Key Takeaways
- Benzodiazepine overdose deaths have risen dramatically, with over 12,000 benzo-involved overdose deaths in the US in 2022.
- Benzodiazepines are rarely fatal when taken alone — the overwhelming majority of fatal benzo overdoses involve co-ingestion with opioids, alcohol, or other CNS depressants.
- Signs of benzo overdose include extreme drowsiness, confusion, slurred speech, respiratory depression, loss of consciousness, and coma.
- Flumazenil is the antidote for benzodiazepine overdose but carries seizure risk in chronic benzo users.
- The combination of benzodiazepines and opioids is the most lethal drug combination, with the CDC reporting that benzos were involved in 14% of all opioid overdose deaths.
- Common benzodiazepines involved in overdoses include alprazolam (Xanax), diazepam (Valium), clonazepam (Klonopin), and lorazepam (Ativan).
What Is a Benzodiazepine Overdose?
A benzodiazepine overdose occurs when someone takes more of a benzodiazepine medication than their body can safely process, leading to dangerous suppression of central nervous system functions. This can result in respiratory depression (slow, shallow breathing), loss of consciousness, coma, and death.
How Benzo Overdoses Happen
Benzodiazepine overdoses most commonly occur through:
- Combining benzos with opioids — the most common and deadly combination
- Combining benzos with alcohol — both are CNS depressants
- Taking higher-than-prescribed doses to cope with tolerance
- Using illicit benzos — counterfeit pills may contain unknown doses or fentanyl
- Accidental overdose — especially in elderly patients taking multiple medications
Signs and Symptoms of Benzo Overdose
Recognizing the signs quickly can save a life:
Mild to Moderate Overdose:
- Extreme drowsiness and difficulty staying awake
- Confusion and disorientation
- Slurred speech
- Blurred vision
- Impaired coordination and stumbling
- Dizziness
Severe Overdose:
- Loss of consciousness
- Respiratory depression (breathing slow, shallow, or stopped)
- Blue-tinged lips and fingertips (cyanosis)
- Unresponsiveness to stimulation
- Very slow heart rate
- Coma
What to Do If You Suspect a Benzo Overdose
- Call 911 immediately — do not wait to see if the person improves
- Check breathing — if breathing has stopped, begin rescue breathing if trained
- Place on their side (recovery position) if breathing but unconscious
- Do not leave them alone — monitor breathing continuously
- Administer naloxone (Narcan) if you suspect opioids were also involved
- Do not try to make them vomit — this can cause aspiration
- Tell paramedics everything you know about what substances were taken
Flumazenil: The Benzo Antidote
Flumazenil is a benzodiazepine antagonist that can reverse benzo overdose. However, its use is limited because:
- It can trigger seizures in people physically dependent on benzodiazepines
- It has a shorter half-life than most benzos, meaning re-sedation can occur
- It is primarily used in hospital settings under close medical monitoring
If you or a loved one is facing these challenges, learn more about specialized benzodiazepine recovery treatment available at Trailhead Treatment Center in Salem, NH.
Prevention
- Never combine benzodiazepines with opioids, alcohol, or other sedatives
- Take benzos only as prescribed by your physician
- Do not purchase benzodiazepines from non-pharmacy sources (risk of counterfeit pills)
- Keep benzos stored securely to prevent accidental or intentional misuse by others
- If you have been prescribed benzos and opioids simultaneously, carry naloxone
Trailhead Treatment Center provides choosing the right level of addiction care to support lasting recovery and wellness.
Conclusion
Benzodiazepine overdose is a serious and potentially fatal medical emergency, especially when benzos are combined with opioids or alcohol. Knowing the signs and acting quickly can save a life. If you or someone you know is struggling with benzodiazepine misuse, professional treatment is available at Trailhead Treatment Center.