Benzo-Dope: The Emerging Danger of Fentanyl Mixed with Benzodiazepines

The opioid epidemic in the United States has been a public health crisis for decades, claiming the lives of hundreds of thousands of individuals. However, in recent years, the crisis evolved in ways that few could have anticipated. One of the most dangerous and increasingly common trends is the deadly mixture of fentanyl, a synthetic opioid, and benzodiazepines, like Xanax, Ativan, or Valium. This dangerous combination is often referred to as a Benzo-Dope, and it is rapidly becoming a leading cause of overdose deaths across the country. 

Both fentanyl and benzodiazepines are potent and dangerous substances on their own. Meanwhile, the combined effects can be catastrophic, creating new challenges for public health systems, emergency responders, and healthcare providers. For this reason, it is essential to know what Benzo-Dope is, its dangers, how it has evolved as a threat, and what can be done to curb its deadly impact. 

Benzo-Dope refers to the combination of two powerful substances. 

First, it includes fentanyl, a synthetic opioid. The second substance is benzodiazepines, a class of drugs often prescribed for anxiety, insomnia, and panic disorders. These two substances, when taken together, have depressant effects on the central nervous system. This makes it even more lethal than when used separately. 

As mentioned, fentanyl is a powerful synthetic opioid that is 100 times more potent than morphine and 50 times more potent than heroin. Originally developed for medical purposes, such as pain management for cancer patients, fentanyl has become a leading contributor to the opioid overdose crisis. 

The potency of fentanyl means that even a tiny amount can induce a lethal overdose. Additionally, it is often mixed with other illicit substances like heroin, cocaine, and even counterfeit prescription pills. Unfortunately, this often occurs without the user’s knowledge, making fentanyl particularly dangerous, as users may unknowingly ingest it.  

When fentanyl is ingested, it binds to the brain’s opioid receptors, which control pain and breathing. As such, when taken in higher doses, it can cause the breathing to slow to a life-threatening level. The respiratory depression becomes dangerously slow or can stop altogether. Without timely intervention, this can lead to death. 

Now, benzodiazepines, such as the ones mentioned earlier, are commonly prescribed medications for anxiety, panic attacks, and insomnia. 

They work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA), which inhibits brain activity and produces sedative effects. At therapeutic doses, benzodiazepines can help manage anxiety and sleep disorders, but carry a high potential for misuse. When taken in large quantities, they can induce euphoria, intense relaxation, and a sense of calm, which is why they are often misused. 

While benzodiazepines can be dangerous on their own, their combination with fentanyl creates a deadly mix. Both substances are central nervous system depressants. That means they slow down brain activity, which includes the respiratory system. When taken together, they amplify each other’s sedative effects, dramatically increasing the risk of respiratory failure, coma, or even death. 

The combination of fentanyl and benzodiazepines is particularly dangerous for several reasons. These include severe respiratory depression, deep sedation, and a heightened risk of overdose. Let us break these down a bit more. 

One of the most significant risks of combining fentanyl and benzodiazepines is severe respiratory depression. 

Both fentanyl and benzodiazepines slow down the body’s ability to breathe, leading to complete respiratory failure. Additionally, fentanyl binds to opioid receptors in the brain and spinal cord, causing the body’s breathing mechanism to slow down. At high doses, fentanyl can stop breathing altogether, leading to death if not treated immediately. 

As is, each has a significant impact on the brain’s respiratory control centers. The combination of the two is what leads to a significant risk that someone will stop breathing completely. Benzos actually have a less potent effect on breathing than opioids, but again, the combination contributes to the catastrophic results. 

Another danger of Benzo-Dope is the level of unconsciousness it can induce. 

While fentanyl alone can cause extreme drowsiness, the addition of benzodiazepines results in deeper sedation, sometimes leading to a comatose state. This makes it difficult for people to recognize the severity of their situation. They may be unaware of their risk of suffocating due to the combined sedative effects. 

