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Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.
Benzodiazepines and opioids are different classes of medications. People often confuse them since both cause sedation, but they work differently: opioids target specific pain receptors to reduce discomfort, while benzodiazepines enhance your brain’s main inhibitory neurotransmitter to promote calm.
Benzodiazepines and opioids share one major risk: they can lead to physical dependence and potentially cause dangerous withdrawal symptoms if you abruptly stop using them.
Ardu offers specialized care to help you break free from addiction to benzodiazepines, opioids, and other substances. With expert guidance and a supportive environment, you can regain control of your life and move toward lasting recovery.
Our opioid rehab services address the physical and emotional challenges of addiction, while our specialized benzodiazepine detox programs start with a safe, medically supervised process to ease you into recovery and a healthier future.
Benzodiazepines are classified as central nervous system (CNS) depressants in the category of sedative-hypnotic drugs, which means they can calm anxiety and promote sleep. They fall under Schedule IV controlled substances in the United States, meaning they have accepted medical use but still carry a risk of dependence. Benzos are less restricted than Schedule II drugs such as opioids, but their prescription and use still need to be closely monitored because of their potential for abuse.
If you’re struggling with benzodiazepine dependence, our benzodiazepine detox program provides comprehensive medical support to help you safely manage withdrawal. Benzo withdrawal is difficult, but we’re here to guide you through each step of the detox process with personalized care and support.
Opioids bind to specific receptors in your brain and body to block pain signals and produce pain relief. Besides blocking pain, opioids produce feelings of pleasure and euphoria, which is one reason why they carry such a high risk for addiction.
Opioids come from two sources: natural opioids are extracted from the opium poppy plant, while synthetic opioids are created in labs to copy these natural pain-relieving effects. They are legally prescribed by doctors for severe pain (prescription medications) or produced illegally (illegal drugs) for recreational consumption.
Despite being legitimately prescribed for pain relief, many people develop an addiction to opioids. If you or someone you love is struggling with opioid addiction, our rehabilitation services can help you on your journey to recovery. Our treatment approach combines medication-assisted therapy with counseling, behavioral therapy, and long-term recovery support to help you heal.
Despite different classifications and mechanisms, people confuse opioids and benzos because both drugs share many similarities.
Although many people confuse opioids and benzos, their mechanisms, applications, and effects are distinct. Opioids and benzodiazepines are different classes of drugs and produce different effects: opioids target pain receptors, while benzodiazepines work on GABA receptors in the brain.
Benzodiazepines are prescribed to calm an overactive nervous system by enhancing GABA. Healthcare providers use them primarily for treating severe anxiety disorders, panic attacks, and persistent insomnia. They’re also prescribed for other conditions where reducing nervous system activity is beneficial such as muscle spasms, seizure management, or helping patients relax before medical procedures. Unlike pain medications, benzodiazepines focus entirely on reducing anxiety and promoting relaxation.
Opioids treat moderate to severe pain when over-the-counter medications are insufficient. Doctors prescribe these strong pain-relievers in specific situations like after major surgery, during cancer treatment, or for severe injuries. Because opioids carry a high risk of addiction, healthcare providers typically only prescribe medications such as OxyContin for short periods and carefully monitor their use.
Benzodiazepines enhance GABA, your brain’s main inhibitory neurotransmitter. Think of it as your brain’s natural “brake pedal.” When benzodiazepines boost GABA activity, they slow down overall brain activity to reduce anxiety, relax muscles, and cause sedation. They are effective for calming an overactive nervous system, but benzodiazepines can cause side effects such as memory loss, decreased motivation, and impaired coordination.
Opioids bind to specific pain receptors throughout your body and brain, blocking pain signals and reducing pain perception. What makes opioids particularly risky is that they also trigger the release of chemicals that cause pleasure and euphoria. The combination of pain relief and pleasurable effects contributes to their high risk of substance use disorders (SUDs). Common side effects of opioid misuse include drowsiness, slurred speech, and difficulty breathing.
