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Guide to Klonopin Addiction and Abuse Potential

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.

klonopin-abuse

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.

Mechanism of Action

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.

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The Abuse Potential of Klonopin

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):

  • In 2015, about 29.7 million individuals engaged in any use of a benzodiazepine; in 2016, this figure was 30.6 million.
  • In 2015, about 5.4 million individuals misused a benzodiazepine at least once; in 2016, this figure was 5.6 million.
  • In 2015, about 6.8 million individuals engaged in some use of clonazepam products (the active ingredient in Klonopin); in 2016, this number was about 6.7 million.
  • In 2015, about 1.2 million individuals misused clonazepam products at least once; in 2016, this figure was 1 million.

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:

  • Using Klonopin without a prescription for it
  • Using it in manners that are not consistent with its prescribed uses, such as using it with other drugs of abuse, in greater amounts than prescribed, or more frequently than prescribed
  • Attempting to get prescriptions for Klonopin from multiple doctors
  • Using Klonopin to deal with everyday stressors
  • Frequently exhibiting signs that use of the drug cannot be controlled, such as:
    • Using the drug in greater amounts or more often than originally intended
    • Engaging in drug-seeking behaviors, such as spending significant amounts of time trying to get Klonopin
    • Using Klonopin in situations where it is not safe to do so
    • Continuing to use Klonopin even though its use is resulting in significant distress or dysfunction
    • Numerous unsuccessful attempts to cut down or stop using Klonopin
    • Experiencing significant cravings associated with Klonopin or other benzodiazepines
  • Using it in manners that are not consistent with its prescribed uses, such as using it with other drugs of abuse, in greater amounts than prescribed, or more frequently than prescribed
  • Often appearing as if intoxicated
  • Developing significant tolerance to the drug
  • Demonstrating withdrawal symptoms when without Klonopin
  • Becoming isolated from family and friends
  • Giving up important activities or personal obligations in favor of using Klonopin or other drugs
  • Finding empty prescription containers in the person’s room, car, clothes, etc.
  • A sudden onset of issues with attention, memory, or problem-solving
  • Periods of alternating mood, such as periods of depression followed by periods of giddiness
  • A deterioration in performance at work, in school, or in personal relationships

Consequences of Abuse

 There are severe consequences associated with benzodiazepine abuse.

These consequences include:

  • A loss of productivity at work or in school that can lead to significant ramifications for one’s career and/or career goals
  • Significant issues with physical health that can include but are not limited to:
    • Cardiovascular issues, such as issues with blood pressure, increased potential for heart attack, increased risk for stroke, etc.
    • Liver and kidney problems
    • Respiratory issues due to the suppression of breathing associated with chronic benzodiazepine use and abuse
    • Organ and brain damage as a result of hypoxia (decreased oxygen flow) or anoxia (a shutoff of oxygen)
    • Increased risk of overdose, which is enhanced when people combine benzodiazepines like Klonopin with other central nervous system depressants, such as narcotic pain medications, alcohol, or other benzodiazepines
  • Significant stress in personal relationships that can lead to problems that may not be reconcilable with one’s spouse, children, close relatives, and close friends
  • Serious financial issues that are associated with drug abuse and/or the ramifications of decreased productivity at work
  • A significant loss of self-esteem due to the above issues
  • Significant issues with cognition that can include problems with memory (particularly problems remembering new information), paying attention, concentrating, using judgment and rational thinking, controlling impulses or emotions, etc.
  • The development of physical dependence on benzodiazepines, which can fuel addictive behavior and lead to numerous potential physical, emotional, and mental issues
  • The development of a formal substance use disorder (a sedative, hypnotic, or anxiolytic use disorder)

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:

  • Long-term substance use disorder therapy in groups or individual sessions (or in combinations of both)
  • Participation in peer support groups such as 12-Step groups
  • Continued use of medical management (e.g., medications) as required
  • Concurrent treatment of any co-occurring mental health conditions (e.g., anxiety, depression, etc.)
  • Concurrent treatment of any other co-occurring substance use disorders
  • Other forms of counseling and therapy, such as family counseling, vocational rehab, occupational therapy, etc.
  • A commitment to abstinence
  • Long-term involvement in treatment-related activities

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