Can You Mix Benzos With Opioids?

What Are Benzodiazepines?

Benzos are a form of tranquilizer that depresses the central nervous system. They enhance the effects of the neurotransmitter gamma-aminobutyric acid, suppressing CNS functioning. Brain activity, respiration and heart rate slow. Doctors prescribe this type of drug to treat conditions such as anxiety, panic attacks, sleep disorders and seizure disorders.

The most common prescriptions are for Klonopin, Ativan, Valium and Halcion. Approximately 3% of the U.S. population is prescribed benzodiazepines for long-term symptomatic relief. They are also the third most common drug used illicitly or with a prescription. Popular street names for this drug type include benzos, chill pills, Kpin (Klonopin) and tranks.

Though benzodiazepines have legal uses with a prescription, many take the drug recreationally for its calming effects. The ease with which these drugs are available makes them appealing to those who wish to feel more relaxed. Unfortunately, they tend to also take them with other drugs, including alcohol and opioids. Addiction is another serious concern that can result in long-term problems and increases the risk of overdose.

Side Effects of Benzodiazepines

Even when people use benzodiazepines as prescribed, they can cause side effects. Some side effects are mild, while others can be severe. People who take benzos may experience any of the following side effects:

• Drowsiness
• Dizziness or light-headedness
• Slurred speech
• Memory loss or confusion
• Dry mouth
• Constipation
• Nausea
• Loss of sexual desire

It is also not uncommon for people to experience muscle weakness and digestive issues. Occasionally, benzo users have more frequent headaches, low blood pressure, tremors, rashes or difficulty urinating. Rare side effects include jaundice, blood disorders and male breast development.

Many common side effects are the same as benzodiazepine overdose symptoms, making it particularly challenging to determine whether a person has overdosed. However, side effects can have serious implications and should not be ignored. If you or someone you know displays side effects, it’s essential to talk to a doctor. Serious side effects warrant a trip to the emergency room.

Benzo Withdrawal Symptoms

The body can become quickly tolerant of and dependent on benzodiazepines, leading to withdrawal symptoms when people stop using them. In as little as a month, people who take benzos can experience withdrawal when they stop using them. Some of the withdrawal symptoms include the following:

• Anxiety, panic attacks and hyperventilation
• Depression
• Insomnia and restlessness
• Nausea, vomiting, sweating, headaches, body aches and pain
• Racing pulse, tremors, muscle spasms and grand mal seizures

When doctors prescribe benzodiazepines, they typically prescribe them for short-term use. When patients are on the drug for extended periods, their doctors decrease dosing gradually to remove them from the drug.

However, people who take these drugs recreationally may become dependent without realizing it. Their bodies may also become tolerant, requiring higher doses to achieve the same effect. If they stop using them, they may start experiencing withdrawal symptoms within eight hours for some of these drugs. For others, symptoms may begin within a couple of days.

Benzo Overdose Signs

Overdosing on benzodiazepines alone is not common, but it does occur. Older individuals are at higher risk due to their increased potential to take prescribed painkillers. However, combining Kpin (Klonopin), Valium or Xanax with alcohol can lead to overdose. Signs of overdose include:

• Mood changes, anxiety, agitation or confusion
• Extreme fatigue
• Slurred speech
• Dizziness
• Blurred vision
• Lack of coordination
• Breathing difficulties

Overdosing on benzos, especially in combination with alcohol or opioids, can also lead to coma and death.

If you or someone you love experiences signs of overdose, it is critical to call 911 immediately. When treated quickly and early, emergency room doctors may be able to counter the drug’s effects with flumazenil and administer other forms of treatment to reverse the overdose.

What Are M-30s and Other Opioids?

Opioids are synthetic derivatives of opium, a naturally occurring chemical found in plants (people are most familiar with its association with seeds from the poppy plant). Doctors prescribe these drugs for pain relief, most often for relief from chronic severe pain or post-surgical pain. These drugs are also central nervous system depressants, but they don’t work like benzos.

Instead of enhancing GABA, opioids block the signals from the body that use pain to tell the brain something is wrong. They do this by attaching to receptors for opioids. These receptors exist throughout the body, including in the gut, brain and spinal cord. Prescription opioids include oxycodone, codeine and hydrocodone.

Some opioids are highly addictive and are a common type of illicit street drug. While Fentanyl is a synthetic opioid available by prescription, it is also widely available for recreational use. Oxycodone is a pharmaceutical drug with a milder effect than the more powerful narcotic Fentanyl. Oxycodone M30 is a prescribed form of the drug. On the street, oxycodone is available and widely used recreationally. It goes by the street names M-30s, blues, dirty 30s or Mexies.