Since benzodiazepines and opioids are classes of drugs, you wouldn’t directly be prescribed one or the other. They are components of name-brand prescription drugs. To understand which drug is which, you need to familiarize yourself with their common commercial names.
Some of the most popular opioids and their commercial names include:
These prescription opioids carry significant overdose risk, especially when combined with other substances. Many people who misuse opioids also use other drugs such as benzodiazepines or alcohol. This dangerous practice is known as polysubstance abuse and it dramatically increases the risk of fatal overdose because multiple substances can suppress breathing and slow down vital functions.
Some of the most popular benzodiazepines and their commercial names include:
Healthcare professionals carefully evaluate risk factors before prescribing either class of drugs.
Ardu Recovery Center offers specialized treatment for people dependent on multiple substances such as opioids and benzodiazepines. Our comprehensive drug rehab programs include medical detox, medication-assisted treatment, and personalized therapy to help you safely recover and rebuild your life.
Benzodiazepines and prescription opioids pose serious risks for substance use disorders. Data from opioid crisis research shows that prescription opioids and benzodiazepine toxicity have contributed significantly to drug overdose deaths.
A systematic review (2019) showed that benzodiazepine misuse affects approximately 6 million people. Most people who take benzodiazepines use them as prescribed, with less than 2% escalating to high doses. Alprazolam (Xanax) causes twice as many abuse-related emergency visits as other benzodiazepines, even though it’s the most commonly prescribed one. Brett and Murnion indicate that, because of its high toxicity, overdose risk, and mortality rates, Xanax was reclassified as a Schedule 8 drug in 2014.
Opioids are highly addictive because they bind directly to pain and pleasure receptors in the brain to create combined pain relief and intense feelings of euphoria that users quickly develop tolerance to. The craving for euphoria and severe withdrawal symptoms lead to a dangerous cycle of dependence and addiction. According to British researchers, fentanyl is particularly deadly compared to other opioids because it’s extremely potent, quickly suppresses breathing, and can cause respiratory muscles to become rigid.
Here are the most important risk factors for opioid and benzodiazepine abuse:
Drug monitoring programs across the United States such as the Centers for Disease Control and Prevention track these prescribed medications because of their high addiction potential and risk of overdose.
These powerful medications can quickly lead to life-threatening complications, especially when used together. Don’t wait to get help if you’re struggling with opioids or benzodiazepines.
We specialize in treating benzodiazepine addiction with a focus on dual diagnosis. We address addiction and co-occurring mental health conditions through our comprehensive approach. We employ carefully managed benzo tapering protocols to prevent severe withdrawal symptoms during detox, along with innovative treatments such as float spa and vibroacoustic therapy to calm the nervous system.
Our treatment integrates holistic practices such as mindfulness and meditation to provide natural alternatives for managing anxiety and stress.
Our intensive inpatient program offers 24/7 care in a structured environment, while our outpatient services allow you to practice recovery skills in real-world situations. Through experiential therapies, nutritional counseling, and experiential therapy, we help you build a strong foundation for lasting recovery from benzodiazepine dependence.
Ardu provides comprehensive opioid addiction treatment through a combination of evidence-based approaches and personalized care. Our treatment program includes medication-assisted treatment with FDA-approved medications to manage cravings and withdrawal symptoms, alongside intensive counseling and therapy.
Our facility offers inpatient and outpatient options to match your needs and circumstances. For those requiring intensive care, our residential program provides 24/7 support in a trigger-free environment. Our services include medically supervised detox, individual and group therapy, cognitive-behavioral therapy, and holistic treatments such as yoga and meditation.
We believe in treating the whole person, not just the addiction. Through family therapy, support groups, and ongoing aftercare planning, we help you build a strong foundation for lasting recovery. Our team of medical professionals and counselors works together to create an individualized treatment plan that addresses both the physical and psychological aspects of opioid addiction.
Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.
