Oxazepam addiction: causes, symptoms, treatments and risk factors

Oxazepam addiction is a condition during which individuals develop a compulsive and uncontrollable pattern of seeking, using, and often craving the medication oxazepam. Oxazepam, often recognized by the brand name Serax, is a medication that belongs to the benzodiazepine class and is commonly prescribed to treat anxiety, insomnia, and acute alcohol withdrawal symptoms.

The causes of oxazepam addiction are prescription dosage and duration, genetic factors, psychological and environmental factors, tolerance development, self-medication, and lastly avoiding withdrawal.

The symptoms of oxazepam addiction are compulsive drug seeking, inability to control drug use, memory and concentration problems, sleep disturbances, impaired functioning at school or work, disinhibition, sexual dysfunction, depression, anxiety, and impaired motor skills.

The treatments for oxazepam addiction are detoxification, behavioral therapy, medication for addiction treatment (MAT), gradual tapering, support groups, dual diagnosis treatment, and aftercare and relapse prevention.

The risk factors of oxazepam addiction are high dosage, prolonged use, history of substance abuse, co-occurring mental health disorders, genetic factors, psychological factors, access to medication, and social and environmental influences.

What is Oxazepam addiction?

Oxazepam addiction is a state in which individuals develop a compulsive and problematic pattern of using oxazepam. It is only available through prescription and is advised to be taken exactly as prescribed by a healthcare practitioner.

Oxazepam is an FDA-approved benzodiazepine, which is prescribed for alcohol withdrawal and the treatment of anxiety disorders, as defined by Singh R. and Abdijadid S. in the StatPearls’ article study on “Oxazepam“, last updated in May 2023.

Beyond its approved uses, oxazepam is employed for various purposes, including confusional arousals, sleep terrors, social phobia, post-traumatic stress disorder (PTSD), insomnia, premenstrual dysphoric disorder (PMDD), and catatonia.

According to the “Prescriber’s Guide: Stahl’s Essential Psychopharmacology” chapter on “Oxazepam,” published online by Cambridge University Press on 19 October 2021, it is typical to experience prompt relief upon the initial administration of oxazepam, while achieving maximum therapeutic benefits may require several weeks of regular daily dosing.

Like other benzodiazepines, oxazepam operates on the central nervous system, inducing a calming and anti-seizure impact on the brain and nerves, as stated in the Medscape patient handout on “oxazepam (Rx)”, last revised in February 2023. It increases the impact of a specific natural substance in the body called gamma-aminobutyric acid (GABA).

While these medications are effective in managing certain conditions, they carry a risk of dependence and benzodiazepine addiction if not used as prescribed. New Zealand Data Sheet by Medsafe on oxazepam, last revised on 28 February 2022, reports that extended use of oxazepam leads to the development of a barbiturate-alcohol type of dependence.

This form of dependence is characterized by a compelling urge to persist in taking the medication, often accompanied by a tendency to escalate the dosage. It involves both a psychological dependence on the medicine’s effects and a physical dependence to maintain homeostasis.

How common is Oxazepam addiction?

While specific and up-to-date statistics on the prevalence of oxazepam addiction are scarce, the Substance Abuse and Mental Health Services Administration’s (SAMHSA) report, titled “Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health”, and published in October 2021, estimated 1.7% of individuals aged 12 or older, totaling 4.8 million people, were involved in the misuse of prescription benzodiazepines within the preceding year.

Notably, the highest percentage was seen among young adults aged 18 to 25, with approximately 3.3% (1.1 million individuals) misusing these medications. Following this demographic, adults aged 26 or older accounted for 3.5 million people, representing 1.6%, and adolescents aged 12 to 17 contributed 157,000 individuals, constituting 0.6%.

Moreover, the National Institute on Drug Abuse (NIDA) report of June 2023, titled “Drug Overdose Death Rates,“ stated that the overall count of US fatalities resulting from benzodiazepine overdoses between 1999 and 2021 displayed a consistent rise, escalating from 1,135 in 1999 to 11,537 in 2017. Subsequently, there was a reduction to 9,711 in 2019. However, between 2019 and 2021, the number of deaths experienced another increase, reaching a total of 12,499.

