In the context of psychoactive substance dependence, benzodiazepines deserve special attention due to their high addictive potential. These substances significantly slow down the process of information transmission from the brain to the body, which induces a feeling of calm and euphoria in patients. Although their use in medicine fits within certain therapeutic frameworks (anxiety, stress, epilepsy), benzodiazepines do not represent the first-line choice for the treatment of insomnia or other problems. Their long-term consumption forms a solid physical and psychological dependence, which often creates the danger of overdose, especially in combination with other depressants.
Statistics
The situation in Georgia is alarming in this regard, as according to a 2022 study, the prevalence of non-prescribed use of psychotropic medications in the general population amounts to 4.1%. Also noteworthy is the circumstance that the average age of the first non-prescribed use of these substances is 30 years, which means that the problem primarily affects the able-bodied and active population.
In a regional breakdown, the differentiation of data shows an even more specific picture. The study highlighted that the highest rate of psychotropic substance use is recorded in the Kvemo Kartli region. The scale of the problem is further intensified by statistics among adolescents: according to 2019 data, 3.1% of 15–16-year-old Georgian students have used tranquilizers or sedatives without a doctor’s prescription at least once.
Classification and Risks of Polydrug Use
Benzodiazepines are divided into three groups according to their duration of action: long-acting (e.g., Diazepam/Valium), intermediate-acting (e.g., Nitrazepam/Mogadon), and short-acting (e.g., Alprazolam/Xanax). It is the short-acting drugs that are distinguished by more severe withdrawal symptoms and a high potential for the formation of dependence.
Patients often use them to achieve drug intoxication or to reduce the side effects of stimulants (amphetamine, cocaine), which gives rise to the dangerous practice of “polydrug use.” When combined with alcohol or opiates, the risk of respiratory depression and fatal overdose increases critically.
Clinical Presentation
The impact of benzodiazepines on the human body is complex. The primary effects of the drug, such as calm and euphoria, are often in combination with cognitive impairments such as memory loss, confusion of orientation, and slurred speech. Especially aggressive pathological processes develop during injection use. In this case, the danger of vein damage, thrombosis, and the spread of blood-borne infections (HIV infection, hepatitis) increases sharply.
In the long-term perspective, regular use leads to the degradation of the central nervous system and personal transformation. Paranoia, chronic lethargy, and a significant slowing of thinking processes are often revealed in patients. Medical evidence also indicates that heavy and systematic consumption represents a risk factor for the development of stroke and oncological diseases of the brain.
Pregnant women and elderly patients constitute a special risk group. The medication causes defects in fetal development and premature birth, while in the elderly, it significantly increases the probability of traumatic falls and fractures due to impaired coordination.
Withdrawal Syndrome
In the process of managing benzodiazepine dependence, the most critical barrier represents the severe withdrawal syndrome (so-called “lomka”). The sharp and arbitrary cessation of drug intake is high-risk for the organism, because during this time neurological complications develop, including epileptic seizures, delusional states, and hallucinations. The symptomatology often carries a prolonged character and lasts from several weeks to one year. Due to these difficulties, the treatment process requires constant professional supervision and a strategy of gradual, controlled dose reduction.
The policy of harm reduction implies a categorical refusal of self-medication on the part of the patient and the use of the drug only in a controlled, safe environment. According to international guidelines, benzodiazepines do not represent the first-line choice (First-line treatment) for the treatment of insomnia or anxiety disorders. Accordingly, to correct the existing situation in Georgia, the healthcare system must shift priority to tightening control over pharmaceutical products and raising public awareness. With this complex approach, it is possible to prevent the severe social and clinical consequences that the abuse of psychotropic medications determines.
Source: პროექტი CPR; EUDA; Drugorders
