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Clorazepate Addiction Explained

Clorazepate is a drug in the benzodiazepine class with sedative, hypnotic, anticonvulsant, muscle relaxant and anxiolytic properties. Clorazepate – which has the chemical formula C16H11ClN2O3 and the chemical synonym clorazepate dipotassium – is a class C controlled substance in the UK, legally available only with a prescription, and is usually provided in tablet form for oral consumption. Like other benzodiazepines, clorazepate is known to be addictive, and once an individual develops clorazepate dependence, withdrawal can be fatal. Despite this, clorazepate is frequently used as a recreational drug, and clorazepate abuse is a growing problem worldwide.

Trade names for clorazepate

Clorazepate is sold under various trade names globally, including Tranxene, Tranxilium and Novo-Clopate.

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What is Clorazepate Addiction?

Clorazepate addiction is a disorder of the brain’s reward system in which repeatedly consuming clorazepate causes the compulsion to continue to do so, despite knowledge of any negative consequences of such repeated consumption. Addiction is often conflated with or mistaken for dependence, which is a related concept but one which can occur distinct from addiction. Taking clorazepate over a period of time increases the likelihood that both addiction and dependence will develop.

What is clorazepate used for?

Clorazepate is commonly used to treat anxiety disorders – including severe anxiety and distress – and insomnia, as well as in the management of acute alcohol withdrawal syndrome. It may also be prescribed as an anticonvulsant in the treatment of epilepsy and similar conditions; as a muscle relaxant; and, combined with clidinium bromide, to ease the symptoms of irritable bowel syndrome.

How addictive is clorazepate?

Like any benzodiazepine, clorazepate is known to be habit-forming. Comparing its dependence liability with other benzodiazepines is difficult, but its long half-life and sustained release formulation may make it somewhat more addictive as it remains active for longer and individuals abusing it may take higher doses than intended. Clorazepate addiction is known to affect thousands of people around the world, and dependence can manifest after only a couple of weeks. As with other benzodiazepines, withdrawal from clorazepate addiction can be fatal.

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Neurological mechanism of clorazepate dependence

Dependence is a condition which manifests when someone taking a certain substance (in this case, clorazepate) over a period of time becomes accustomed to the presence of a certain level of the substance in their brain and central nervous system; that system then adjusts to that level of the substance, and requires it to function normally (becomes dependent upon it). Once someone has become dependent, the withdrawal of that substance from the system (i.e., if they stop taking clorazepate) causes the brain and body to function abnormally until they can readjust to the absence of the substance. This abnormal function typically causes various unpleasant and potentially dangerous symptoms, together known as withdrawal syndrome.

Clorazepate Dependence Versus Addiction

As noted above, addiction and dependence are closely related phenomena. Dependence is a primarily physiological phenomenon which manifests when an individual system adjusts to the presence of a specific substance in the body, while addiction is a primarily psychological concept in which someone feels a compulsion to repeatedly engage in a specific behaviour, such as consuming clorazepate. Dependence is normally an element of addiction, but each can occur independently of the other.

Why People Abuse Clorazepate

As with other benzodiazepines, clorazepate is used recreationally because its sedative and hypnotic properties can create an enjoyable “high” in the user.

This high can also be sought out by people who begin to consume clorazepate having been prescribed it, but who go on to abuse it by taking it for longer, and in higher quantities, then they should. Also like other benzodiazepines, clorazepate is sometimes abused by being taken by methods other than prescribed, such as being ground up and snorted.

Causes of clorazepate addiction

The phenomenon of addiction is not yet completely understood by medical science, in that doctors do not yet know to any degree of certainty why one person may fall victim to addiction while another, in very similar circumstances, might not. What is known, though, is that both environmental and genetic factors play a part; equally certain is that consuming clorazepate regularly over a period of time risks giving rise to the development of addiction and dependence and that someone who never takes clorazepate at all does not risk becoming addicted to it.