What are the causes of Oxazepam addiction?

The causes of oxazepam addiction, like other benzodiazepines, are multifaceted and involve a combination of biological, psychological, and environmental factors. The potential causes of oxazepam addiction are listed below.

• Prescription dosage and duration
• Genetic factors
• Psychological factors
• Environmental factors
• Tolerance development
• Self-medication
• Avoiding withdrawal

1. Prescription dosage and duration

Prescription dosage and duration is the specific amount of oxazepam prescribed by a healthcare professional and the length of time for which it is recommended.

New Zealand Data Sheet by Medsafe on oxazepam, last revised on 28 February 2022,  stated that the risk of developing oxazepam addiction is influenced by the dose and duration of treatment, and it is heightened in individuals with a history of alcohol or drug abuse, as well as those with significant personality disorders.

Continuous, long-term prescription of benzodiazepines is discouraged, and careful monitoring is crucial for patients with a predisposition to dependence. If physical dependence occurs, abrupt discontinuation of treatment results in withdrawal symptoms. Healthcare providers typically prescribe benzodiazepines like oxazepam for short-term use to mitigate these risks.

2. Genetic factors

Genetic factors refer to the influence of an individual’s genetic makeup or DNA on various traits, characteristics, and susceptibility to certain conditions. Genetics contribute to the variability in how individuals metabolize and respond to drugs.

As per the National Institute on Drug Abuse’s 2023 March article, titled “New NIH study reveals shared genetic markers underlying substance use disorders,” researchers have pinpointed specific genes that are commonly inherited among individuals with addiction disorders, irrespective of the particular substance involved. 

The findings reveal that the combination of genes associated with addiction disorders is linked to the regulation of dopamine signaling. Dopamine is a neurotransmitter involved in reward and pleasure pathways in the brain, and its dysregulation has long been implicated in addictive tendencies.

Certain genetic variations affect how efficiently the body processes oxazepam, potentially influencing the intensity and duration of its effects. Moreover, genetic predispositions to substance use disorders increase the likelihood of developing an addiction to benzodiazepines like oxazepam.

It is worth noting though that genetic predisposition does not invariably dictate an individual’s vulnerability to addiction. The article by swiss medical weekly journal titled “Is there a way to curb benzodiazepine addiction?,” and published in October 2011, highlighted that studies examining both identical and non-identical twin pairs found that if one identical twin developed an alcohol addiction, the likelihood of the other twin developing addiction was inevitable.

However, in the case of non-identical twins, when one twin had an addiction, the other twin did not develop one. This observation led to the proposal that genetic factors partially cause benzodiazepine addiction, including oxazepam addiction.

3. Psychological factors

Psychological factors in oxazepam addiction encompass the emotional and mental aspects that contribute to an individual’s susceptibility to dependency. Those with preexisting psychological conditions, such as anxiety or mood disorders, are drawn to oxazepam for relief.

The drug’s calming effects provide a temporary escape from emotional distress, fostering a psychological dependence on oxazepam as a coping mechanism. Additionally, individuals facing challenges like low self-esteem or past trauma are more prone to developing psychological dependence.

A 2017 research paper by Konopka A. et al., published in the Postepy higieny i medycyny doswiadczalnej (Online), suggested a potential link between benzodiazepine addiction, including oxazepam, and psychological factors. These factors include traits like elevated neuroticism, introversion, and difficulty in alleviating tension through interpersonal interactions, as well as a prevalence of emotional coping approaches.

4. Environmental factors

Environmental factors refer to the external influences and conditions in a person’s surroundings that contribute to the development or exacerbation of oxazepam addiction. These factors encompass various elements such as social, familial, and cultural aspects that shape an individual’s behavior and choices regarding substance use. 

The 2018 issue of Psychology Today, titled “6 Ways Your Environment Is Influencing Your Addiction,“ outlined that family interactions, parenting styles, and levels of supervision in early life are some of the most significant environmental factors influencing the development of addiction.

Maladaptive coping strategies formed in response to adversity in the family environment lead to risky behaviors and addiction, including benzodiazepine addiction, later in life.

