Have you been prescribed this medication too? Let's talk about benzodiazepines!

Perhaps your doctor has prescribed you a medication to help you sleep better, to help you with anxiety, or to help you with muscle pain. Benzodiazepines are a type of medication that we are talking about today. Although they are useful for many ailments, they can also be dangerous if not used exactly as directed. So let's talk about everything clearly and simply.

What are these benzodiazepines?

Simply put, benzodiazepines are a class of drugs that slow down the activity of our nervous system, making it 'calm'. This slowing down of the nervous system provides relief from many symptoms. They are also known as "benzos" among the general public.

The most important thing is that this type of medicine is classified as a controlled substance in many countries, including Sri Lanka. This means that you cannot just go to a pharmacy and buy these. You definitely need a prescription from a doctor. It is illegal to possess or obtain these without a prescription.

How does this medicine work in the body?

Think of our nervous system as a large network of messages. Messages are sent through chemicals called neurotransmitters. Just like a key fits into a lock, these chemicals bind to their corresponding receptors to initiate a process.

Benzodiazepines work by stimulating the production of a chemical in our brain called GABA (Gamma-aminobutyric acid) . The main function of this GABA is to 'calm down', or slow down, the activity of our nervous system. When this activity is reduced, we experience the following effects:

How are benzodiazepines classified?

These medications can be mainly divided into two types:

1. Strength: Some benzodiazepines are stronger than others, meaning they can have a greater effect with a lower dose.

2. Duration of action: Some medications are short-acting, meaning they only last a few hours. Others are long-acting, meaning they can last for days.

Your doctor will choose a medication for you based on both of these factors. For an emergency, if you need a quick effect, you may be given a short-term, strong medication. For an ongoing condition, you may be prescribed a less potent, long-term medication.

What conditions is this medicine used for?

These medicines are used for many medical conditions.

• Anxiety disorders: Conditions like social anxiety disorder and panic disorder.
• Insomnia: Difficulty falling asleep and sleep-related disorders.
• Epilepsy and Seizures: Control seizures and treat status epilepticus, an emergency condition caused by seizures.
• Muscle control issues: Conditions such as muscle spasms.
• Pre-anesthesia: To calm the patient and temporarily lose memory before surgery and other medical tests.
• Alcohol withdrawal: Manage the severe symptoms that occur when someone addicted to alcohol stops drinking.

What are the most commonly seen benzodiazepines?

The table below lists some of the most commonly prescribed benzodiazepines in Sri Lanka and around the world, along with their main uses.

So what are the disadvantages and risks of these medications?

Although this medication is very useful, it also has some risks. It is very important to be aware of this.

• Potential for misuse: Some people use these without medical advice. That is very dangerous.
• Habit-forming risk: With long-term use, the body can become accustomed to this medication, which can lead to dependence and addiction.
• Risk of overdose: If you take too much medication, the nervous system can become dangerously depressed, causing breathing to stop, and even death .
• Interactions: Taking this medication with alcohol is extremely dangerous. Also, taking it with other medications, such as some opioid painkillers, can have dangerous effects.
• Criminal use: Some criminals use this drug to unconsciously inject someone with a drink, causing them to lose consciousness and then use it for things like sexual assault or robbery. The drug `Flunitrazepam (Rohypnol)` is notorious for this.
• Effects on driving and operating machinery: This medication may slow your reflexes. Therefore , you should avoid doing tasks that require alertness, such as driving or operating heavy machinery .

What should we do to stay safe?

To get the most out of these medications and avoid risks, be aware of these things.

Advice for those using medication

1. Take your medicine exactly as your doctor tells you: Take the prescribed dose, at the prescribed time, and for the prescribed duration. Never increase the dose at will.

2. Keep your medicines safe: Keep them locked in a safe place where children can't get to them and others can't easily access them . One of the most common things people do when they misuse medicines is to steal them from other people's medicine cabinets.

3. Talk to your doctor if you are concerned about addiction: If you are concerned or have any doubts that you may be addicted to this medication, talk to your doctor openly about it. He or she will help you.

How can you protect yourself from unknowingly ingesting such medications?

At social events and parties, someone may put a drug like this in your drink without you knowing. Follow these tips to avoid this.

• Keep an eye on your drink: At a bar or party, never leave your water bottle or glass for even a second. Cover your glass with your hand while you're talking.
• Don't accept drinks from just anyone: This could happen even to someone you know well and consider a friend. So be careful.
• Be careful when drinking from shared containers: Drinking from a large punchbowl or mug can be risky.
• If in doubt, don't drink:If your drink tastes, smells, or looks a little different, or if you have the slightest suspicion that someone has put something in it, never drink it. If you feel uncomfortable, immediately ask someone you trust for help.