Risk factors for clorazepate abuse

Genetic: a family history of substance abuse and addiction is known to be a very significant risk factor for the development of clorazepate abuse and addiction, as is a family history of any other mental health disorder/s.
Environmental: notable environmental risk factors for clorazepate abuse and addiction include the experience of trauma and/or very difficult life circumstances; associating with a peer group in which clorazepate abuse is commonplace. Taking clorazepate for longer or in higher doses than instructed by a prescribing doctor.

Co-Occurring Disorders with Clorazepate Addiction

Clorazepate addiction often occurs alongside other mental health disorders, partly because clorazepate itself is used in the treatment of certain such disorders. In such cases of dual diagnosis (where substance abuse disorders cooccur with other mental health issues) treatment is typically significantly more complicated, usually requiring specialist expertise.

The Effects of Clorazepate Addiction on the Brain

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Benzodiazepines, including clorazepate, act by stimulating receptors in the brain. These receptors are affected by a neurotransmitter known as gamma-aminobutyric acid (GABA), which is responsible for having a calming effect upon the brain and central nervous system activity. Clorazepate addiction disrupts the normal functioning of GABA and related processes, and withdrawal from clorazepate dependence can greatly increase that disruption, leading to the development of withdrawal syndrome. Though studies are not yet fully inclusive, it is thought that long-term clorazepate abuse could lead to permanent brain damage.

Relationship between Clorazepate and Other Substances/Contraindications

Clorazepate should be treated with particular caution if ascribed to the elderly, children, people with co-occurring psychiatric disorders, and alcohol– or drug-dependent individuals. Special care should be taken in the treatment of pregnant women or women trying to conceive.

Drugs that may interact dangerously with clorazepate include all sedatives and hypnotics (including other benzodiazepines, alcohol, antihistamines, neuroleptics, opiates, antiepileptics and sleep aids). There are also disulfiram, fluoxetine, digoxin, ketoconazole, levodopa, metoprolol, isoniazid, rifampin, propranolol, probenecid, hormonal contraceptives, theophylline, selective serotonin reuptake inhibitors (SSRIs), valproic acid, macrolide antibiotics, cimetidine, antimycotics, phenytoin, carbamazepine and phenobarbital.

Health Risks with Clorazepate Addiction

Addiction typically has very deleterious consequences upon an addict’s physical and mental health, as a result of its impact upon the addict’s life circumstances and prospects. Clorazepate addiction and abuse specifically have been shown to have various health risks, outlined below.

Short-Term Effects of Clorazepate

As well as the effects for which it may be prescribed, the consumption of clorazepate can have numerous negative short-term effects, including:

  • confusion
  • constipation
  • drowsiness
  • fainting
  • altered sex drive
  • liver problems
  • lack of muscle coordination
  • minor menstrual irregularities
  • nausea
  • skin rash or eruptions
  • swelling due to fluid retention
  • yellow eyes and skin

Long-Term Effects of Clorazepate

Potential brain chemistry changes including

memory problems, depression, anhedonia, anxiety, insomnia, dependence, tolerance, Alzheimer’s disease.

Potential physical changes:

abdominal cramping, hernia, liver failure, altered hormonal balance, weight gain/loss.

Clorazepate Abuse Signs and Symptoms

Alongside the visible manifestation of any of the physical effects listed above, some symptoms which might indicate clorazepate abuse include: frequent intoxication (featuring slurred speech, drowsiness and loss of motor control). Much higher levels of intoxication when consuming alcohol or other substances of abuse. “Doctor shopping” (going to multiple doctors to get prescriptions for clorazepate). A general preoccupation with getting hold of and taking clorazepate, withdrawal symptoms after stopping taking clorazepate and various long-term symptoms which may include cognitive impairment, insomnia, anxiety and depression are all part of the symptoms.