Social influences within a person’s environment, such as the normalization of substance use or the availability of prescription medications, contribute to the risk of oxazepam addiction. Moreover, the accessibility of oxazepam within one’s environment, whether through legitimate prescriptions or illicit channels, impact the likelihood of misuse.

5. Tolerance development

Tolerance development is the physiological adaptation that occurs when an individual’s body becomes accustomed to the presence of the drug and requires higher doses to achieve the same therapeutic effects.

Benzodiazepine therapy leads to both physiological and psychological dependence, influenced by the drug’s dosage, duration of therapy, and potency, as stated in the 2000 issue of the American Family Physician, titled “Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives”. Drug tolerance develops more rapidly with high doses of potent agents, leading to a gradual loss of efficacy.

As a result, individuals find that the initial dosage of oxazepam, or other benzodiazepines, becomes less effective, prompting them to increase their intake to attain the desired relief from anxiety or insomnia. This leads to a cycle of addictive behaviors, and difficulty in discontinuing the drug.

6. Self-medication

Self-medication refers to the practice of individuals using medications or substances to treat their symptoms or conditions without the guidance or supervision of a healthcare professional.

The self-medication hypothesis suggests that individuals with substance use disorders, including those involving benzodiazepines like oxazepam, often use these drugs to relieve or manage painful emotional states.

This is particularly prevalent in individuals with difficulties in regulating effects, self-esteem, relationships, and self-care, as highlighted by Khantzian EJ. in the 1997 study “The self-medication hypothesis of substance use disorders: a reconsideration and recent applications,” published in the Harvard Review of Psychiatry.

The study pointed out that painful effects and subjective states are significant psychological determinants in the use, dependence, and relapse of addictive substances​.

7. Avoiding withdrawal

Avoiding withdrawal is the pattern of continued use of the medication to prevent or alleviate the symptoms of withdrawal that occur when a person attempts to reduce or discontinue oxazepam use.

Oxazepam, like other benzodiazepines, leads to physical dependence when used regularly over an extended period. When a person becomes dependent on oxazepam, abrupt discontinuation or a significant reduction in dosage results in withdrawal symptoms.

These individuals may be reluctant to withdraw the benzodiazepine to avoid perceived or anticipated withdrawal effects, as stated by Professor C Heather Ashton in the 1995 study on “Toxicity and adverse consequences of benzodiazepine use,” published in the Psychiatric Annals. 

The researcher adds that this behavior leads to drug-seeking actions, manifesting as anxiety if the next prescription is delayed or unavailable. These people carry their medication at all times and occasionally take extra doses in anticipation of stressful events or unfamiliar sleeping environments.

What are the risk factors for Oxazepam addiction?

The risk factors for oxazepam addiction are diverse and vary from person to person. The risk factors for oxazepam addiction are listed below.

• High dosage: Taking higher doses than prescribed or escalating the dosage without medical supervision contributes to the risk of oxazepam addiction.
• Prolonged use: The longer someone uses oxazepam, the higher the likelihood of developing dependence and addiction.
• History of substance abuse: Individuals with a history of alcohol or drug abuse are at an increased risk of developing dependence on oxazepam.
• Co-occurring mental health disorders: People with underlying mental health conditions, such as anxiety disorders, are more vulnerable to substance misuse, including oxazepam.
• Genetic factors: A family history of substance use disorders or addiction contributes to an individual’s susceptibility to oxazepam addiction.
• Psychological factors: Factors such as stress, trauma, or a lack of healthy coping mechanisms influence the likelihood of misusing oxazepam.
• Access to medication: Easy access to oxazepam, whether through legitimate prescriptions or other means, increases the risk of misuse.

Social and environmental influences: Peer pressure, a social environment that normalizes substance use, or exposure to individuals with substance use disorders contribute to the risk of oxazepam addiction.

Why is using Oxazepam addictive?

Using oxazepam is addictive because it interacts with the central nervous system (CNS), and slows down the brain and the body, producing a calming and soothing effect. The calming and enjoyable impact of this medication occasionally leads to misuse, subsequently leading to drug dependence and addiction.

