The Role of Clonazepam
Consistently ranking among the most readily available and widely served intoxicants in the world, alcohol has caused serious problems for countless people. In the United States alone, over 140,000 people die from alcohol-related effects each year, and one in 10 Americans over the age of 12 suffer from alcohol use disorder (AUD).
When experimental or recreational alcohol consumption becomes daily use, people are on the path to addiction. As continued drinking causes progressive changes in the brain’s chemistry and functions, some alcohol users lose their ability to stop drinking. Plagued by uncontrollable cravings and increasing physical and psychological symptoms, many fail early on in recovery or turn to other substances to alleviate their pain. Clonazepam is one such substance. Among the most heavily prescribed classes of drugs in the nation, clonazepam is a benzodiazepine (benzo) that’s both highly addictive and exceedingly dangerous when paired with alcohol. Considered an effective tool in medically managed detox, this drug is unsafe for use as a withdrawal aid outside of a controlled medical setting.
What Is Alcohol Withdrawal and Why Might You Need Help?
For years, researchers surmised that alcohol withdrawal was either a consequence of nutritional deficiencies during detox or the cumulative short- and long-term effects of alcohol itself. Now, however, alcohol withdrawal (AW) or AW Syndrome is recognized as resulting from dramatic changes in the brain’s chemistry caused by excessive or prolonged alcohol use. These changes affect many inhibitory and excitatory neurotransmitters, but they have the most significant impact on GABA-Aminobutyric acid, or GABA.
People who regularly consume alcohol gradually develop an increased tolerance. As a result, they keep needing more alcohol to feel intoxicated, and they may feel the need to drink more often. These changes mirror the changes that are simultaneously occurring in the brain as GABA receptors grow less responsive to GABA, and more of this inhibitory neurotransmitter is required to achieve the same effects.
When people drink, alcohol stimulates the GABA receptors, which, in turn, dampens brain activity and creates an immediate sense of relaxation and release. Anxiety abates, inhibitions decline, and confidence grows. However, when people stop drinking suddenly or dramatically reduce their alcohol consumption, the opposite occurs. GABA is no longer produced or released in sufficient quantities for moderating or alleviating anxiety, and important physiological functions that rely on this neurotransmitter flounder or fail.
The Common Symptoms of Alcohol Withdrawal
Alcohol and other drug (AOD) disorders are largely about manipulating the release of neurotransmitters or “feel good” chemicals. Unfortunately, these same chemicals are important for far more than their mood-boosting effects. For instance, while GABA plays a major role in reducing anxiety and stress, it also plays a hand in smooth muscle control, nausea control, temperature regulation, and other vital functions.
As such, with sudden abstinence and when neurotransmitters like GABA misfire, people in alcohol withdrawal experience uncomfortable symptoms, like:
- Nausea
- Chills
- Vomiting
- Diarrhea
- Sweating
- Disorientation
The severity of the changes that have occurred in a person’s brain chemistry is often relative to the severity of their withdrawal symptoms.
The Dangers of Self-Managed Alcohol Detox
In some instances, unmanaged alcohol withdrawal can lead to hallucinations, seizures, and even death. These symptoms are most likely to occur during delirium tremens. Delirium tremens is a severe stage of alcohol withdrawal that often develops two to five days after a person’s last drink. Characterized by rapid and extreme changes in the central nervous system, the DTs can cause various organs and organ systems to shut down.
Clonazepam: What It Is and How It Works
Sold under the brand name Klonopin, Clonazepam is a benzodiazepine that’s frequently prescribed for the treatment of seizures and panic disorders. Clonazepam works by stimulating the release of GABA. This calming chemical alleviates muscle spasms and anxiety and causes the body to instantly relax. As with alcohol, overuse of clonazepam can cause this neurotransmitter to misfire or result in an increased GABA tolerance and dependency on outside GABA triggers.
Conditions Clonazepam Is Prescribed to Treat
Clonazepam is used to treat nonconvulsive status epilepticus, epilepsy, panic disorder, and agoraphobia. It is also used off-label for the treatment of insomnia, acute mania, restless leg syndrome, and other conditions. However, clonazepam is recommended only for the acute or brief treatment of these illnesses. Due to its highly addictive nature, it is not considered a safe or manageable way to address long-term or recurring issues. The long-term use of any benzodiazepine drug is associated with cognitive decline, ataxia, changes in motor coordination and more.
The Risk of Clonazepam Dependence
Like alcohol, clonazepam produces chemical changes in the brain that become more severe with extended use. Studies show that after two weeks of continuous clonazepam use, these changes may be enough to incite withdrawal symptoms that can only be avoided by slow-tapering.
