AKA:

Medically, drugs in the benzodiazepine group (benzos) are used for a number of purposes. They are often lumped together as MINOR TRANQUILLISERS (tranx). Drugs in this group include:

SOURCE:

Benzodiazepines are widely prescribed as sedatives, to combat anxiety, as skeletal muscle relaxants, anti-epileptics and anti-convulsants. However, some benzodiazepines leak onto the street, and are quite widely misused. The most frequently available drugs are those with italicised slang names above. Valium, Temazepam and Rohypnol are the most commonly available on the illicit market.

APPEARANCE:

The appearance of each drug varies widely from drug-company to drug-company. Most come as tablets, in a variety of shapes, colours and strengths. A few also come in preparations for injection, such as Valium ampoules, which command a higher street value.

COST:

At a street level, benzodiazepines have a very low value, typically around 50p per tablet. Ampoules can cost a pound or two.

QUALITY:

Assuming that the pills are correctly identified and genuine, quality is assured. However, it is difficult to correctly identify all of the drugs in this family by eye, let alone assay the strength, so mistakes in strength and name are frequent amongst those purchasing outside medical spheres.

METHODS OF USE:

Tablets are designed for oral use, though some users crush and inject tablets.

EFFECTS:

They induce physical relaxation, and reduce stress and anxiety. Drowsiness and sleepiness are often present. In addition, they may cause forgetfulness, slurred speech, clumsiness and confusion. Some users experience depression and, paradoxically, a few users become over-excited or violent.

HEALTH IMPLICATIONS:

When used within a supervised medical regime, benzodiazepines should not be used for extensive periods as tolerance develops rapidly and withdrawal can be an unpleasant and, in some cases, dangerous process. After a few weeks, and certainly within a few months, they cease to be effective at promoting sleep and subsequently cease to be effective in reducing anxiety. Indeed, the converse becomes true; without increasing the dose, a user is liable to experience insomnia, anxiety, tremors and, in severe cases convulsions. Withdrawal from Benzodiazepines, especially when they have been used for more than a month, should only be done under medical supervision. IT IS POSSIBLE TO DIE DUE TO SEVERE BENZODIAZEPINE WITHDRAWAL.

There is a low risk of fatal overdose; this risk is raised through ignorance as to the strength of various tablets. Risks are exacerbated when benzodiazepines are combined with other depressant drugs such as alcohol or heroin. When tablets are crushed for injection, this brings with it a range of associated health risks. Of specific concern are Temazepam Capsules. These capsules were originally introduced as a response to growing concern over Temazepam tablets being crushed for injection. The capsules contained a viscous jelly that was intended to discourage injecting. However, users found that heating the jelly made it become liquid, and so injected it. However, at lower temperature, such as at body temperature, the gel solidifies, and a large number of gruesome injecting injuries were reported. Recently, gel capsules have been withdrawn.

LEGAL STATUS:

Benzodiazepines are Class C drugs. Most of them are Schedule 4i drugs, meaning that they can only be supplied and produced by those authorised to do so. Since February 2002 it has been an offence to possess Schedule 4i drugs without prescription. Temazepam and Rohypnol, however, were rescheduled, and are Schedule 3 drugs; it is also an offence to possess these without authorization, such as a prescription.

OTHER INFORMATION:

Benzodiazepines were introduced and have largely supplanted the BARBITURATE group of drugs, which were widely prescribed and widely misused in the seventies. They were seen as preferential to barbiturates as the risks of overdose, dependence and side-effects were thought to be less. They are very widely prescribed; some critics argue that they are over-prescribed, and do not tackle the causes, merely masking symptoms temporarily.

They are used recreationally in a number of settings. Some people combine benzodiazepines with alcohol to enhance and increase intoxication. Some stimulant users take benzodiazepines to alleviate the "come-down" from speed, Ecstasy or cocaine, and to promote sleep.

It is not uncommon for dependent heroin users to use benzodiazepines when heroin is unavailable, or to use them to help offset some of the symptoms of withdrawal. A few people self-medicate with benzodiazepines to alleviate mental discomfort caused by mental health problems, painful memories, or to escape unpleasant circumstances. For such users, where unsupervised use may be long-term and extensive, careful assessment of needs, of underlying reason for the drug use, and comprehensive care plans are likely to be needed to achieve reduction and cessation of drug use.