Clorazepate Overdose Explained

An overdose occurs when someone takes too much of a given substance for their system to be able to process effectively. Some symptoms of clorazepate overdose include:

  • somnolence (difficulty staying awake)
  • mental confusion
  • hypotension
  • hypoventilation
  • impaired motor functions
  • impaired reflexes
  • impaired coordination
  • impaired balance
  • dizziness
  • muscle weakness
  • coma

If you observe any of these symptoms in someone who you know to have taken clorazepate, you must contact the emergency services immediately.

Cost of Clorazepate Addiction to Families and Society

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Any addiction can destroy families, and clorazepate addiction is no exception. Watching someone struggle with addiction, and deal with the physical and mental health issues which result, can prove incredibly distressing, as can dealing with that person’s potentially manipulative and deceitful behaviour as they seek to hide their condition. It is no surprise that clorazepate addiction is a factor in numerous divorces each year. Meanwhile, the social cost of clorazepate addiction includes millions of pounds spent by the NHS each year on addiction treatment and the deployment of police and social health resources that could otherwise be engaged in other activities.
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What to do if a loved one is struggling with clorazepate addiction

Watching someone you love dealing with addiction can be hugely distressing, and it is no surprise that if you find yourself in this situation, you may wish to take action immediately. However, doing so could make the situation much worse and result in your alienation from your loved one. Instead, contact an addiction specialist to discuss your situation; they can give you advice on how best to proceed without risking doing further damage. Most of all, ensure you prioritise your own safety and that of those around you.

Teen clorazepate abuse and addiction

Like any other benzodiazepine, clorazepate is a popular choice amongst young people thanks to its relative ease of access and low cost. If you suspect a young person post you may be taking clorazepate, contact an addiction specialist as soon as you can to discuss the best course of action.

What to Do if You Need Help to Detox

Withdrawal from benzodiazepines can be fatal, and it is imperative that you do not try to detox from clorazepate dependence without medical assistance, no matter how much you may want to overcome your addiction. Speak with your GP and an addiction specialist about how you can detox from clorazepate safely.

Clorazepate Withdrawal

Withdrawal from benzodiazepine dependence is generally considered to be one of the most unpleasant and most dangerous – indeed, potentially fatal – forms of withdrawal syndrome. While going through withdrawal is probably inescapable if you have developed a clorazepate dependence, the silver lining is that many of the most unpleasant elements of clorazepate withdrawal can be ameliorated with medication.

Symptoms of withdrawal

Some commonly observed clorazepate withdrawal symptoms include:

  • confusion
  • toxic psychosis
  • seizures
  • convulsions (like delirium tremens)
  • depression
  • nervousness
  • rebound insomnia
  • irritability
  • sweating
  • diarrhoea

Duration of withdrawal

Withdrawal from clorazepate dependence typically takes two to four weeks, with acute withdrawal commencing roughly three days after the last dose and usually lasting up to a week. Please note that this is only a rough guide: some individuals may experience withdrawal lasting significantly longer. Moreover, some people develop a condition known as protracted, or post-acute, withdrawal, in which withdrawal symptoms may remain for months or even years.

Why You Should Contact a Professional for Detox

As mentioned above, withdrawal from benzodiazepine dependence can be very dangerous. If you have developed a dependence to clorazepate, it is imperative that you do not attempt to detox by yourself. Contact your GP and an addiction specialist to find out more about benzodiazepine detox and what medical help you may be able to get.

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Clorazepate Addiction Treatment

As a result of the proliferation of cases of benzodiazepine addiction in recent years, a good number of facilities now operate around the country treating the condition. Addiction treatment typically consists of two main phases: detox and withdrawal (with medical assistance); and therapy.

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Therapy for Clorazepate Addiction

Therapy lies at the core of all addiction treatment, as only therapy can uncover and tackle the fundamental psychological causes of addiction, and provide patients with psychological defence mechanisms against relapse. Going through detox and withdrawal may deal with the immediate pressures of dependence, but without the subsequent support of therapy, an individual is likely to fall back into previous patterns of behaviour, including substance abuse and addiction. Addiction therapy may be given in a great variety of formats and models, and in both group and one-to-one settings.

