Understanding Benzodiazepines: Risks, Effects, and Alternatives
by Dr. Charles R. Freeman Ph.D

Understanding Benzodiazepines: Risks, Effects, and Alternatives<br> by Dr. Charles R. Freeman Ph.DMillions of Americans are prescribed benzodiazepines each year to manage sleep disorders and anxiety. However, emerging research indicates that the use of these medications, especially in the long term, is not without risks (Baldwin et al 2013). This post aims to provide you with updated information on benzodiazepines and equip you with the knowledge to make informed decisions about your mental health and well-being.

What are Benzodiazepines?

Benzodiazepines, such as Ativan, Klonopin, Valium, Librium, and Xanax, are commonly prescribed for insomnia, anxiety, seizures, muscle spasms, and other sleep issues. They work by slowing down the central nervous system, producing sedation, inducing sleep, and relieving anxiety. While generally safe and effective for short-term use, prolonged use can lead to a host of complications including dependency, tolerance, aggression, or impulsivity.

The Risk of Dependency and Withdrawal

Recent research has shed light on the serious consequences of long-term benzodiazepine use (Barker et al 2004). A comprehensive survey involving 1,207 benzodiazepine users found that 76.6 percent of respondents experienced symptoms on tapering and after discontinuation that persisted for “one year or longer”. These symptoms were often new and distinct from the symptoms for which benzodiazepines were originally prescribed. The survey also revealed that more than half (54.4 percent) reported suicidal thoughts or attempted suicide, and almost a quarter endured violent thoughts or exhibited actual violence against others while tapering (Lane 2023).

Moreover, 88.1 percent reported anxiety, nervousness, or fear; 86.9 percent experienced sleep disturbances; 86.2 percent had low energy levels; and 85.3 percent had significant difficulty focusing or were distracted. The average respondent also experienced 8.1 out of 16 possible adverse life consequences, including significantly affected relationships (56.8 percent), job loss or inability to work (46.8 percent), and violent thoughts or actual violence against others (23.5 percent) (Lane 2023).

Withdrawal effects can include increased anxiety, muscle pain, depression, and prolonged insomnia. These symptoms may last from days to months, depending on several factors such as the length of time the drugs have been taken and the dosage (Lane 2023).

The Impact on Pregnant Mothers and Newborns

Benzodiazepines can cross the placental barrier, meaning that if taken during pregnancy, they can affect the newborn. Newborns might experience withdrawal symptoms as they are essentially quitting the drug cold turkey. Complications during recovery in newborns include breathing problems, sucking difficulties, poor body temperature control, and poor muscle tone. It is highly advised not to quit using benzodiazepines suddenly as this can lead to severe withdrawal symptoms, including seizures. The passing of the drug can continue through breastfeeding and may offer a better alternative to forcing them into abrupt withdrawal symptoms if dosages can be tapered off.

Seeking Help and Exploring Alternatives

If you are using or considering using benzodiazepines, it is crucial to understand the potential side effects and long-term risks. Consult with your healthcare provider and explore alternatives when appropriate. Sleep psychologists and other mental health professionals can work closely with primary care providers to implement Cognitive Behavioral Therapies and other interventions while gradually weaning patients off benzodiazepines.

Educating yourself about the effects of these medications and understanding the potential long-term consequences will empower you to communicate effectively with your healthcare provider and make informed decisions about your mental health.

Remember, it is essential to approach the use of benzodiazepines with caution and to consider both the short-term and long-term effects on your health. This updated information emphasizes the importance of being well-informed and seeking professional guidance for managing sleep issues and anxiety. Your mental health and well-being should always be the priority, and there are various avenues of support available to help you make the best decisions for your unique circumstances.

Charles R. Freeman, Ph.D.  | Sleep, Pain, Behavioral Medicine Psychologist & Addictionologist  |  Available online via teletherapy and in-person in San Diego


Baldwin, D.S., Aitchison, K.J., Bateson, A.N., Curran, H.V., Davies, S.J., Leonard, B.E., Nutt, D.J., Stephens, D.N., & Wilson, S.J. (2013). “Benzodiazepines: Risks and benefits. A reconsideration.” Journal of Psychopharmacology, 27, 967 – 971.

Barker, M.J., Greenwood, K.M., Jackson, M., & Crowe, S.F. (2004). Cognitive Effects of Long-Term Benzodiazepine Use. CNS Drugs, 18, 37-48.

Lane, Christopher,  Ph.D. (2023).”Benzodiazepines Linked to Long-Term Neurological Dysfunction.” Psychology Today South Africa. Link

 This blog post is authored by Dr. Charles R. Freeman, PhD, a psychologist specializing in sleep disorders and cognitive-behavioral therapy. The information provided here is for educational purposes and should not be considered as medical advice. Please consult a healthcare professional for personalized medical advice.

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