Why can't you overdose on benzodiazipenes?

[Elite Engineer]

I'm very shocked to hear this, but apparently overdose on benzodiazipenes alone is fairly uncommon. I always figured it would lead to severe CNS depression and the person would stop breathing. However, this only happens in conjunction with other drugs being taken at the same time..namely alcohol.

 

My question is, by what mechanism can these drugs NOT kill you? I know that alcohol increases the binding affinity of benzodiazipenes to receptors, thereby enhancing their effect...but still I cant wrap my head around the fact that you can't overdose on 500 mg of benzo's.

 

~EE

[CharonY]

The short answer is that they generally have low toxicity. We are talking about concentrations of more than a hundred grams for humans. It would be close to impossible to ingest that much orally.

[Velocity_Boy]

I'm very shocked to hear this, but apparently overdose on benzodiazipenes alone is fairly uncommon. I always figured it would lead to severe CNS depression and the person would stop breathing. However, this only happens in conjunction with other drugs being taken at the same time..namely alcohol.

 

My question is, by what mechanism can these drugs NOT kill you? I know that alcohol increases the binding affinity of benzodiazipenes to receptors, thereby enhancing their effect...but still I cant wrap my head around the fact that you can't overdose on 500 mg of benzo's.

 

~EE

Let we you're correct as far as the mild toxicity of benzos making it extremely difficult to overdose fatally on from them alone.

 

But yet, benzos are implicated in a high percentage of suicides. Both accidental and intentional. As when they're mixed with opioids and or alcohol. But with only benzos, the user will pass out before a fatal dose could be invested.

 

People have died, btw, from benzo overdose. Usually from asphyxiation on their vomit.

 

People are more likely to die from cardiac arrest, however, during benzo withdrawal, then from taking an overdose of them.

 

There is a joke among hospital ER staff that the only way to od on benzos is to choke on the pills!

[Elite Engineer]

The short answer is that they generally have low toxicity. We are talking about concentrations of more than a hundred grams for humans. It would be close to impossible to ingest that much orally.

I was thinking it was receptor saturation..hence why alcohol and bezno's is so dangerous, because the ethanol increases the affinity

[CharonY]

It is not that straightforward. The deaths associated with overdose are varied and a significant amount is due to obstruction of the upper airways (i.e. choking on vomit). In that case drug boosted one of the lethal effects of alcohol. Another effect is that alcohol reduces the clearance of certain benzodiazepines such as triazolam, increasing the effective does in the body. So that goes together with potentiating the biochemical effect.

[thomasm]

In some cases, benzodiazepines can be harmful, especially when taken without a prescription or used in ways other than prescribed. In fact, non-medical use of benzodiazepines is an increasing concern. In 2014, the National Survey on Drug Use and Health (NSDUH) revealed that 8.8% of Americans reported abusing benzodiazepines at some point in their lifetimes 3.The number of emergency department visits in the United States for benzodiazepine misuse and abuse increased 139% between 2004 and 2010 .