Klonopin (Clonazepam) Abuse & Treatment
Designed as a long-acting tranquilizer medication for the treatment of seizures, panic and anxiety disorders, clonazepam (brand name: Klonopin) is a benzodiazepine drug. Benzodiazepines, often called benzos for short, increase the function of the inhibitory neurotransmitter GABA in the brain and work as central nervous system depressants. This lowers body temperature and blood pressure, and slows heart and respiration rates. GABA also works to reduce anxiety, ease muscle tension, and calm overactive nerve firings.
Klonopin is a prescription-only medication distributed as a tablet, oral solution, or wafer (disintegrating tablet), Mayo Clinic reports. The tablets and wafers are generally scored with a letter “K” on them. The prescribing information for Klonopin, as published by Genentech, Inc., reports on the long half-life of the drug – between 30 and 40 hours. Klonopin remains active in the bloodstream then for 2-3 days and may be useful in treating withdrawal symptoms from alcohol, opioids, and other short-acting benzodiazepine drugs. Klonopin is a medically beneficial drug when used as directed and under the supervision of a trained healthcare provider.
The Drug Enforcement Administration (DEA) classifies Klonopin as a Schedule IV controlled substance. Individuals, likely largely adolescents and young adults, may crush the tablets to snort them for a “high.”
The Monitoring the Future (MTF) survey publishes that in 2015 nearly 5 percent of high school seniors reported past-year tranquilizer abuse. The National Institute on Drug Abuse (NIDA) reports that prescription drugs (and over-the-counter ones) are some of the most regularly abused substances in the United States by those aged 14 and older (behind alcohol and marijuana). Some 20 percent of Americans have abused a prescription drug at some point in their lives, NIDA further publishes, and benzodiazepines are a class of drug that tops the list.
Any use of Klonopin without a prescription, or even beyond the scope of a prescription, is abuse of the drug. Individuals seeking a “high” may chew or crush Klonopin; take the drug outside of a licit prescription; snort, smoke, or inject the drug; or mix it with alcohol or other drugs. According to the National Survey on Drug Use and Health (NSDUH), nearly 2 million American adults misused a prescription tranquilizer in the month prior to the 2014 survey, the largest percentage of which were between the ages of 18 and 25.
Klonopin abuse may start out as seemingly innocuously, as a person taking more than the recommended dosage at one time. Individuals may continue taking Klonopin after a prescription has run out, or exaggerate or invent symptoms in order to get more prescriptions when there is no longer a medical need for the drug. Others may “doctor shop” or go to multiple doctors in order to obtain Klonopin.
Once a person has been taking Klonopin for a length of time, the brain becomes dependent on it. Withdrawal symptoms and cravings may crop up when Klonopin wears off. This may encourage a person to want to keep taking it even if the drug is no longer medically necessary. Regardless of how Klonopin abuse begins, any nonmedical use of the drug can be potentially hazardous.
Dangers of Abusing a Benzodiazepine Drug
Klonopin can cause impairment both mentally and physically, as it can slow reaction time, reduce motor coordination, disrupt normal cognitive abilities and decision-making skills, cause sleepiness and dizziness, and lead to out-of-character thoughts. In April 2009, the FDA approved changes to the boxed warnings on Klonopin prescription labeling to include warnings of the potential for increased suicidal thoughts and behaviors while taking the drug.
Klonopin use or abuse may lead to aggressive, violent, self-harming, or reckless acts. The DEA reports that benzodiazepine drug abuse can cause hostility, amnesia, disturbing dreams, and irritability. Klonopin can also have physical side effects, as the Drug Abuse Warning Network (DAWN) publishes that in 2011 clonazepam abuse was involved in over 60,000 medical emergencies that required treatment in an emergency department (ED).
Taking a drug like Klonopin outside of a prescription, and especially if it is combined with alcohol or other central nervous system depressants, can cause a toxic buildup in the body, leading to overdose. NIDA reports that in 2014 around 8,000 Americans died from a benzodiazepine overdose.