The Relationship Between Fentanyl and Oxycodone

There is a growing crisis in the street-drug scene in the form of counterfeit oxycodone drugs. These drugs originate from illegal labs with no regulatory oversight. There is no guarantee of what is in them, and an increasing number of them are laced with Fentanyl. The highly addictive nature and strong effects of fentanyl make these counterfeits even more dangerous than the recreational use of prescription oxycodone.

Side Effects of Opioids, Including Blues

As benzodiazepines and opioids are both CNS depressants, there are overlapping side effects. However, there are also some differences between the side effects opioids may produce. Some common effects include the following:

• Dizziness
• Drowsiness and sedation
• Nausea and vomiting
• Constipation
• Dry mouth
• Respiratory depression

People who use opioids may also experience sudden muscle twitching or spasms, muscle rigidity, delayed gastric emptying, heightened sensitivity to pain and hormone and immune system dysfunction.

Withdrawal Symptoms for Dirty 30s and Other Opioids

M-30s, Fentanyl and other opioids are also highly addictive. Furthermore, when people use them regularly, whether recreationally or as a prescribed drug, their bodies develop a tolerance and dependence on the drug. Coming off the drug too quickly produces withdrawal symptoms, some of which are highly uncomfortable and can begin in as little as 24 hours after the last dose. They include the following:

• Restlessness, anxiety and insomnia
• Nausea, vomiting and diarrhea
• Runny nose, teary eyes and dilated pupils
• Muscle aches and abdominal cramps
• High blood pressure and rapid heart rate

These symptoms tend to decrease within 72 hours and diminish in intensity after around seven days.

Overdose Signs for Opioids

Opioid overdose is a national crisis. In the U.S., overdose fatalities from all opioids, including M-30s, increased from 21,088 in 2010 to an alarming 68,630 deaths in 2020. The number of fatalities from opioids other than methadone in 2020 was 56,516. Fentanyl was the primary drug used in those instances.

An opioid overdose almost always leads to death due to the effects on the respiratory system. Signs of overdose include:

• Irregular and slowed respiration
• Extreme drowsiness or unconsciousness
• Slowed heartbeat and very low blood pressure
• Pale, clammy skin and pinpoint pupils

Overdose also causes hypoxia, a condition that leads to a reduction in the flow of oxygen to the brain. This condition can lead to a heart attack, brain damage and death.

Getting immediate medical attention is critical to giving a person who overdoses on M-30s and other opioids a chance of survival. If you are with someone who displays any signs of opioid overdose, do not delay calling 911. Likewise, calling an ambulance is imperative if you suspect you took too much of the drug or ingested counterfeit M-30s laced with Fentanyl.

Why Do People Mix These Drugs for Recreational Use?

Sometimes, people inadvertently take benzos and opioids simultaneously. They may have a prescription from one doctor for a painkiller while another prescribes an anti-anxiety drug. Though the two should not be taken together, the prescribing physicians are likely unaware that the patient is taking a medication that could pose a severe threat. The patients themselves are unaware of the potential dangers.

However, there is also a growing trend among recreational drug users to mix opioids — such as M-30s — and benzos. Combining the two drug types produces an enhanced effect. People may use both drugs to self-medicate and escape pain or trauma. They may also simply seek a heightened chill factor. In either case, the results can be tragic.

What Are the Dangers?

Mixing the two classes of drugs poses a severe danger. The two drugs suppress the central nervous system, and the impacts on the CNS are heightened when taken simultaneously. The risk of overdose increases significantly due to the synergistic effects of benzos and opioids. Taking both drugs results in depressed breathing, so taking them together increases the risk of death from hypoxia.

Even when people don’t take high enough doses to cause a fatal overdose, combining the two drugs over a prolonged time has other negative impacts. Consistent mixing may result in impaired memory and brain and organ damage.

How Does Polysubstance Use Contribute to Overdose Issues?

Polysubstance use is simply using more than one drug at a time, which can be intentional or unintentional. Alcohol is the drug most frequently used in combination with other drugs, but it isn’t the only one. Combining opioids, such as heroin, Fentanyl and M-30s, with other drugs (including benzos) is also common. In 2019, nearly 50% of those who died from a drug overdose had more than one drug in their system.

Those who use more than one drug often become addicted to the substances they mix, leading to increased tolerance and dependence on each drug. The increase in tolerance results in the person taking higher doses for the same effects, producing a greater risk of overdose. When people mix multiple drugs, it often doesn’t just lead to enhanced results. Unfortunately, the interactions between the two drugs are frequently unpredictable and can be deadly.

Does Naloxone Help With Overdose?

