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Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.
Benzodiazepines slow your breathing by suppressing brain signals to your respiratory system. They can cause respiratory depression, especially at higher doses or in vulnerable individuals, but the risk increases when combined with alcohol, opioids, or other central nervous system depressants.
Our specialized benzo detox program at Ardu provides medical supervision and personalized support to guide you through withdrawal while monitoring vital respiratory function.
Respiratory depression happens when your breathing can’t supply oxygen or remove carbon dioxide from your body. Benzodiazepines trigger this dangerous condition by suppressing your brain’s breathing control centers. If breathing becomes critically impaired, patients may require emergency medical support and mechanical ventilation.
When benzodiazepines affect your breathing, you might notice:
At Ardu, our team monitors your breathing patterns throughout benzodiazepine treatment, stepping in at the first sign of trouble. We’ve created an environment where you can heal without worrying about respiratory complications derailing your recovery.
Reach out to Ardu specialists and start your supervised benzodiazepine detox today.
Benzodiazepines target your brain’s GABA system, the main inhibitory network that calms neural activity. When they bind to GABA-A receptors, they amplify the natural calming effect of GABA throughout your nervous system. This enhanced inhibition impacts brainstem regions controlling your breathing.
The breathing centers in your brain monitor carbon dioxide levels in your blood and adjust your breathing. Benzodiazepines dampen this monitoring system, making your brain less responsive to the chemical signals that normally trigger breathing.
Vodovar, et. al. reveal that benzodiazepines disrupt and interfere with normal breathing rhythm. They reduce diaphragm contraction strength, weakening breathing mechanics. Flumazenil, a medication that blocks benzodiazepine effects, blocks benzodiazepines from binding to GABA-A receptors and prevents them from competing for the same brain targets. This hinders benzos from suppressing your breathing centers, allowing normal respiratory function to return.
Benzodiazepines also affect breathing by lowering overall arousal and consciousness. Vodovar’s team found that benzodiazepines relax upper airway muscles and decrease your body’s ability to respond to low oxygen or high carbon dioxide levels. This explains why benzodiazepines alone are less likely to cause fatal respiratory failure, but when combined with alcohol, opioids, or other medications with sedative effects, the risk of death multiplies through their overlapping effects on breathing control.
A 2014 research article demonstrates that benzodiazepines decrease arousability during sleep, prolonging respiratory abnormalities and increasing aspiration risk. They also reduce respiratory muscle strength and create ventilation-perfusion mismatches that compromise breathing efficiency. These adverse events are especially concerning in outpatient respiratory settings, where patients may experience respiratory exacerbations without immediate medical supervision.
The dangers are even more pronounced if you have underlying health conditions or mix benzos with alcohol or other medications that slow your central nervous system.
Certain factors make you more vulnerable to benzodiazepine-induced respiratory compromise.
Your body’s ability to process benzodiazepines changes with age and physical condition.
Underlying health problems increase your vulnerability to respiratory complications. The following conditions create dangerous scenarios when combined with benzodiazepine use:
Respiratory risk is affected by how much benzodiazepine you take and how you take it. Risk increases with:
Certain circumstances amplify your respiratory depression risks, such as:
Your medication history and past substance use patterns affect your current respiratory risk profile.
At Ardu, we conduct comprehensive assessments of these risk factors before any benzodiazepine treatment. Our clinical practice emphasizes safety through individualized patient evaluation, careful tapering protocols, and continuous monitoring protocols that address your risk profile.
Many people mix benzos with other medications or substances without realizing the deadly risks involved. Polysubstance abuse multiplies your mortality risk. Here’s a list of substances that amplify respiratory depression when combined with benzodiazepines:
Our dual diagnosis program addresses benzodiazepine dependence and the underlying psychiatric disorders that drive polysubstance use. We provide integrated treatment with benzodiazepine withdrawal alongside mental health care, helping you overcome dangerous drug combinations while managing the anxiety that leads to multisubstance use.
Reach out to Ardu. Our specialists will guide you through a safe detox today.
Benzodiazepine overdose can become lethal fast when your breathing shuts down. Too much of these medications floods your system and causes excessive sedation that progresses to life-threatening respiratory failure. Your breathing rate crashes below eight breaths per minute while oxygen levels drop dangerously low throughout your body.
You’ll notice slurred speech and extreme drowsiness before losing consciousness. Single drugs in large amounts create serious problems, but mixing benzodiazepines with opioids multiplies the danger. These combinations become deadly even when each drug alone might not seem dangerous.
Most overdoses happen when physical dependence drives people to take increasingly dangerous amounts, creating a cycle that requires professional intervention.