Clorazepate Abuse Detox Process

There is no one single detoxification process for clorazepate addiction: different facilities offer different processes, and different patients may have very different experiences.

For instance, some individuals may be required to taper down their clorazepate intake prior to commencing detox; meanwhile, some people may benefit from the prescription of certain medications, while others may not. If you are contemplating a clorazepate detox at a treatment facility, get as much information as possible from the doctors there ahead of time, so you are aware of what to expect.

Possible complications in clorazepate rehab

Again, clorazepate detox withdrawal can be dangerous; in order to avoid the possibility of any dangerous complications arising during detox, or any other state of the rehab process, you need to be fully candid about the history of your clorazepate abuse and any other relevant aspects of your medical history.

Clorazepate Relapse Prevention

Recovery is a long-term – sometimes lifelong – process, with many potential pitfalls along the way. While avoiding relapse is key to recovery, if you do find yourself relapsing, you should not despair and feel that you have totally failed and that a resumption of your addiction is inevitable: people make mistakes. Therapy such as that provided in rehab can give you various relapse prevention mechanisms, while you can also benefit from recovery from participation in self-help groups and counselling. Discuss relapse prevention techniques with an addiction specialist.

Clorazepate Addiction Statistics

  • Over 250,000 people in the UK have currently been taking benzodiazepines for longer than advised by their doctors.
  • Over 12 million benzodiazepine prescriptions are written in the UK every year.
  • In 2016 more than 400 people died in England and Wales as a result of the abuse of benzodiazepines.
  • More than 40% of people who take clorazepate for more than six weeks will develop an addiction.
  • According to a study in the British Journal of Psychiatry, almost 8% of people in the UK have misused benzodiazepines.

Ready to Get Help?

If you are wrestling with a clorazepate addiction, the condition with which you are struggling has the potential to ruin – and even end – your life, and it is absolutely vital that you take the first step towards defeating it by admitting your addiction. Only then can any help you receive be effective.

If you are wrestling with a clorazepate addiction, the condition with which you are struggling has the potential to ruin – and even end – your life, and it is absolutely vital that you take the first step towards defeating it by admitting your addiction. Only then can any help you receive be effective.

Take control of your life – get started on the road to recovery

Don’t let addiction do any more damage: take back control of your life by getting the help you need. Call your GP and/or an addiction specialist and take the first step on the road to a happy, healthy and successful life.

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Throughout the UK, there are many high-quality facilities and organisations treating addiction. If you’re ready to ask for help, you could join them: speak with your GP and/or an addiction specialist today about the treatment options available to you.

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FAQs

What type of drug is clorazepate?
Clorazepate is a sedative and hypnotic drug in the benzodiazepine class.
What does clorazepate look like?
Clorazepate is typically provided in variously coloured tablets for oral consumption.
How can I spot clorazepate addiction?
It may be impossible to spot a clorazepate addiction if someone is intent on hiding it, but there are some signs and symptoms which could betray the condition. See above for more details.
Is clorazepate harmful?
If taken strictly in accordance with the instructions of the prescribing doctor, clorazepate can be a very useful and beneficial medicine. If abused, however, it can be harmful or even deadly.
Where can I get help for clorazepate addiction?
There are facilities treating clorazepate addicts across the UK. Speak with your GP and/or addiction specialist about what help may be available to you.
What is clorazepate dependence?
Clorazepate dependence is the condition whereby an individual taking clorazepate becomes accustomed to the presence of the drug in their system, and that system becomes unable to function normally without the presence of clorazepate.
How to I avoid getting addicted to clorazepate?
The only certain way of avoiding addiction to clorazepate is never taking clorazepate at all. If you are prescribed clorazepate, however, taking it only in accordance with your doctor’s instructions, and immediately reporting any unexpected or unpleasant side-effects, should minimise the risk of addiction.
Can I detox from clorazepate at home?
Detoxification from benzodiazepines can be fatal; never attempt clorazepate detox by yourself. Speak with your GP and an addiction specialist about what medical assistance you may be able to obtain.

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