Diazepam is not an opioid; it belongs to the benzodiazepine class of drugs. Diazepam enhances the activity of GABA, the brain’s primary inhibitory neurotransmitter to reduce anxiety, relax muscles, and control seizures. Opioids such as morphine and oxycodone act on opioid receptors to relieve pain.
Despite their differences, benzodiazepines and opioids carry significant risks of dependence, withdrawal, and overdose, especially when combined. The Centers for Disease Control and Prevention (CDC) warns that combining diazepam with opioids increases the risk of overdose fatalities, breathing difficulties, and adverse events.
Medications stronger than Xanax (alprazolam) include midazolam and triazolam, which have more pronounced sedative effects, especially in short-term or procedural use. Clonazepam and lorazepam are more potent for treating conditions such as seizures and severe anxiety due to their longer-lasting effects.
These drugs, while effective, come with a high addiction potential and risk of benzodiazepine toxicity. Short-acting benzodiazepines such as triazolam are known for their rapid onset, which makes them potent but also increases the likelihood of misuse. Healthcare professionals emphasize caution because stronger medications carry an elevated risk of overdose and adverse events, particularly when combined with opioid pain relievers.
Clonazepam is not an opioid, it is a benzodiazepine. Clonazepam enhances GABA activity in the brain to produce calming effects and manage anxiety, panic disorders, and seizures. Unlike opioids, which act on pain receptors to relieve discomfort, clonazepam works by reducing excessive brain activity.
While it is not a narcotic, clonazepam has high addiction potential, especially with long-term use, and carries risks of dependence and withdrawal. Combining clonazepam with opioid drugs or other central nervous system depressants significantly increases the risk of overdose and breathing difficulties, as noted by addiction medicine specialists.
It is possible to overdose on benzodiazepines, particularly when taken in large amounts or combined with opioids, alcohol, or other depressants. Symptoms of benzodiazepine overdose include:
Benzodiazepine toxicity is a major concern when misused, especially with designer benzodiazepines or medications obtained illegally. Immediate medical intervention is critical in suspected overdose cases to prevent long-term complications or death.
Benzodiazepines are not classified as narcotics. Narcotics generally refer to opioids, which are used to relieve severe pain by acting on opioid receptors. Benzodiazepines are prescribed for anxiety, insomnia, seizures, and muscle relaxation and work by enhancing GABA activity in the brain. While they are not narcotics, benzodiazepines share similar risks, including addiction potential, overdose, and withdrawal symptoms. Combining benzodiazepines with narcotics such as opioids increases the risk of respiratory depression and overdose fatalities, highlighting the importance of careful monitoring and proper medical supervision.
Flunitrazepam, often referred to as one of the strongest benzodiazepines, is known for its powerful sedative and hypnotic effects. It is typically used in specific medical contexts or in countries where it is approved. Other strong benzodiazepines include midazolam and clonazepam, which are potent in treating seizures and inducing sedation.
The strength of a benzodiazepine depends on its potency, half-life, and the dosage prescribed. Strong benzodiazepines carry high risks of dependence, benzodiazepine toxicity, and adverse events. Healthcare professionals emphasize responsible use and monitoring to mitigate risks, especially in individuals with a history of substance abuse.
Midazolam and triazolam are among the most sedating benzodiazepines due to their rapid onset and strong hypnotic effects. These medications are often used in medical settings, such as preoperative sedation or short-term treatment of severe insomnia. Their high sedative potential makes them effective but also increases the risk of respiratory depression, addiction, and benzodiazepine toxicity. Combining these drugs with opioids or alcohol amplifies the risk of overdose. Healthcare professionals carefully monitor the use of highly sedating benzodiazepines to minimize the potential for misuse and adverse events.
Oxazepam and lorazepam are among the least toxic benzodiazepines, particularly for individuals with liver impairment. These drugs are metabolized outside the liver, reducing the risk of accumulation and adverse effects.
While less toxic, these medications are not without risks, as prolonged use can lead to benzodiazepine dependence and withdrawal symptoms. They are often recommended for elderly patients or those with comorbidities because their safety profile is better than long-acting benzodiazepines such as diazepam.