The desire to combine these substances is to intensify one’s higher. However, because they may unintentionally induce a level of sedation, it becomes very life-threatening. Users in this state may not be able to respond to stimuli or seek help, leaving them vulnerable to fatal respiratory depression.

Along with the already fatal outcomes that come with benzo-dope, there is an increased risk of fatal overdose, too.

Overdose deaths involving fentanyl alone have surged in recent years, and the addition of benzodiazepines amplifies that risk. According to the Centers for Disease Control and Prevention (CDC), over 70% of all drug overdose deaths in 2023 involved opioids. Unfortunately, adding benzodiazepines to the mix only causes those already high numbers to rise even more dramatically. 

Now, in many instances of opioid overdose, naloxone (Narcan) can reverse the effects of opioid overdoses. 

Unfortunately, it does not have the same effect on benzodiazepine overdoses. Naloxone works by binding to opioid receptors in the brain, reversing the respiratory depression caused by opioids like fentanyl. However, because benzodiazepines work through a different mechanism, naloxone does not address the sedative effects of these drugs.

Unfortunately, this means that while naloxone might save someone from a fentanyl overdose, the person could still be at risk of respiratory failure due to benzodiazepines. This creates an extremely dangerous and often fatal scenario, requiring emergency medical professionals to treat both substances simultaneously. Even in those instances, there can still be difficulty in reversing the effects. 

To understand how Benzo-Dope became such a dangerous and widespread threat, we need to look at the broader trends in the world of substance use. The rise of Benzo-Dope is tied to two significant factors: the growing availability of fentanyl and the widespread misuse of benzodiazepines. 

Fentanyl’s role in the opioid epidemic cannot be overstated. 

Over the past decade, fentanyl has become one of the primary drivers of overdose deaths. As mentioned earlier, its potency, which is stronger than morphine, has made it commonly addictive and added to a number of other substances. Its ability to cause fatal overdose with a small amount has contributed significantly to the growing issue. 

As a result of this rise in fentanyl, there has been a shift in the drug market. More and more individuals unknowingly ingest it. Counterfeit pills are sold as prescription medication, such as Xanax or Percocet, and are often laced with fentanyl. This astronomically increases the risk of overdose for thousands and thousands of unsuspecting users. 

Along with this widespread disruption of fentanyl, the misuse of Benzodiazepines is another significant concern. 

Benzos are commonly prescribed medications across the United States. As mentioned, they are frequently used in the treatment of anxiety, panic disorder, and insomnia, to name a few. Unfortunately, they are also frequently misused, ultimately leading to a risk of addiction and overdose. 

A person might combine a benzo with any number of substances to prolong the high or increase the effect. Such a growing issue of misuse only becomes a cause for greater concern when medications are purchased off the street and contain fentanyl. 

Again, a focal point of this overarching issue is polydrug use. Any time a person combines substances to enhance their effects, there are exacerbated circumstances. 

Whether a person is intentionally mixing substances or is unaware, the practice is extremely dangerous. Such a desire for strong effects, combined with the increased availability, has created the perfect storm for the rise of Benzo-Dope. 

This emergence of Benzo-Dope has had devastating consequences for public health systems across the United States and beyond. Further, this lethal mixture of fentanyl and benzodiazepines has intensified the already severe opioid crisis. This has subsequently created new challenges for healthcare providers, emergency services, and addiction treatment programs. The impact is being felt, not only in major cities, but in smaller communities that are not as well-equipped to handle the growing number of overdose emergencies. 

Benzo-Dope overdoses are extremely difficult for emergency responders to treat. 

In an overdose emergency, Narcan is often administered. Doing so can help reverse the effects of opioids, particularly the respiratory depression often associated with a fentanyl overdose. Unfortunately, as mentioned, this does not affect a benzodiazepine overdose. 

This complexity significantly strains the emergency departments and paramedics, who may find themselves administering doses of naloxone while simultaneously managing symptoms it can not address. These cases often require prolonged hospitalization, which may include advanced life support and mechanical ventilation. 

The number of overdose deaths involving both opioids and benzodiazepines has increased sharply in recent years. 

