Marketed for medicinal use in other countries as a sedative-hypnotic drug with muscle-relaxing, insomnia-reducing, and anti-anxiety properties, etizolam is a benzodiazepine analogue drug that is not used in the United States; therefore, it unclassified by the Drug Enforcement Administration (DEA). Etizolam, or etizzy as it may be called on the street, may be abused and used recreationally for its relaxant properties. Since 2012, the DEA has noticed an uptick in illegal etizolam drug seizures in America, up to 140 total seizures across 21 states between 2012 and June 2014, while prior to 2012 there were none.
Etizolam may work similarly to other benzodiazepine drugs like diazepam (Valium) or clonazepam (Klonopin) by enhancing gamma-aminobutyric acid (GABA) production in the brain and acting as a central nervous system depressant. GABA is a kind of natural tranquilizer that slows down the body’s fight-or-flight reaction to stress and lowers heart rate, body temperature, blood pressure, and respiration levels, leaving individuals relaxed, less anxious, and more able to sleep.
When abused, these drugs may produce a euphoric effect, or “high,” in addition to relaxation. The Blue Ridge Poison Centre in Virginia notes an upward trend in Poison Control Center calls around the country and lists etizolam as a drug of concern, as it may be being purchased as a “research chemical” on the Internet, valued for its anxiolytic and sedative effects that typically last 4-6 hours after taking the drug.
Etizolam is often found in a blue tablet form, or as a white powder, which is generally swallowed. Sometimes, it is found on blotter paper that can be placed under the tongue and dissolved, or taken sublingually. Etizolam may be 10 times more hypnotic than Valium, according to the DEA. It may be just as addictive as traditional benzodiazepines, which are tightly regulated in the United States.
Warning Signs of Etizolam Abuse
When abused, etizolam mimics the effects of other commonly abused benzos, like Valium or Klonopin, producing a rush of pleasure, lowering inhibitions, impairing judgment, and causing temporary amnesia. When people are intoxicated on a benzo, they may appear to be drunk on alcohol and may slur their speech. They may have slowed reaction times, impaired muscle coordination, elevated self-confidence, and mood swings. They may take bigger risks, or do things they wouldn’t normally do, and seem drowsy.
Depression and anxiety may be common side effects of repeated etizolam abuse after the drug leaves the body. Headaches and muscle weakness may also be common.
Etizolam is not marketed in the US, so individuals buying it may be spending a lot of time on the Internet ordering the drug, and suspicious packages may come in the mail from other countries. The Blue Ridge Poison Centre reports that etizolam may not be detectable in routine drug screens due to its slight chemical differences from traditional benzos; therefore, it is important to recognize the problematic behaviors that may indicate etizolam abuse.
Etizolam abuse may be recognized by erratic behavior and drastic mood swings as the individual swings from intoxication to sobriety. Sleep patterns may be disrupted, and simple things like showering and taking care of personal appearance may be neglected. Weight loss may occur. Socially, individuals abusing etizolam, may withdraw, become increasingly secretive, and no longer participate in activities they used to enjoy. Grades in school may drop, or work production may slide. Unexplained absences may crop up, and everyday obligations may be shirked or ignored.
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Dangers of Etizolam Abuse
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that between 2005 and 2011, close to 1 million Americans sought treatment in an emergency department (ED) for a negative reaction to a benzodiazepine medication. Benzodiazepines are commonly mixed with other drugs or alcohol, which increases the chances for adverse effects.
Since both alcohol and benzos like etizolam are central nervous system depressants, the combination of the two can lower vital life functions to dangerously low levels and may result in a life-threatening overdose. In 2014, there were around 8,000 overdose deaths involving benzodiazepines in the United States, which is an increase of five times more than the number of fatalities from a benzo overdose in 2001, the National Institute on Drug Abuse (NIDA) publishes.
An overdose occurs when the drug reaches toxic levels in the bloodstream, which may occur at different levels for different people. Overdose can occur the first time the drug is taken or the 100th time. An etizolam overdose is characterized by:
- Blurred vision
- Trouble remaining conscious
- Trouble breathing due to lowered respiration
- Muscle weakness
- Hypotension from slowed blood pressure
- Cardiac dysrhythmia or irregular heart rate
An overdose should be considered a medical emergency. With proper treatment, it may be safely reversed, avoiding tragic consequences. Sometimes, an individual abusing etizolam may suffer from skin lesions, dizziness, daytime drowsiness, headaches, muscle tremors and weakness, and blepharospasm, which is an involuntary closing of the eyelids, the World Health Organization (WHO) reports. Long-term use of benzodiazepine medications has also been linked to a potential increased risk for developing Alzheimer’s disease, a form of dementia, according to the British Medical Journal (BMJ).
