Addiction is not the right word for the majority of benzodiazepine consumers.

While many symptoms of addiction and dependence overlap, the main distinction is between those who take  their medication as prescribed and those who abuse or misuse that drug.

Addiction is defined as a “compulsive need for and use of a habit-forming substance” or  “persistent compulsive use of a substance known by the user to be harmful”.  Addiction has a physiological pay-off so to speak and can be extremely rewarding.  This “high” is the main reason why the drug is used in spite of adverse effects.

Dependence is defined as  “an adaptive state that develops from repeated drug administration, and which results in withdrawal upon cessation of drug use.”  In other words, dependence is a neuro adaptation to a drug as it is taken regularly. Dependence on a drug is not necessarily rewarding, but getting off of it can be very painful.

These very definitions warrant a different response. The treatment of someone who is addicted to drugs is usually quick and severe, and often without the input of the one being treated. With people who have become dependent on benzodiazepines taken as prescribed, this approach is inappropriate, unnecessary and often detrimental.

In the case of benzodiazepines the neuro adaptations that create a state of dependency mean that someone who rapidly tapers or cold turkeys off this drug (on their own or at a detox/rehab facility) can actually have seizures and die.  It is possible to have an addiction to a benzodiazepine, abuse it and have relatively little physical adjustment once the drug is out of the system. Paradoxically there are those who take “low doses” of benzodiazepines for only a few weeks, withdraw and find their bodies have so drastically adapted to the drug that they suffer with severe mental and physical symptoms for months or even years after.

Withdrawal from other drugs such as opiates or even heroin and cocaine does not cause death. Withdrawal from benzodiazepines can. This is why it is so important to understand the difference between benzodiazepine addiction and dependence and assist people in pursuing the appropriate form of treatment.

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