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Klonopin (clonazepam) is a benzodiazepine medication that is primarily used to treat anxiety disorders, such as panic disorder, and seizures. It has other potential dditional uses, including as a muscle relaxant and preanesthetic. In some cases, it may be used as an aid for sleep.
Benzodiazepines were designed to treat issues with clinically significant anxiety, not the anxiety that occurs as a result of day-to-day living. Because their use results in the rapid development of tolerance, these drugs are best utilized when they are designed for short-term use and when used in conjunction with behavioral interventions to help individuals control their anxiety. As behavioral interventions become more successful and the person develops control, the dose of the drug can slowly be decreased.
In some instances where issues with anxiety are due to problems with significant brain damage and behavioral methods may not fully control the severe anxiety, the drug may be used in the long-term. However, individuals who suffer from panic disorder and other anxiety disorders can benefit from behavioral interventions to help them control their anxiety, significantly reduce the symptoms of anxiety, and learn to control their reactions to their environment. As a result of the overall treatment program, the person may not need a benzodiazepine over the long-term. Treating conditions like epilepsy and other seizure-related conditions is typically a long-term endeavor.
Any use of a benzodiazepine for more than 4-6 weeks will result in some level of tolerance in most individuals. If the drug is continued, eventually some level of physical dependence will develop. When an individual develops physical dependence as a result of medicinal use of the drug (using the drug as prescribed and under the supervision of a physician), the person is not considered to be “addicted” to the drug. Developing tolerance and eventually potential withdrawal symptoms while being treated for some chronic condition is one of the cost/benefit analyses that must be weighed by the physician, the patient, and other relevant parties.
Because benzodiazepines like Klonopin do have a moderate potential to be abused and to result in the development of physical dependence by even by those who use them medicinally, they are listed as controlled substances by the United States Drug Enforcement Administration (DEA). Klonopin is classified in the Schedule IV category.
Benzodiazepines like Klonopin are often referred to as sedative, tranquilizer, or anti-anxiety drugs. In reality, they are central nervous system depressant medications (CNS depressants), which means that they act by suppressing the functioning of the neurons in the brain and spinal cord; however, they also work on nerves outside the central nervous system as well.
These drugs facilitate the functioning of the neurotransmitter GABA, the major inhibitory neurotransmitter in the brain. Inhibitory neurotransmitters work by suppressing or depressing firing rates of other neurons in the CNS. When a person takes a benzodiazepine like Klonopin, the functions of GABA are enhanced, and this accounts for its therapeutic effects. In addition, some of the extra effects that occur with CNS depressants include feelings of euphoria or wellbeing, sedation, less reaction to stress, loss of inhibitions, increased feelings of sociability, etc. These associated effects help to establish drugs like Klonopin as potential substances of abuse.
Klonopin is a benzodiazepine that is very often referred to as an intermediate-acting benzodiazepine, meaning that its effects last relatively long. It has a relatively long half-life that ranges from 18 to 39 hours. Its peak onset of action typically occurs between one and four hours after taking it, and it is a high-potency benzodiazepine, meaning its effects are achieved with small doses of the drug.
Because it has a relatively long half-life and is potent, it can be an attractive drug of abuse for individuals seeking its psychoactive effects.
According to the latest data provided by the Substance Abuse and Mental Health Services Administration (SAMHSA):
These are estimates based on survey data that SAMHSA collects. Although the estimated use of clonazepam products increased from 2015 to 2016, the estimated cases of misuse decreased, indicating that some of the interventions used by the medical profession have been successful regarding misuse of Klonopin.
The above survey data provided by SAMHSA and information from other sources gathered by SAMHSA also indicates that benzodiazepine abuse over all age groups is most often associated with abuse of another primary drug, such as alcohol, narcotic pain medications, or even other benzodiazepines. Benzodiazepines are most commonly abused by individuals between the ages of 18 and 34. As Klonopin has a fairly high prescription rate in the United States, this greater availability makes it easier for abusers to procure it, although the majority of individuals who have prescriptions for Klonopin do not abuse the drug. Instead, the majority of abusers of prescription medications get the drug from a family member or friend, or they steal it or buy it illicitly.
Some of the signs that someone may be abusing Klonopin include:
There are severe consequences associated with benzodiazepine abuse.
These consequences include:
Treatment for an individual with a sedative, hypnotic, or anxiolytic use disorder (the clinical term for a substance use disorder that would be diagnosed as a result of benzodiazepine abuse) can often be long and complicated. Individuals who develop physical dependence on benzodiazepines face serious and even potentially fatal consequences as a result of the withdrawal syndrome from benzodiazepines. Withdrawal from benzodiazepines may produce seizures, which can be fatal.
Individuals who have chronically used or abused benzodiazepines must discontinue them under the supervision of a physician. After completing the withdrawal management process, individuals will need to become involved in an intensive substance use disorder treatment aftercare program and remain abstinent from drugs and alcohol except when medications are prescribed under the supervision of a physician.
A long-term aftercare program typically includes:
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