Safer alternatives to benzodiazepines for anxiety and sleep disorders include SSRIs (e.g., sertraline, fluoxetine), which have a lower addiction potential, and melatonin for sleep regulation. Cognitive-behavioral therapy (CBT), mindfulness, and non-addictive medications such as beta-blockers are effective non-pharmaceutical options. Non-benzodiazepine sedatives such as zolpidem (Ambien) are also prescribed in some cases, though they carry fewer risks than benzodiazepines. Addiction medicine specialists often recommend combining these approaches to minimize reliance on high-risk drugs and promote long-term stability and mental health.
Managing certain medical conditions doesn’t always require addictive medications. Many effective non-addictive options are available for treating anxiety, depression, pain, and sleep disorders, along with non-pharmaceutical approaches that reduce reliance on high-risk drugs such as opioids and benzodiazepines.
Non-addictive drugs and treatments include:
A benzodiazepine is characterized by its chemical structure, which includes a benzodiazepine ring fused with other functional groups, and its mechanism of action, enhancing GABA activity in the brain. This class of drugs, including diazepam, lorazepam, and clonazepam, is commonly used to treat anxiety, insomnia, and seizures. Benzodiazepines differ from opioids and other drug classes in their effects and receptor targets. While effective, they carry significant risks such as benzodiazepine dependence, withdrawal symptoms, and overdose when misused.
Opiates are naturally derived from the opium poppy plant and include morphine and codeine. Opioids, a broader term, encompass both natural opiates and synthetic or semi-synthetic drugs such as fentanyl, oxycodone, and methadone. Opiates and opioids act on opioid receptors in the brain to relieve pain but carry risks such as addiction, respiratory depression, and overdose. The opioid epidemic highlights the dangers associated with these substances.
Fentanyl overdose is extremely dangerous and often fatal. It has contributed significantly to the rising number of opioid overdose deaths in recent years. According to the CDC, fentanyl is particularly lethal because it’s up to 50 times stronger than heroin and 100 times more potent than morphine.
Here’s what makes fentanyl overdose especially dangerous:
According to a 2022 study, fentanyl has become a leading cause of drug overdose deaths. What makes it particularly deadly is that it can override tolerance to other opioid medications, meaning someone who regularly uses opioids can still easily overdose on fentanyl.
Russell, C., Law, J., Bonn, M., Rehm, J., & Ali, F. (2022). The increase in benzodiazepine-laced drugs and related risks in Canada: The urgent need for effective and sustainable solutions. International Journal of Drug Policy, 111, 103933. https://doi.org/10.1016/j.drugpo.2022.103933
Votaw, V. R., Geyer, R., Rieselbach, M. M., & McHugh, R. K. (2019). The epidemiology of benzodiazepine misuse: A systematic review*. Drug and Alcohol Dependence, 200, 95. https://doi.org/10.1016/j.drugalcdep.2019.02.033
Brett, J., & Murnion, B. (2015). Management of benzodiazepine misuse and dependence. Australian Prescriber, 38(5), 152. https://doi.org/10.18773/austprescr.2015.055
Gill, H., Kelly, E., & Henderson, G. (2019). How the complex pharmacology of the fentanyls contributes to their lethality. Addiction (Abingdon, England), 114(9), 1524. https://doi.org/10.1111/add.14614
Benzodiazepines and Opioids | National Institute on Drug Abuse. (2024, May 17). National Institute on Drug Abuse. https://nida.nih.gov/research-topics/opioids/benzodiazepines-opioids
Park, J. N., Schneider, K. E., Fowler, D., Sherman, S. G., Mojtabai, R., & Nestadt, P. S. (2022). Polysubstance Overdose Deaths in the Fentanyl Era: A Latent Class Analysis. Journal of Addiction Medicine, 16(1), 49. https://doi.org/10.1097/ADM.0000000000000823
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