Benzodiazepine drugs like diazepam (Valium) and lorazepam (Ativan) can cause the development of a tolerance within weeks of daily drug use.
Tolerance can develop through taking a prescription drug as directed by a healthcare provider, or as a consequence of substance abuse.
Here you’ll find information on:
- what a benzodiazepine tolerance is
- types of benzo tolerance
- signs and symptoms of a benzo tolerance
- risks of a benzo tolerance
- treatment options for a benzo addiction
What Is A Benzodiazepine Tolerance?
A tolerance occurs when the body becomes accustomed to the presence of a substance, such as alcohol or drugs, in your system.
This develops through the regular use of drugs, including illicit drugs, alcohol, and prescription medications like benzodiazepines.
What to know about benzodiazepine tolerance:
- tolerance to the sedative effects and anticonvulsant actions of benzodiazepines can develop rapidly, while tolerance to anxiolytic effects develops more slowly
- it can develop through taking the drug as prescribed by a doctor, and is not by itself a form or sign of substance abuse
- it can develop as soon as a few weeks after regular use
- it can be influenced by metabolic, genetic, environmental, and behavioral factors
- benzodiazepine tolerance is not the same as dependence, which can cause withdrawal symptoms with reduced use or sudden, stopped use
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Common Forms Of Benzodiazepine Tolerance
Benzodiazepines are a class of central nervous system (CNS) depressants commonly used for treating anxiety disorder, insomnia, panic disorder, epilepsy, and alcohol withdrawal.
Tolerance can develop with the use of all benzodiazepines, although the length of time it takes and effects of benzodiazepine tolerance may vary by drug type.
Common types of benzo tolerance include:
- alprazolam (Xanax) tolerance
- clonazepam (Klonopin) tolerance
- lorazepam (Ativan) tolerance
- diazepam (Valium) tolerance
- chlordiazepoxide (Lithium) tolerance
- triazolam (Halcion) tolerance
- temazepam (Restoril) tolerance
What Causes A Benzodiazepine Tolerance?
Benzodiazepine tolerance develops through the repeated use of a benzodiazepine drug.
Generally, tolerance develops because a person’s metabolism of the drug speeds up, and because the number of binding sites (benzodiazepine receptors) the drug attaches to decreases.
Tolerance can develop by:
- taking benzodiazepine drugs by mouth (orally)
- snorting benzos, also known as sniffing or snorting
- injecting benzos through intravenous methods
- abusing benzos with other drugs (e.g. opioids, barbiturates)
- plugging benzos, or inserting them rectally
Taking benzodiazepines regularly will eventually cause the body to become tolerant to the drug’s effects, causing the drug to become less effective.
Signs Of A Benzodiazepine Tolerance
The primary sign of benzodiazepine tolerance is the reduced effectiveness of the drug while taking the same dosage as before.
Signs and symptoms of a benzodiazepine tolerance include:
- reduced drug effects (e.g. sleepiness, anxiety relief, calmness)
- requiring higher doses to feel the desired side effect (i.e. dose escalation)
- increased anxiety or insomnia symptoms
- taking high doses of benzodiazepines
Factors That Can Affect Benzodiazepine Tolerance
The development of a benzodiazepine tolerance, and the amount of time it takes, can be influenced by a variety of personal factors.
Factors that can affect this include:
- type of benzodiazepines
- half-life of the benzodiazepine
- frequency of drug use
- history of benzodiazepine use
- genetic factors
Risks Of Benzodiazepine Tolerance
Tolerance to a drug is not dangerous or a health issue by itself. When drug use is closely monitored by a doctor, it can be effectively managed through dosage adjustments.
However, if a person attempts to overcome tolerance alone, by increasing their dosage without a prescriber’s approval, this can carry with it certain risks.
For instance, tolerance may be a risk factor for substance abuse in certain people, as well as addiction if the drug abuse becomes a habit and worsens with time.
Benzodiazepine Tolerance And Substance Abuse
Having a high tolerance to benzos can be a sign of substance abuse. Benzodiazepine abuse is a serious issue that may require treatment to overcome.
This problem can develop in anyone, regardless of age, gender, race, ethnicity, or socioeconomic status.
Treatment For Benzodiazepine Abuse And Addiction
Tolerance by itself does not necessarily require treatment. But it may become an issue if it’s a consequence of prescription drug abuse or a substance use disorder.
Benzodiazepines can cause severe physical dependence and withdrawal effects with chronic use. They can also become addictive when abused for non-medical purposes.
Treatment will typically involve benzodiazepine detoxification (detox) for withdrawal, in addition to other behavioral health interventions.
Benzodiazepine Tolerance FAQs
Find answers to frequently asked questions about benzodiazepine tolerance and addiction.
Can Benzodiazepine Tolerance Cause Withdrawal?
No. Withdrawal symptoms develop with the discontinuation of benzodiazepine use, as a result of physical dependence. Tolerance does not cause withdrawal syndrome.
Like tolerance, benzodiazepine dependence can develop with short-term or long-term benzodiazepine use.
❓ What Is The Difference Between Benzodiazepine Tolerance And Addiction?
✔️ Benzo tolerance occurs through chronic use of a benzodiazepine drug. This can develop through taking the drug as prescribed, or abusing benzodiazepines without a prescription.
Addiction, on the other hand, is a disease with physical, psychological, and biological components. This is characterized by a compulsive need to take a benzo.
❓ Does Melatonin Reverse Benzo Tolerance?
✔️ No. Some research suggests melatonin may help certain people experiencing insomnia during benzodiazepine withdrawal. But it does not affect benzo tolerance.
❓ How Long Does It Take To Develop A Tolerance To Benzodiazepines?
✔️ Tolerance to benzodiazepine treatment can develop within a few weeks of daily use. This may depend on factors related to physical health, genes, and multidrug use.
Get Help For A Benzodiazepine Addiction
Millions of Americans report misusing prescription medications like benzodiazepines each year, which can lead to high tolerance, dependence, and addiction.
If this describes you or a loved one, you’re not alone. Call our helpline today to learn more about treatment options for benzodiazepine abuse and addiction.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
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- Journal of Pharmacology and Experimental Therapies — Reducing abuse liability of GABAA/benzodiazepine ligands via selective partial agonist efficacy at α 1 and α 2/3 subtypes.
- Merck Manuals — Tolerance and Resistance to Drugs
- Pharmacology, Biochemistry, and Behavior — Rapid tolerance and cross-tolerance as predictors of chronic tolerance and cross-tolerance doi:
- U.S. National Institute on Drug Abuse (NIDA) — Summary of Misuse of Prescription Drugs
- U.S. National Library of Medicine: PubMed — Mechanisms Underlying Tolerance after Long-Term Benzodiazepine Use: A Future for Subtype-Selective GABAA Receptor Modulators?
- U.S. National Library of Medicine: PubMed — Rapid reversal of tolerance to benzodiazepine hypnotics by treatment with oral melatonin: a case report