While the opioid epidemic has been grabbing headlines nationwide for its staggering impact on lives and productivity, prescriptions of benzodiazepines, another class of potent drugs, have also been soaring. Between 1996 and 2013, the number of adults filling a prescription for some type of benzodiazepine, or benzo, jumped by 67%. These powerful medications for anxiety, insomnia and a number of other conditions are implicated in roughly 8,000 overdose deaths a year. But just as it does for opioids, cannabis could be an exit drug out of benzodiazepine dependency and abuse, because of its ability to affect the same neural pathways in the brain.
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What Are Benzodiazepines?
Benzodiazepines are a large class of lab-synthesized drugs that includes:
- Diazepam (Valium)
- Lorazepam (Ativan)
- Clonazepam (Klonopin)
- Alprazolam (Xanax)
These medications are widely prescribed for conditions such as:
- Anxiety
- Insomnia
- Nervousness
- Panic disorders
- Seizures
- Muscle spasms
Sometimes they’re also used for sedation during surgery, and to treat premenstrual syndrome and the symptoms of alcohol withdrawal.
The Many, Sometimes Deadly Side Effects of Benzodiazepines
Like opioids, benzodiazepines are intended largely for short-term use, because they act relatively quickly. This means they’re prescribed for acute situations, such as calming a patient before a surgical procedure or easing the anxiety of a traveler before a flight. But also, similar to opioids, these drugs are frequently prescribed for long periods of time, which can lead to a number of serious side effects and addiction.
Benzodiazepines alone are only rarely responsible for overdose deaths. But because they depress the central nervous system, which controls respiration, heart rate and other autonomous functions, they can contribute to death by overdose when they’re taken along with other kinds of central nervous system depressants such as alcohol or opioids.
Though they’re not likely to be fatal, these drugs do have a long list of side effects. The more minor of these include:
- Dizziness
- Confusion
- Problems with memory and concentration
- Gastrointestinal problems
- Poor balance
- Fatigue
But serious effects can also occur, such as:
- Jaundice
- Severe low blood pressure
- Elevated heart rate
- Musculoskeletal problems
- Cognitive decline and dementia (especially in older people who take them for long periods of time)
How Do Benzodiazepines Work?
Science still hasn’t clearly established the exact reasons benzodiazepines work, but recent research points to their ability to affect a network of receptors in the brain related to the body’s production and use of gamma aminobutyric acid (GABA), an amino acid that inhibits the transmission of nerve impulses in the central nervous system. Because GABA slows neural activity, and benzodiazepines have been shown to enhance the effects of GABA, this relationship appears to account for benzos’ calming, slowing effects that reduce anxiety and promote sleep and muscle relaxation.
Malfunctions in the GABA receptor system seem to play a role in a number of psychological and neurological conditions such as:
- Anxiety
- Panic
- Insomnia
- Epilepsy
Some research suggests that schizophrenia and other psychoses might be related to GABA deficiency. Though GABA receptors are found in many areas of the brain, they’re especially prevalent in the prefrontal cortex, hippocampus and amygdala, areas related to managing emotion, cognition and coordination.
Benzodiazepines can bind to GABA receptors to boost their inhibitory activity. But so can cannabis—and the relationship between the GABA receptor system and the body’s large network of endocannabinoid receptors reveals why cannabis products can be safe and effective alternatives to benzodiazepines for just about every condition these drugs are used to treat.
The Cannabis/GABA Connection
Endocannabinoid receptors are found in organs and tissue throughout the body, binding both to cannabinoids produced internally and to those from outside sources such as spices and cannabis. The cannabinoid receptor CB1 occurs widely in the
brain, especially in the prefrontal cortex, hippocampus and amygdala—areas that are also rich in GABA receptors.
Anandamide and 2-AG, the body’s natural cannabinoids, also promote feelings of calm and relaxation—and recent research indicates that they can affect processes
that reduce the release of GABA, just as benzodiazepines do. And because cannabinoids from cannabis, particularly cannabidiol (CBD), bind to the same receptors as natural cannabinoids do, they support those processes, too.
Cannabis Offers Benzo Benefits—Without the Risks
Cannabis products of all kinds, especially those high in CBD, can be effective—and far safer—alternatives for benzodiazepines. Although endocannabinoid receptors are found in relatively large numbers in many areas of the brain, they’re notably absent in the brainstem—unlike receptors for both opioids and GABA. For that reason, cannabis is extremely unlikely to cause or contribute to an overdose death.
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When used for long periods of time, benzodiazepines can override the body’s own expression of GABA. These medications can become addictive, and when stopped, they can trigger a series of potentially dangerous withdrawal symptoms. The risk of benzodiazepine addiction is so high that a majority of drug rehab programs now include treatment for them alongside protocols for opioids and other kinds of drugs.
But stopping cannabis causes few, if any, physical withdrawal symptoms. And because cannabis affects all of the functions of the endocannabinoid system (ECS), it brings with it other positive effects such as immune system support and relief from pain and the symptoms of a long list of health conditions.
Recent research on cannabis as a substitute for prescription medications reveals that an overwhelming majority of cannabis consumers were able to reduce or stop using not only opioids, but also other medications including benzodiazepines, by using cannabis.
The documented benefits of cannabis include relief from anxiety, insomnia and depression, as well as the symptoms of epilepsy and other disorders that are currently treated with benzodiazepines. In all its forms, cannabis works with the brain’s GABA pathways just as benzos do—and it just might be an exit drug from this burgeoning addiction epidemic, too.
Photo credit: Thought Catalog
If you’re new to cannabis and want to learn more, take a look at our Cannabis 101 post. HelloMD can help you get your medical marijuana recommendation; it’s easy, private and 100% online.
