Dangers of Mixing Opioids and Benzo’s

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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The opioid epidemic in the U.S. continues, despite the efforts of the medical community, law enforcement, and activists. Furthermore, the use of benzos, known in full as benzodiazepines, is on the rise. This is a bad combination. In 2019, for instance, more than 16% of all opioids overdose deaths also included benzos. Benzodiazepines are a form of sedative that doctors prescribe when you have severe anxiety and insomnia issues. It calms and sedates you and then increases the neurotransmitter GABA in your brain.

Some of the benzodiazepines commonly on the market today include alprazolam (Xanax), diazepam (Valium), and clonazepam (Klonopin).

What Do the Stats Say?

Opioid overdose causes at least 136 deaths every day in the U.S. However, as the National Institute on Drug Abuse notes, there is an increase in the number of adults who need a benzodiazepine prescription. The number started going up in 1996. At that time, the number of adults with a benzodiazepine prescription was 8.1 million and that number went up to 13.5 million by 2013.

People were also using more benzodiazepines than before as the quantity shot up from 1.1 kilograms per 100,000 adults all the way to 3.6 kilograms. The problem is that so many people were prescribed these two sedatives between 2001 and 2013. Because the two are highly addictive, it’s difficult for long-time users to stop taking them.

More than 44% of all benzodiazepine users become dependent on the drug. Thankfully, the professionals at Defining Wellness Center can help you.

Understanding the Effects of Mixing Opiates and Benzodiazepines

It is not advisable to ingest more than one type of drug at the same time. When discussing polydrug use, advice usually centers on heroin, cocaine, alcohol, and marijuana. However, the increase in the use of prescription drugs for recreational purposes has led to more people combining drugs like benzodiazepines with painkillers.

Mixing opioids and benzodiazepines enhances the painkilling and their euphoric effects. It works in these two areas until it poses a danger to the user. When taken together, these two type of drugs can sedate the user and suppress their breath, leading to death. They can also impair the cognitive functions of the user so that they can’t think on their own. Anyone using the two prescription drugs is at a high risk of visiting the emergency room.

Opiates Explained

Opioids are strong painkillers. If a person is in a lot of pain, doctors may prescribe opioids. When taken, these painkillers bind with your brain’s opioid receptors and block the pain. The drug is an extract of opium poppy, and its main function is to ensure that pain messages do not reach the brain.

The doctor might prescribe them after surgery or to people who have chronic pain from conditions such as arthritis or cancer. Vicodin and OxyCodone are two of the most popular opioids. Vicodin is a product of acetaminophen and hydrocodone. Oxycodone is one of the ingredients in prescription medications, such as OxyContin and Percocet. These two products of Oxycodone are prescribed for moderate or severe pain. If common over-the-counter drugs cannot counter the pain, a doctor prescribes these medications.

But unlike ibuprofen, these opioids are addictive.


Benzodiazepines are a group of medications that treat anxiety, muscle spasms, alcohol withdrawal symptoms, and seizures. When ingested, the medication relaxes the central nervous system so that your muscles can relax. Xanax and Valium are the most common benzodiazepines on the market today. A doctor can prescribe either of these medications to help ease panic disorders and anxiety.

Valium is most commonly used for alcohol withdrawal symptoms and in the treatment of seizures. Just like opiates, benzodiazepines are addictive. This leads to abuse of the two drugs, and this is where the problem starts.

Abusing Benzodiazepines and Opioids

When you take benzodiazepines, the levels of dopamine in your body surges, and this floods the brain with feel-good transmitters. This helps alleviate anxiety and pain. However, after using the benzodiazepines for some time, the pleasure becomes irresistible and dangerously addictive.

The addictive power you get from using benzodiazepines is the same as that from using opioids and cannabinoids. All these substances have very powerful addictive qualities, thanks to their interference with the brain.

When you use either opioids or benzodiazepines for a long time, or at the same time, they have the ability to alter the structure of some of your brain receptors. These receptors also change in function, making them more excitable. The dopamine rushes keep increasing the more you take these two prescription drugs.

The actions of opioids and benzodiazepines on the brain will add up until you don’t want to give up their use. This quickly moves from honest use to abuse and later to addiction. With most people, tolerance develops after six months of use, but for some people, physical dependency can start within a few weeks of using the drugs.

Once you’re addicted, quitting is very difficult. The withdrawal symptoms are severe and can include sweating, headaches, muscle stiffness, pain in the muscles, sleep disturbance, irritability, panic attacks, increased tension and anxiety, perceptual changes, muscle tremors, and heart palpitations.

Instead of treating anxiety, abusing benzodiazepines causes severe anxiety and tension. It can also result in psychosis and seizures. Even if you take low doses of these medications, you can still experience severe withdrawal symptoms.

Beating addiction is much easier when you have a team of dedicated professionals on your side.