The combination is responsible for a growing share of the opioid crisis. As such, the rising death toll is a tragic reminder of the dangers of mixing these substances. Unfortunately, with this increase, access to effective treatment remains a struggle for many. 

Treating individuals with Benzo-Dope addiction is a complex challenge. Many addiction treatment programs focus on either opioid or benzodiazepine dependence, but they do not always address both. Those struggling with polydrug addiction often require specialized care that addresses both. That includes the withdrawal symptoms and long-term needs associated with fentanyl and benzodiazepine dependency. 

Dual diagnosis care such as this is essential for treatment, recovery, improving treatment outcomes, and helping individuals truly heal from addiction. Unfortunately, not all addiction treatment centers are equipped to offer this level of comprehensive care. Ultimately, this leads to caps in the system that leave many individuals without the support they need. 

Addressing the Benzo-Deop epidemic requires a multifaceted approach. Such an approach illicit a need for public education, law enforcement involvement, harm reduction strategies, and improvements within treatment programs. Below are some key actions that communities can take to help reduce the impact of this deadly phenomenon:

First, public education campaigns are integral when raising awareness. 

That includes when trying to prevent further harm from something as serious as the dangers of mixing fentanyl and benzodiazepines. Campaigns such as these can inform individuals about the risks of counterfeit prescription pills and the dangers of polydrug use. Targeted efforts should focus on educating people who may not fully understand the lethal risks associated with Benzo-Dope and just how dire a situation it is. 

Additionally, while naloxone is not effective against benzodiazepine overdoses, it can save lives when administered to someone who has overdosed on fentanyl. 

Expanding access to naloxone and increasing training on its use can still help prevent opioid-related deaths. Even in cases where it is mixed with other substances, administration can still be instrumental in helping to save a life. Efforts should also be made to equip first responders with the necessary tools to handle overdoses involving opioids and benzodiazepines. Even further, efforts to continue educating and training the public on what to do if they witness such an overdose may also prove helpful. 

Similar to training first responders, we must also strengthen law enforcement’s response to overdoses. 

Doing so will help, along with strengthening their illicit drug regulation. Law enforcement agencies need to continue their efforts to intercept fentanyl-laced counterfeit pills and other illicit drugs before they reach the street. Strengthening international cooperation to disrupt drug trafficking organizations and increasing regulations on online drug sales can help reduce the availability of these deadly substances.

Of course, there is only so much that can be done. As such, ensuring officers have the proper training to manage an overdose is a vital way to reduce the number of deaths associated with Benzo-Dope.

The unfortunate reality is that even with the most top-tier prevention methods, individuals will continue misusing these substances. 

As such, we must continue improving current treatment programs and creating new programs specialized toward treating Benzo-Dope. Addiction treatments evolve to address the unique challenges posed by this kind of polydrug use. Offering dual diagnosis care that treats both opioid and benzodiazepine dependence is a critical first step. Additionally, expanding access to specialized rehabilitation programs, including those that use medication-assisted treatment (MAT), can help individuals recover safely from Benzo-Dope addiction. 

Lastly, harm reduction strategies and efforts are another important part of the equation. 

These should be strategies centered around reducing the negative health and social impact of Benzo-Dope. That includes minimizing the risks of overdose, physical harm, and mental health deterioration. 

Some ways this can be done are through: 

Hawaii Island Recovery is committed to providing individualized addiction treatment. We believe recovery is possible for every person. Our cutting-edge, evidence-based treatment can help you or a loved one detox safely and recover from Benzo-Dope dependence. Reach out to Hawaii Island Recovery today to learn more about us and how our residential treatment center can help you in the fight against addiction. 

If you or someone you know is struggling with substance use or addiction, help is available. Whether fentanyl, benzodiazepines, or a combination of substances, treatment and support can make recovery possible. Please do not hesitate or wait until it is too late. Reach out to Hawaii Island Recovery by calling us at (866) 390-5070 to start your path to treatment and recovery today.