Opioids are divided into two categories: agonists and antagonists. Agonistic opioids are addictive and include drugs such as heroin, methadone, oxycodone, M-30s and Fentanyl. Antagonists are not addictive. Naloxone is one of these. Like the agonists, Naloxone and other antagonists bind with opioid receptors. However, when these drugs attach, they block the effects of the antagonistic opioids.

They help reverse overdose symptoms when given soon enough, and emergency room doctors frequently give Naloxone to opioid overdose patients. However, the drug is ineffective in treating addiction because it does not have any counteractive effect when there is no opioid present in the system.

Why Do Street Drugs Play a Role in Benzodiazepine and Opioid Abuse?

The prevalence of counterfeit drugs such as M-30s increasingly contributes to fatal overdoses involving opioids and benzos. They may also play a significant role in drug abuse. Counterfeit drugs lead to more drug availability so that people can get their hands on them quickly.

These drugs are made to look like the real thing, and street drug sellers pass them off as the real thing. They may sell them for a lower price, making them affordable for a wider sector of the population. This higher availability and cheaper prices can lead to higher rates of use and an increased risk of drug abuse.

What Should You Know About the Kindling Effect?

The kindling effect is often associated with alcohol abuse, but it also applies to benzos because drugs that interact with GABA are particularly susceptible to the kindling effect. When someone is addicted to drugs and quits using them, they risk a relapse.

If they relapse and use benzos again, the body is more sensitive to the drug’s effects. When they take benzos again, the neurotransmitter floods the brain at high levels. The body’s neurological responses have trouble adapting as the drug wears off. The ebb and flow of high levels of GABA can lead to higher risks of serious health concerns. If you or a loved one are at risk of addiction to benzodiazepines, getting professional help is critical for long-term health and well-being.

What Is Opioid Use Disorder?

Opioids are chemically and emotionally addictive. People often use these drugs recreationally because they enjoy the effects they produce. The experience is enjoyable and leads some to repeated uses. Eventually, the need to consume the drug increases distress levels and disruption to the person’s life. Signs of opioid use disorder for drugs such as M-30s include the following:

• Taking a drug in more significant amounts or for more extended periods than initially intended
• Spending substantial time obtaining, using or recovering from the drug
• Displaying a desire to quit or failing in attempts to do so
• Experiencing drug cravings
• Experiencing problems with relationships, at work or at school

Clinicians diagnose opioid use disorder when two or more signs are present for at least 12 months.

How Do Post-Acute Withdrawal Symptoms Factor Into Opioid Recovery?

Opioid use disorder recovery is often a long-term process. Many mistakenly believe that once they move through the withdrawal phase and complete a short-term recovery program, their symptoms will go away. However, people recovering from opioid use disorder have high rates of post-acute withdrawal symptoms.

Though not an official medical diagnosis, PAWS causes significant distress to anyone who experiences them. Post-acute withdrawal symptoms are milder than those people experience when first withdrawing from M-30s and other opioids. Even so, the symptoms often drive those in recovery to use it again to end the discomfort when they don’t receive the professional guidance they need to get through this stage of recovery.

Why Is Holistic Care the Optimal Choice?

You may feel hopeless when dealing with a substance use disorder. When illicit drugs are involved, it further complicates addiction issues because of availability and susceptibility. It is essential that you know recovery is within your reach. It takes courage and commitment to get clean, and you are worth it.

Our program delivers an innovative three-step approach that involves preparation, action and maintenance. We look at the entirety of an individual’s well-being: physical, emotional, social and spiritual needs. A pathway to lasting recovery focuses on you as a whole person so you can become whole once again. We see life-changing results by concentrating on individual strengths and building from there. We hope you get in touch and begin your journey with us today. Contact us with any questions you’d like to ask.

Sources:

• https://nida.nih.gov/research-topics/opioids/benzodiazepines-opioids
• https://apm.amegroups.com/article/view/35734/29319
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639084/
• https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
• https://www.cdc.gov/stop-overdose/caring/polysubstance-use.html
• https://nida.nih.gov/publications/drugfacts/naloxone
• https://www.dea.gov/sites/default/files/2021-05/Counterfeit%20Pills%20fact%20SHEET-5-13-21-FINAL.pdf
• https://www.cdc.gov/mmwr/volumes/70/wr/mm7034a2.htm
• https://www.dea.gov/sites/default/files/2021-12/DEA-OPCK_FactSheet_December%202021.pdf
• https://psychiatry.org/patients-families/addiction/opioid-use-disorder/opioid-use-disorder
• https://www.cleanrecoverycenters.com/beware-of-the-kindling-effect/
• https://www.cleanrecoverycenters.com/getting-clean-using-the-paws-timeline-for-opiate-addiction-recovery/
• https://www.cleanrecoverycenters.com/what-is-heroin/