Prescription drug overdoses have reached epidemic proportions in the United States and are a major health concern. Klonopin overdose can be reversed if swift medical attention is sought and a reversal drug, or antagonist medication, like flumazenil is administered. The following are signs of a Klonopin overdose:
- Shallow breathing
- Clammy, cool skin
- Bluish tinge to the fingernails and lips
- Weak or irregular pulse
- Mental confusion
- Significantly impaired reflexes
- Dilated pupils
- Extreme drowsiness or loss of consciousness
Emergency medical attention is needed in all cases of overdose.
Klonopin is considered a habit-forming drug. This means that when a person takes it on a regular basis, either through a legitimate prescription or by abusing the drug, they can become dependent on it. Since Klonopin alters the way neurotransmitters are transmitted around the brain and central nervous system, in time, the brain can stop manufacturing and moving them around in the same way it did before the drug was introduced. Normal levels of GABA and dopamine may then be disrupted.
While GABA is considered a kind of natural sedative, dopamine is involved in mood regulation and feelings of happiness. Low levels of dopamine in the brain can cause a person to become irritable and depressed, suffer mood swings, impair learning and memory functions, and cause difficulties in feeling pleasure at all. As GABA levels decrease without stimulation from Klonopin, a sort of rebound can occur. Nerve firings can become overactive without the drug holding them back. As a result, anxiety, panic, tremors, muscle tension, insomnia, and even seizures may result. These are symptoms of Klonopin withdrawal, which is a side effect of dependence on the drug that can be potentially dangerous.
Cravings may become intense, as can the desire to avoid withdrawal symptoms, creating a strong desire to keep using Klonopin. Individuals may take more Klonopin more often and in larger amounts than originally intended and may lose control over their ability to stop taking Klonopin even when they try to do so.
As brain circuitry is changed with chronic Klonopin use and a loss of control over drug use becomes apparent, addiction may result. Behaviors can change with addiction, as individuals may spend large amounts of time deciding how to get Klonopin, taking it, and then recovering from use. Finances and job production may suffer, and grades at school may drop. Mood swings as well as erratic, impulsive, reckless, and out-of-character behaviors may be evident. Individuals may become withdrawn, secretive, irritable, hostile, depressed, and self-destructive. Weight fluctuations, altered sleep schedules, and a decline in physical appearance are often side effects of addiction as well. Addiction can impact many different parts of a person’s life, having physical, emotional, personal, social, financial, and behavioral ramifications.
Treatment Options for Klonopin Misuse and Dependency
Addiction is a complex brain disease that can be treated with a combination of medical, supportive, and behavioral techniques. There is no treatment modality that is right for everyone; rather, care is highly personal and specific to each individual. NIDA reports that the following are often components of a comprehensive drug addiction treatment program:
- Detox: In the case of Klonopin, medical detox is recommended. It is provided in a specialized facility that can offer around-the-clock mental health support and medical supervision as well as medications to manage withdrawal symptoms. Klonopin is often tapered off slowly in order to minimize withdrawal symptoms.
- Thorough assessment: Individuals are evaluated for the presence of a co-occurring disorder, such as anxiety or depression, so these mental health conditions can be treated in an integrated manner during an addiction treatment program.
- Behavioral therapies and counseling: Clients work with therapists in group, family, and individual sessions to build healthy coping mechanisms, relapse prevention tools, communication skills, and stress management tools.
- Medications: Pharmaceutical tools are often useful during addiction treatment, especially if a co-occurring disorder is also present, in conjunction with therapeutic techniques.
Complementary medical and holistic methods may also be included in a treatment program. These may include massage therapy, yoga, fitness programs, art or creative therapy, nutrition planning, mindfulness meditation, acupuncture, chiropractic care, and more. Individuals in treatment may also participate in a 12-Step or self-help program that can provide long-term support and healthy peer interactions that often extend into recovery. Addiction treatment programs help individuals to stop using Klonopin safely, refrain from returning to use, and provide a strong foundation for a healthy recovery.