As per Drugs.com July 2023 article on “Oxazepam: 7 things you should know,” oxazepam is addictive and causes dependence. Withdrawal symptoms such as tremors, abdominal and muscle cramps, vomiting, sweating, and even seizures may occur if oxazepam is taken long-term or at higher-than-recommended dosages and then stopped abruptly.

Psychological dependence on oxazepam emerges when individuals rely on oxazepam to cope with stress or anxiety. Misuse, such as taking higher doses or using it for extended periods, amplifies the risk.

How addictive is Oxazepam?

Oxazepam has been proven to be a drug of lower risk for developing addiction, with only four instances of dependence reported over an extended period, as stated in an old study from 1978 by Bliding A., titled “The abuse potential of benzodiazepines with special reference to oxazepam”. However, like other benzodiazepines, oxazepam abuse or misuse poses certain risks for developing addiction.

The shallow abuse potential of oxazepam is attributed to three main factors: its gradual onset of central nervous system activity, which avoids sudden intoxication effects; its tendency to induce dizziness at high dosages, discouraging dose escalation; and its short half-life and lack of major active metabolites, enabling complete drug elimination with intermittent therapy.

A more recent study published in the 2016 issue of the British Journal of General Practice, titled “A 5-year follow-up study of users of benzodiazepine: starting with diazepam versus oxazepam,” suggested that oxazepam has an exceptionally low potential for producing dependence.

Even though oxazepam is a schedule IV drug, as a benzodiazepine it leads to physical and psychological dependence, especially with prolonged or improper use.

How long does it take to become addicted to Oxazepam?

It takes about 4-6 weeks to become addicted to oxazepam. Oxazepam is designed for short-term relief of intense anxiety, typically spanning 2-4 weeks, as described in the Patient Information Leaflet by electronic medicines compendium on “Oxazepam; 10mg And 15mg Tablets,” revised in August 2018. Extended use beyond this recommended period, without breaks, contributes to heightened tolerance, potentially fostering physical dependence and increasing the risk of addiction.

It is worth noting that the timeframe to become addicted to oxazepam varies widely among individuals. Factors influencing addiction risk include the dosage, duration of use, individual susceptibility, genetics, and adherence to prescribed guidelines.

What are the signs of Oxazepam addiction?

The signs of oxazepam addiction are listed below.

• Withdrawal symptoms when not using oxazepam: These symptoms manifest as both physical and psychological distress when an individual is not taking the prescribed medication, indicating a potential dependence.
• Seeming confused and drowsy: Oxazepam addiction causes individuals to appear confused and drowsy due to the drug’s sedative effects.
• Being unable to discontinue oxazepam even after trying to: Loss of control becomes apparent when an individual faces challenges in reducing or controlling their oxazepam use despite experiencing negative consequences.
• Continued use despite harm occurs: When individuals persist in using oxazepam even when it results in negative impacts on their personal, social, or professional lives, is an indication of experiencing addiction to the drug.
• Using a higher dosage of oxazepam: Escalating doses, such as taking higher amounts than prescribed or increasing frequency without medical guidance, contribute to the development of dependence.
• Cravings: Feeling unable to function normally without oxazepam refers to strong desires or cravings for oxazepam, indicating a psychological dependence on the medication.
• Social and occupational impairment: A significant decline in work or school performance becomes apparent due to excessive oxazepam use.

Using oxazepam in unintended ways:  Using oxazepam in unintended ways, such as snorting it as a powder, poses serious health risks and is an indicator of developing addiction.

What are the symptoms of Oxazepam addiction?

The common symptoms of oxazepam addiction are listed below.

