Benzodiazepine dependence defines a situation in which one has developed one or more of either tolerance, withdrawal symptoms, drug seeking behaviors, such as continued use despite harmful effects, and maladaptive pattern of substance use, according to the DSM-IV.
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Signs and symptoms of benzodiazepine dependence include feeling unable to cope without the drug, unsuccessfulattempts to cut down or stop benzodiazepine use, tolerance to the effects of benzodiazepines, and withdrawal symptoms when not taking the drug.
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Benzodiazepine dependence is a frequent complication for those prescribed for or using for longer than four weeks, with physical dependence and withdrawal symptoms being the most common problem, but occasionally drug-seeking behavior.
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Long-term use and benzodiazepine dependence is a serious problem in the elderly.
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Risk factors for benzodiazepine dependence are long-term use beyond four weeks, use of high doses, use of potent short-acting benzodiazepines, dependent personalities, and proclivity for substance use.
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The pharmacological mechanism of benzodiazepine tolerance and dependence is the internalization of receptor site in the brain and changes in gene transcription codes in the brain.
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In clinical practice, benzodiazepine dependence should be suspected in those having used benzodiazepines for longer than a month, in particular, if they are from a high-risk group.
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Benzodiazepine dependence should be suspected in individuals having substance use disorders including alcohol, and should be suspected in individuals obtaining their own supplies of benzodiazepines.
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Benzodiazepine dependence is almost certain in individuals who are members of a tranquilizer self-help group.
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Research has found that about 40 percent of people with a diagnosis of benzodiazepine dependence are not aware that they are dependent on benzodiazepines, whereas about 11 percent of people judged not to be dependent believe that they are.
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Benzodiazepine dependence is the condition resulting from repeated use of benzodiazepine drugs.
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Low- or normal-dose Benzodiazepine dependence was not suspected until the 1970s, and it was not until the early 1980s that it was confirmed.
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Low-dose dependence has now been clearly demonstrated in both animal studies and human studies, and is a recognized clinical disadvantage of benzodiazepines.
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Therefore, long-term benzodiazepine use and dependence seems to carry a negative effect on mental health, with a significant risk of causing depression.
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