Our medical team guides you through safe, supervised detox to prevent respiratory arrest and other life-threatening complications.
During detox, you receive:
Once stabilized through detox, our comprehensive drug treatment program includes:
Whether you’re beginning your recovery journey or need specialized care for complex benzodiazepine dependence, Ardu provides the medical expertise and compassionate, supportive care for lasting change.
Contact us online or call us at (801) 512-0086 to learn how our personalized treatment approach can help you overcome addiction safely and rebuild your life.
Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.
No benzodiazepine is completely safe for anxiety treatment. All carry a mortality risk when combined with other substances and can cause physical dependence with long-term use. Shorter-acting options, like lorazepam (Ativan), clear your system faster, reducing accumulation risks, while longer-acting ones, like clonazepam, require less frequent dosing. Your clinical practice provider should evaluate your medical history, psychiatric disorders, and risk factors when prescribing.
At Ardu Recovery Center, we emphasize non-benzodiazepine approaches for anxiety through treatment programs that address root causes without respiratory compromise risks.
Several benzodiazepines have higher potency than Xanax (alprazolam). Clonazepam is roughly twice as potent, while lorazepam has similar strength but a longer duration. “Stronger” doesn’t mean better for anxiety treatment. Higher potency increases the risk of death, adverse effects, and physical dependence. The daily dose matters more than the specific benzodiazepine drugs chosen. Excessive sedation and respiratory compromise occur with any potent option, especially in combination with other substances.
Lorazepam and oxazepam are easier on the liver because they undergo simpler metabolism without creating active breakdown products. Diazepam and chlordiazepoxide require more complex liver processing, creating long-term use concerns for people with liver dysfunction.
All benzodiazepines stress the liver to some degree and can accumulate in people with pulmonary disease or other health conditions. Your liver function affects how quickly these medications clear from your system, influencing respiratory risk and adverse effects.
One milligram of clonazepam daily represents a moderate daily dose that can cause physical dependence and adverse effects. This amount equals roughly 20 mg of diazepam, which is enough to create benzodiazepine withdrawal symptoms if stopped suddenly. Long-term use at this dose increases the risk for mortality when combined with alcohol or opioids, and can worsen psychiatric disorders over time. Many people develop tolerance requiring higher amounts, escalating respiratory risk.
Benzo belly describes severe gastrointestinal symptoms during benzodiazepine withdrawal, including bloating, cramping, nausea, and digestive dysfunction. This condition results from benzodiazepines affecting your gut-brain connection through GABA receptors in your digestive system. Symptoms can persist for months during benzodiazepine withdrawal and significantly impact quality of life. Long-term use of benzodiazepines disrupts normal digestive function, creating adverse effects that extend beyond respiratory concerns.
Two milligrams of diazepam is a low daily dose that may provide mild anxiolytic effects without significant respiratory risk in healthy individuals. Effectiveness varies between people, and many require higher amounts that increase adverse effects and physical dependence. Even low doses can cause problems when combined with alcohol or other medications, creating respiratory compromise and excessive sedation. Long-term use of any amount leads to tolerance and benzodiazepine dependence.
Procedural sedation with benzodiazepines is risky because of how they interact with other drugs. The anxiolytic effects that make benzodiazepines useful for reducing anxiety symptoms before procedures can lead to unexpected respiratory compromise when combined with other sedatives or sedation-dose opioids. The administration of benzodiazepines during procedures requires careful monitoring because patients cannot report breathing difficulties while sedated.
Healthcare providers assess potential confounders, like patient age, baseline characteristics, and comorbid anxiety, when weighing the pros and cons of procedural sedation with benzos. Acute effects of benzo use can include cognitive impairment that persists beyond the procedure and may affect recovery.
Dominique Vodovar, Lucie Chevillard, Fabien Caillé, Patricia Risède, Géraldine Pottier, Sylvain Auvity, Bruno Mégarbane, Nicolas Tournier, Mechanisms of respiratory depression induced by the combination of buprenorphine and diazepam in rats, British Journal of Anaesthesia, Volume 128, Issue 3, 2022, Pages 584-595, ISSN 0007-0912, https://doi.org/10.1016/j.bja.2021.10.029.
Vozoris NT, Fischer HD, Wang X, Stephenson AL, Gershon AS, Gruneir A, Austin PC, Anderson GM, Bell CM, Gill SS, Rochon PA. Benzodiazepine drug use and adverse respiratory outcomes among older adults with COPD. Eur Respir J. 2014 Aug;44(2):332-40. doi: 10.1183/09031936.00008014. Epub 2014 Apr 17. PMID: 24743966.
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