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Benzos and Opioids: A Fatal Combination

Benzos and opioids are 2 commonly prescribed medications with potent effects on the central nervous system. When used separately, they can be effective in treating a variety of conditions, such as anxiety, insomnia, and pain. However, when mixing benzos and opioids, these substances can have dangerous and potentially fatal consequences.

What Are Opioids?

Opioids include prescription pain relievers such as oxycodone, codeine, and morphine, as well as illicit substances like heroin. Opioids work by binding to opioid receptors in the spinal cord and brain, reducing the perception of pain and producing feelings of euphoria. While opioids can be highly effective in managing severe pain conditions, they also carry a high risk of dependence, addiction, and overdose when misused or abused. 

What Are Benzos?

Benzos are a class of medications that act as central nervous system depressants. They are often prescribed to treat conditions such as anxiety, insomnia, seizures, and muscle spasms. Benzods enhance the effects of GABA (gamma-aminobutyric acid), a neurotransmitter in the brain, causing calming and soothing effects.

Commonly prescribed benzos include Valium, Xanax, Klonopin, and Ativan. While benzos can be effective when used as directed, they, too, carry the risk of tolerance, dependence, and addiction when misused and abused. 

Differences Between Benzos and Opioids

Benzos and opioids are different classes of medications with several differences. For example, benzos enhance GABA’s effects, resulting in sedative and calming effects. In comparison, opioids bind to opioid receptors to block pain and produce feelings of euphoria. Opioids are mainly prescribed for managing moderate to severe pain conditions, whereas benzos are primarily used to treat anxiety disorders, insomnia, seizures, and muscle spasms.

Risk Factors:

Both benzos and opioids carry risks of dependence, tolerance, and addiction when misused or abused. The following risk factors include but are not limited to:

  • People with chronic pain: Individuals who suffer from chronic pain are more likely to be prescribed opioids, increasing their risk of developing dependence and addiction.
  • Mental health conditions: People with underlying mental health disorders such as anxiety, depression, PTSD, or personality disorders may be more susceptible to developing an addiction to benzos as they use these medications to treat their symptoms. 
  • A history of substance abuse: Individuals who have a family history of alcohol or drug abuse are at higher risk for developing an addiction to benzos and opioids.
  • Genetics: Research suggests that genetics can play a role in susceptibility to addiction.
  • High-dose prescriptions and long-term use: Being prescribed high doses of benzos or opioids for extended periods can increase the likelihood of dependence and ultimately lead to addiction.

As tolerance and dependence on the drugs grow, people can also resort to doctor shopping to attempt to obtain multiple prescriptions for benzos and opioids. Eventually, as addiction takes hold, obtaining and using the drugs becomes their primary focus.


Overdosing on benzos and opioids can lead to respiratory depression, coma, or death when taken in excessive amounts separately or together. 

How Does This Combination Impact the Body and Organs?

The combination of benzos and opioids can have serious effects on the body and organs, leading to dangerous consequences. Both medications depress the central nervous system, slowing down brain activity and respiratory function. When taken together, they amplify these effects, increasing the risk of respiratory depression, coma, and death.

Respiratory depression causes inadequate oxygen to reach vital organs like the brain and heart. This can result in neurological deficits, cardiac arrest, organ failure, or overdose. Additionally, this combination impacts liver function as both benzos and opioids are metabolized by enzymes in the liver. Chronic misuse and abuse puts additional strain on the liver and increases the risk of liver damage and failure.

Benzo and Opioid Overdoses

According to the National Institute on Drug Abuse, in 2021, there were 68,630 overdose deaths from mixing opioids with other substances. Out of those, 14%, or 10,771 deaths, were from mixing benzos and opioids. Furthermore, for people prescribed both benzos and opioids, the overdose death rate was 10 times higher compared to people prescribed just opioids. 

Most Commonly Abused Combinations

These most commonly abused combinations of benzos and opioids include:

  • Xanax and heroin
  • Ativan and heroin
  • Klonopin and heroin
  • Xanax and fentanyl
  • Xanax and codeine
  • Xanax and methadone
  • Klonopin and methadone

Mixing these substances can have dangerous and potentially lethal consequences. Since the combination enhances the effects of each other, it can be difficult to know whether the drugs are working. Unfortunately, this leads people to take further doses and causes overdose and death. 

Withdrawal Symptoms

Benzos and opioid abuse can yield withdrawal symptoms. These can be challenging and potentially dangerous without medical supervision. Withdrawal symptoms vary depending on factors such as the drugs used, dosages, frequency of use, and duration of use.

Some common withdrawal symptoms for both include:

  • Anxiety
  • Insomnia
  • Tremors or shaking
  • Irritability
  • Seizures
  • Muscle pain or stiffness
  • Flu-like symptoms (nausea, vomiting, diarrhea)
  • Sweating and chills
  • Body aches and pains
  • Depression
  • Increased heart rate and blood pressure
  • Irritability and agitation
  • Thoughts of self-harm or suicide
  • Difficulties concentrating and focusing


Treatment for addiction to benzos and opioids involves a combination of medical supervision, supportive care, and behavioral therapy. Medically supervised detox is usually the first step in treatment and helps to manage withdrawal symptoms safely. Some individuals may benefit from medication-assisted treatment (MAT), where medications are prescribed to help reduce withdrawal symptoms and cravings.

Behavioral therapies such as Cognitive-Behavioral Therapy (CBT), individual counseling, and group therapy can help address underlying issues contributing to substance use disorder and help develop coping mechanisms for relapse prevention. As detox nears completion, creating a comprehensive aftercare plan is vital to ensure ongoing treatment in an appropriate program to ensure long-term recovery from benzos and opioids. 

Personalized Addiction Recovery in Nashville, TN

Taking the initial step to a life free from benzos and opioids is easier when you do not attempt to do it alone. At Detox Nashville, our caring and compassionate team is here to help with comprehensive detox and addiction treatment programs personalized to your needs. We provide a safe, secure, and supportive environment where you can break free from drug addiction.

Contact us today to discover the path to a brighter future. 

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24/7 Help Is Standing By, Call Us Now.