an extended-release formulation on top of its short-acting formulation and can remain in the body for up to 26 hours after the initial dose. It is one of the most prescribed benzos by clinical providers. However, because of its widespread availability and addictive nature, Xanax has also been listed as one of the top 10 drugs responsible for the most benzos-related overdose deaths in the United States.
Ativan is another substance that can be considered a strong benzos. This is because it offers a half-life of around 24 hours and the onset of effects can occur within 30 minutes after intake.
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Treatment for Substance Use Disorder
Benzodiazepines are some of the most popular prescription medications that are prescribed and abused. Benzos are highly potent and can be highly habit-forming leading to dependence and addiction. Many factors can affect drug safety including the dosage taken, whether the drug is taken in combination with other substances as well as the overall health status and age of the user.
Professional treatment programs such as Hotel California by the Sea provide effective treatment for substance use disorders such as an addiction to benzos. We provide treatment at all levels of care including detox, residential, partial hospitalization program and intensive outpatient program. We utilize evidence-based treatment methods including cognitive behavioral therapy, dialectical behavioral therapy, family therapy and group therapy. Hotel California by the Sea provides the necessary support, tools, and resources clients need to overcome their addictions.
References:
https://www.thefreedomcenter.com/these-are-the-strongest-benzodiazepines/
https://www.addictionresource.net/blog/benzodiazepines-strongest-weakest/
https://www.addictionresource.net/blog/strongest-benzodiazepine/
https://www.detoxrehabs.net/blog/list-of-benzos/
https://vertavahealth.com/blog/list-of-benzos-from-weakest-to-strongest/