Dependence and Addiction
Etizolam, like other benzos, also has a high potential for dependence and addiction due to its interference with the body’s natural reward processing system, the Indian Journal of Pharmacology publishes. Benzodiazepine and similar medications are generally considered to be appropriate for short-term relief of symptoms and often only part of the overall solution for anxiety, panic, chronic stress, or sleep issues. This is due to the fact that these drugs disrupt the natural chemical balance of the brain, and long-term use may lead to tolerance, meaning that the drug is no longer effective at the same dosage. Individuals may then be tempted to increase the dosage to keep feeling the same effects, and a chemical dependency may form wherein the brain relies on the drug to function “normally.” When someone is dependent on a benzo, the person may feel depressed, anxious, and have trouble sleeping without the drug. Drug cravings may then crop up between doses or when the drug leaves the bloodstream.
Dependence may turn into addiction when drug use becomes compulsive, and people can no longer control their drug use. Most of their time may be spend figuring out how to get etizolam, using it, and recovering from the effects of the drug. They may get into trouble with the law and suffer financial strain due to their drug abuse. Lapses in memory and uncharacteristic or risky behaviors may be common, and loved ones may notice a shift in personality. Suicidal behaviors or thoughts may be side effects of benzodiazepine abuse or dependence as well.
Stopping a drug like etizolam suddenly, without medical supervision and guidance, is never a good idea, as withdrawal may cause serious and potentially life-threatening symptoms. Medical detox is the safest and smoothest way to begin recovery from etizolam or benzodiazepine addiction.
Etizolam Withdrawal and Medical Detox
The severity of the dependence and the length of time it takes for a person to become dependent on, or even addicted to, etizolam differ from person to person. Someone taking high doses more frequently for a long period of time is likely to be more heavily dependent on the drug than a more casual user, for example. Polydrug abuse, or the abuse of other drugs or alcohol in conjunction with etizolam, is likely to increase the side effects of, and potential dependence on, both substances as well. Underlying medical or mental health conditions, as well as family history and genetic factors, may also be involved in the development of a dependence on or addiction to drugs.
If the brain is dependent on etizolam, or another benzo, when the drug is suddenly removed, a kind of rebound effect may occur. Anxiety, depression, agitation, and insomnia, which were all dampened by the drug, may return in full force. In addition to these powerful psychological side effects, muscle tremors and life-threatening seizures may also occur during withdrawal from a benzodiazepine. For this reason, etizolam should not be stopped “cold turkey” after dependence has been established. Other potential side effects of benzo withdrawal include:
- Muscle weakness or tension
- Vivid dreams
- Mental fogginess
Instead of just stopping a drug like etizolam suddenly, it may be recommended to slowly lower the dosage over a set amount of time through a tapering, or weaning off, schedule set up and monitored by medical professionals, the International Medical Case Reports Journal reports. This is often accomplished through medical detox, which is provided in a specialty facility that provides around-the-clock medical monitoring and care to stabilize an individual and manage withdrawal symptoms, often with the use of medications. Etizolam is considered a short-acting benzodiazepine-type medication, and it may be replaced with longer-acting benzos during detox to mitigate withdrawal and curb drug cravings. Other medications may be used to help with specific symptoms of withdrawal as well.
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Abuse and Addiction Treatment
The initial goal of detox is stabilize an individual physically and emotionally, and it is an important step in a substance abuse treatment plan. Beyond detox, behavioral therapies, such as Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI), may be part of a comprehensive treatment and recovery model. CBT helps individuals to explore the way their thoughts and emotions translate into actions, and teaches new and healthier ways to cope with stress, anxiety, and other difficult emotions.
By learning new techniques through group and individual therapy sessions, individuals can determine what their personal triggers may be and how to avoid and manage them in the future without needing mind-altering substances. MI is a nonconfrontational approach that validates individuals and their feelings while helping them to realize the necessity of change for personal growth.
Outpatient, intensive outpatient, and residential programs all provide a host of treatment methods that will likely include therapy and counseling sessions, including group, individual, and family models. An outpatient program may be best suited for individuals with a strong support system at home who need flexibility in their schedules, while residential treatment is the most comprehensive option.
Massage therapy, acupuncture, exercise programs, nutritional planning, meditation, and mindfulness techniques may all be beneficial as well during substance abuse treatment and recovery as alternative ways to manage stress and promote life balance. A variety of programs and options are available to families and loved ones in need of care.