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Benzodiazepines

Classification: Central nervous system (CNS) depressant

Background: Benzodiazepines are a large group of drugs that act as central nervous system depressants. Opiates and alcohol are also CNS depressants, and like their use, benzodiazepines provide the user with an overall calming effect. The marketing of benzodiazepines began in the 1960s, designed for the treatment of seizures, insomnia, anxiety disorders, acute alcoholism withdrawal and convulsions and as muscle relaxants.

Benzodiazepines are commonly abused for their sedative properties and widespread availability. In fact, it has been predicted that one in five current controlled substance prescriptions in the United States is a benzodiazepine.

Prescribed as: Nordiazepam, Oxazepam, Diazepam, Lorazepam, Alprazolam, Chlordiazepoxide, Flurazepam, Estazolam, Bromazepam, Nitrazepam, Temazepam, Quazepam, Triazolam, Lormetazepam, Flunitrazepam, Clonazepam and Midazolam.

Metabolism and Detection in Urine: There are three general time-of-effect categories for benzodiazepines:

  • Ultra-short acting (Midazolam, Triazolam)
  • Short acting (Alprazolam, Lorazepam)
  • Long acting (Chlordiazepoxide, Diazepam)

Accordingly, the faster the reaction and effect of the drug, the smaller the detection window for the drug. This means the detection of benzodiazepines can range from hours to weeks, depending on the drug.

Physiological Effects: Decreased libido, erectile dysfunction, hypotension, respiratory suppression, nausea, lack of coordination, impaired driving skills, blurred vision, increased seizures in epileptics

Psychological Effects: Drowsiness, dizziness, decreased alertness and concentration, depression, disinhibition, changes in appetite, confusion, euphoria, nightmares, aggression, violence, impulsivity, irritability, anterograde amnesia, decreased IQ

Toxicity: Benzodiazepines are especially more dangerous when abused with alcohol, opiates and barbiturates because they act on the same receptors in the body and therefore potentiate the effect of the drug. Since many drug abusers combine multiple drugs, this becomes a dangerously risky game that leads to increased sedation, impaired motor coordination, suppressed breathing and other adverse effects that may potentially be lethal.

Symptoms of overdose may include: drowsiness, slurred speech, nystagmus, hypotension, ataxia, respiratory depression, coma, cardiorespiratory arrest and death.

chemical structure of benzodiazepine
Benzodiazepine

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Prescribed Use: Treatment of anxiety disorder, panic disorder with or without agoraphobia, and anxiety associated with depression

Prescribed as: Xanax, Alprazolam Intensol, Xanor, Alprax, Niravem

Street Names: Z-bars, Bars, Zannies, Zanbars, Handlebars, Blue Footballs, Upjohn

Mode(s) of Use: Tablet and liquid form, to be taken orally

Toxicity: Alprazolam can be habit-forming, and abrupt discontinued use can cause withdrawal symptoms and sometimes fatal side effects such as seizures.

Detection Time in Urine: 1–4 days 

Detection Time in Oral Fluid: 1–2 days

Prescribed Use: Management of anxiety disorder or for the short-term relief of symptoms of anxiety, withdrawal symptoms of acute alcoholism, and preoperative anxiety or apprehension.

Prescribed as: Librium, Klopoxide, Libritabs, Mesural, Multam, Zetran, Novapan, Risolid, Silibrin, Sonimen, Tropium

Street Names: Tranqs, Downers, Nerve Pills

Mode(s) of Use: Tablet and liquid form, to be taken orally

Metabolism: This drug metabolizes into nordiazepam and oxazepam. 

Detection Time in Urine: 1–10 days 

Detection Time in Oral Fluid: 1–2 days

Prescribed Use: Alone or as an adjunct in the treatment of petit mal variant, akinetic and myoclonic seizures, petit mal seizures unresponsive to succimides and panic disorder with or without agoraphobia.

Prescribed as: Klonopin, Klonopin Wafers, Rivotril, Rivatril

Street Names: Tranqs, Downers, Nerve Pills, Pins, Super Valium, K-Pins, K-Cuts

Mode(s) of Use: Orally disintegrating tablet and regular tablet form

Detection Time in Urine: 1–4 days 

Detection Time in Oral Fluid: 1–2 days

Prescribed Use: Management of anxiety disorders, ethanol withdrawal symptoms, skeletal muscle relaxant, status epileptics, muscle spasm associated with tetanus.

Prescribed as: Valium, Valrelease, Diastat, Diastat AcuDial, Diazepam Intensol

Street Names: Tranqs, Downers, Nerve Pills, Vals, Vallies, Candy, French Blues, Wiltshire Blues, Ardins

Mode of Use: Tablet, extended-release tablet, and concentrated liquid for oral consumption, rectal gel.

Metabolism: Diazepam metabolizes into nordiazepam, temazepam and oxazepam.

Detection Time in Urine: 1–7 days 

Detection Time in Oral Fluid: 1–2 days

Prescribed Use: Management of anxiety disorders or short-term (≤4 months) relief of symptoms of anxiety or anxiety associated with depressive symptoms. IV use: status epileptics, pre- anesthesia for desired amnesia.

Prescribed as: Ativan, Lorazepam Intensol, Temesta, Loraz

Street Names: Tranqs, Downers, Nerve Pills

Mode(s) of Use: Tablets as a freebase, solution prepared for oral administration, and parenteral solution; liquid concentrate comes in a specialized dropper.

Detection Time in Urine: 1–7 days 

Detection Time in Oral Fluid: 1–2 days

Prescribed Use: Short-term treatment of insomnia

Prescribed as: Methyloxazepam, Normison, Restoril

Street Names: Tranqs, Downers, Nerve Pills, Rugby Balls, Eggs

Mode(s) of Use: Oral tablet

Metabolism: Temazepam is found as a metabolite of medazepam (nobrium) and diazepam. Metabolites of temazepam include oxazepam.

Detection Time in Urine: 1–7 days 

Detection Time in Oral Fluid: 1–2 days

The information provided is for educational purposes only and is not intended to be used as medical or legal advice. Detection times are approximate and may be influenced by a number of factors, including BMI, duration of drug use, dosage and interindividual metabolic differences. For specific drug testing result interpretation questions, please contact us.

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