How Does Addiction Start?

According to Drug Abuse Warning Network, using both opioids and benzodiazepines increases the chances of an overdose. If you are using the two together, there is a high risk that you’ll end up in a medical emergency room.

A report by the British Medical Journal suggests that many emergency room visits are from accidentally mixing the two medications. However, the same report shows that most people mix the two drugs to get a “high” feeling. Researchers found that using benzodiazepines enhanced the painkilling effects of opioids. In short, this makes the combination even more dangerous and habit-forming.

The BMJ study looked at a case of 2,400 veterans who died from using opioids. Of all these people, 49% were using both opioids and benzodiazepines. Although the deaths may have resulted from an overdose and abuse of these two medications, the users were first exposed to low doses of the two medications before they were addicted.

It all starts with a doctor’s prescription and then ends up with an increased intake of the two before the user develops an uncontrollable urge to take the medications. For instance, people who have chronic pain conditions such as cancer will get an opioid prescription for the pain on a long-term basis. The same group may also have a benzodiazepines prescription to manage muscle spasms. If they have anxiety and not muscle spasms, they still get a benzodiazepine such as Xanax.

The concern on the effects of mixing these two painkillers started in 2016 when some lawmakers started pushing the FDA to issue warnings on the effects of mixing opioids and benzodiazepines. See what former addicts and their loved ones had to say.

What Are the Dangers of Mixing Benzodiazepines and Opioids?

Mixing these two drugs can cause a domino effect that leads to death. Although abusing the two medications individually can still lead to death, the risks are increased when you take them together.

Before 2016, deaths from painkiller-related overdoses were on the rise. According to the American Society of Addiction Medicine, there were about 18,893 deaths resulting from an opioid overdose in 2014. Between 1999 and 2006, the rate of overdose-related deaths increased by more than 250%. Most of the deaths resulted from overdosing a combination of opioids and another medication, mostly benzos.

The American Society of Addiction Medicine continues to note that people hospitalized for a benzos overdose between 1995 and 2008 had an overdose of another drug. In most cases, 54.2% of the cases, these people overdosed on opiates.

It is evident that mixing opioids and benzos is dangerous and can lead to death. When taken together, the drugs seem to be more effective for heavy users. If you are addicted to oxycodone or Vicodin, you develop tolerance after a few months, so you will need a higher dose to experience the same effects you experienced when you just started.

Abusing the two leads to two dangerous conditions, according to the CDC:

• Enhanced sedation
• Depressed breathing

These two conditions need immediate medical attention or else you will die from an overdose. Before it gets to that point, you will experience mild symptoms such as:

• Unconsciousness
• Slowed breathing
• Pinpoint pupils

These symptoms exacerbate to suppressed breathing. Besides depressed breathing, overdosing on these two medications can cause oversedation where the body is unable to respond to any stimuli and the individual falls. If you are standing and the body experiences oversedation, you will fall. If you are driving, you will likely cause an accident.

There is a risk of going into a coma from the body’s inability to respond to stimuli. These medications can also change your breathing patterns to a point that your brain doesn’t get enough oxygen. If this happens for a long time, some of your vital organs might shut down, and you may also have brain damage, which could ultimately result in death.

How Else Does Mixing Opioids and Benzos Affect the Body?

There are so many more dangers that come with mixing opioids and benzos. For instance, when you are heavily sedated and have a euphoric feeling, you will likely lie for long periods until your muscles start breaking down. The chemicals from the breakdown are poisonous to your kidneys and can lead to kidney failure.

Opioids are toxic to the liver when taken for a long time and in high doses. They are even more poisonous when taken together with acetaminophen, which is also highly toxic. Further, the conditions affect your lungs by suppressing breathing. Oversedation can reduce the intensity and frequency of breathing and also increase the chances of conditions such as pneumonia.

The prescription medications can also slow down the digestive process and affect your appetite. When this happens, you’ll feel weak, nauseous, and have bowel distention.

Lastly, opioids and benzos can thin your bones, making them weak and susceptible to breaking. You only need to use opioids for two weeks to weaken your bones enough for them to break.

Get Help

Opioids and benzos are dangerous even if you use them individually. If you mix the two, the dangers increase. If you realize you have a substance use problem, you do not have to wait until the condition is uncontrollable. Reach out to Defining Wellness Centers, and you will get help. Regardless of the level of addiction, there is a program to suit your needs.

At Defining Wellness Centers, we offer customized rehab programs. We will help you based on the level of your addiction, your state of health, and several other factors. This way, you do not have to follow a generic program with feeble chances of success.

The use of technology, therapy, and wellness programs has proven to offer high chances of success among addicts who visit Defining Wellness Centers. You can be part of the success story by registering today, or start by talking to our doctors. If you or a loved one is battling addiction, contact us.

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