Why Someone Might Use Clonazepam for Alcohol Withdrawal Support
There are many reasons why a person might decide to use clonazepam as withdrawal support during self-managed detox. Given its action on the neurotransmitter GABA, this drug produces feelings of euphoria that are similar to those experienced with alcohol. For a person in withdrawal, the desire to self-treat withdrawal symptoms, like panic, anxiety, and muscle tension, could cause them to reach for this drug, especially if it’s readily available. However, doing so without the guidance of a medical doctor is ill-advised.
Clonazepam for the Treatment of Delirium Tremens
Surprisingly, however, along with other benzodiazepine drugs, clonazepam is used in many rehab facilities and detox centers throughout the nation for the management and prevention of delirium tremens and several common DT-related symptoms. When prescribed by doctors and after the body has already rid itself of alcohol, clonazepam is effective for minimizing muscle spasms, seizures and overwhelming panic. However, many prescribing professionals often choose other benzodiazepine drugs instead, such as diazepam or lorazepam, given the greater, although still lacking, amount of research on these treatments.
Using Clonazepam and Alcohol Together
The risk of prescribing clonazepam for outpatient use is often considered too high. The risk of relapsing during the earliest stages of alcohol withdrawal is significant. When people who are taking clonazepam drink alcohol, they can suppress their respiratory systems. In addition to difficulty breathing, this combination causes central nervous system suppression and may lead to coma or death. However, according to the Centers for Disease Control (CDC), benzodiazepine drugs, like clonazepam, are rarely enough on their own to cause these reactions.
How Withdrawal, Anxiety, and Panic Attacks Are Treated in Detox
In a medical setting, clonazepam is typically prescribed only to alleviate the physical symptoms and physiological risks of alcohol withdrawal. Meant more for reducing muscle spasms and preventing DT-related seizures, clonazepam is not an effective, long-term solution to diagnosable panic or anxiety disorders. This remains true even for people who don’t have AUD disorder.
Many detox centers immediately seek alternative strategies for treating and managing mental health disorders that are co-occurring. While clonazepam might be used to alleviate short-term anxiety that’s recognized as being a strictly withdrawal-related symptom, it is not prescribed for people who suffer from long-term anxiety or panic and require ongoing management.
Co-occurring Disorders, Clonazepam and AUD
Co-occurring disorders are mental health disorders that simultaneously occur with alcohol use disorder. They include but are not limited to:
- General anxiety disorder
- Schizophrenia
- Bipolar disorder
- Panic disorder
- Post-traumatic stress disorder
In many instances, people turn to alcohol as a means of alleviating the symptoms of these undiagnosed and unmanaged illnesses. In others, excessive or ongoing alcohol use creates chemical changes within the brain that cause the symptoms of secondary mental health issues to manifest. In both cases, self-treating co-occurring disorders with alcohol presents a high risk of worsening symptoms.
AUD is hardly the only addiction associated with co-occurring disorders. Many people who abuse clonazepam and other benzos suffer from co-occurring disorders, too. In addiction treatment, identifying and managing co-occurring disorders is critical for minimizing the risk of relapse. When people have safe, effective, and manageable ways of alleviating their symptoms, they often lose their greatest triggers for substance abuse.
Dual-Diagnosis Treatment
Treatment for co-occurring disorders or dual-diagnosis treatment uses psychotherapy, medication, skill-building, and other strategies for addressing underlying mental health disorders. While clonazepam is effective for limiting the risk of seizures, muscle spasms, and short-term overwhelming panic, most practitioners use mood-stabilizing drugs, cognitive behavioral therapy, and other interventions for the long-term management of panic disorders instead.
Alcohol Recovery and Clonazepam
For many people, alcohol use disorder is a chronic disease. Recognized by many authorities on addiction as a lifelong challenge, this complex illness affects the health and chemistry of the brain in multiple ways. Binge drinking, prolonged periods of excessive alcohol use, and a long history of untreated AUD are all risk factors for various forms of potentially permanent, alcohol-related brain damage (ARBD).
Part of the recovery process is learning how to minimize risk factors and triggers for relapse even as the brain and its chemistry balance, heal, and gradually resume normal functioning. One of the major side effects of benzodiazepine drugs is their addictive potential. Extended benzodiazepine treatment incites an adaptive central nervous system (CNS) response in which people either develop an increased tolerance to these drugs or become physically dependent. According to research, the path to physical dependence with benzodiazepine drugs can take several weeks or just 24 hours, depending upon the individual.
Taking benzos, like clonazepam, to alleviate the symptoms of alcohol withdrawal could set the stage for all-new addictions when these drugs are used in non-medical settings and without the guidance of licensed medical practitioners. Moreover, it does so while creating an additional incredibly high risk of fatal overdose when people relapse and pair benzos with alcohol. However, in controlled medical environments, clonazepam and other benzodiazepines are frequently used for the short-term management of severe withdrawal symptoms and acute panic, and often with marked success.