• Compulsive drug seeking: Those addicted to oxazepam engage in compulsive behaviors to obtain and use the drug, even when aware of the negative consequences associated with such actions.
• Social isolation: Preoccupation with oxazepam use causes individuals to withdraw from social activities, friends, and family, contributing to social isolation.
• Inability to control drug use: Oxazepam addicts find it challenging to control the frequency or amount of their drug intake, leading to persistent and excessive use.
• Memory and concentration problems: Oxazepam abuse leads to difficulties in maintaining focus and short-term memory loss.
• Sleep disturbances: Individuals experience disruptions in their sleep patterns, potentially leading to insomnia or fragmented sleep.
• Impaired functioning at school or work: People struggling with oxazepam addiction find it challenging to perform effectively in academic or occupational settings due to the drug’s impact on cognitive and motor functions.
• Disinhibition: Extended use of oxazepam results in disinhibition, characterized by a lack of restraint in behavior and impulse control.
• Sexual dysfunction: Long-term benzodiazepine use, including oxazepam, contributes to sexual dysfunction, affecting libido and performance.
• Depression: Prolonged use of oxazepam is associated with depressive symptoms.
• Anxiety: Instead of alleviating anxiety, long-term oxazepam use paradoxically leads to increased anxiety levels.
• Impaired motor skills: Long-term use impacts coordination and motor skills, affecting tasks that require physical dexterity.

How is Oxazepam addiction diagnosed?

Oxazepam addiction is diagnosed through a comprehensive evaluation conducted by a healthcare professional. This assessment encompasses a detailed examination of the individual’s medical history, considering factors such as oxazepam use, co-existing medical conditions, and prior substance use.

Moreover, interviews with the individual, along with input from family members or close contacts, provide valuable insights into the patterns of oxazepam use and its impact on their lives. Toxicology screens, involving drug tests, are often employed to detect the presence of oxazepam or other substances in the individual’s system, assisting in the diagnostic process.

A physical examination is performed to identify any observable symptoms or signs associated with oxazepam use. Established diagnostic criteria, outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), are applied to determine if the person meets the criteria for oxazepam addiction.

According to the DSM-5, released in May 2013, if at least two of these criteria are manifested within 12 months, a diagnosis of sedative, hypnotic, or anxiolytic (benzodiazepine) use disorder, including oxazepam addiction, is to be considered.

The DSM-5 criteria for diagnosing oxazepam addiction encompass symptoms, such as the consumption of excessive amounts of oxazepam or its prolonged use beyond the intended duration, a desire to reduce drug intake coupled with an inability to achieve this goal, and dedicating excessive time to acquiring or recovering from substance use.

Despite facing enduring social or interpersonal challenges resulting from substance use, individuals persist in this behavior, overlooking significant responsibilities. Additionally, substance use persists even in situations presenting physical risks.

Additionally, continued use endures despite the awareness of persistent physical or psychological problems exacerbated by these substances. Lastly, the substance use pattern is marked by the development of tolerance and the manifestation of withdrawal symptoms.

Where can you seek Oxazepam addiction diagnosis?

You can seek an oxazepam addiction diagnosis at specialized addiction clinics and rehabilitation centers which offer consultations with healthcare professionals such as primary care physicians, addiction specialists, or psychiatrists.

These professionals possess the necessary tools to review your medical history, assess your condition, and apply diagnostic criteria to identify oxazepam addiction. Mental health specialists, substance abuse counselors, and addiction treatment clinics conduct thorough diagnostic assessments and develop personalized treatment plans.

What are the dangers of Oxazepam addiction?

The dangers of oxazepam addiction are multifaceted and encompass both physical and mental health risks. One significant risk is the potential for tolerance development, where the body becomes accustomed to oxazepam, necessitating higher doses to achieve the desired effects.

This escalating pattern increases the likelihood of overdose, which leads to severe respiratory depression, loss of consciousness, and, in extreme cases, death. Abusing oxazepam in conjunction with opioids and other depressants increases the risk of overdose and death.

According to Ashton H.’s 1995 study on “Toxicity and adverse consequences of benzodiazepine use,” published in the Psychiatric Annals, benzodiazepines, including oxazepam, contribute to 30-40 percent of cases involving self-poisoning when used in conjunction with other substances.

In such situations, the combined impact of benzodiazepines with other CNS depressants worsens or triggers respiratory failure, especially in the elderly and individuals with respiratory conditions. Similarly, the blood pressure-lowering effects of benzodiazepines amplifies the adverse cardiovascular effects of drugs that depress heart function.

Additionally, the drug’s sedative properties lead to impaired judgment and coordination, heightening the risk of accidents and injuries. Furthermore, abruptly discontinuing oxazepam results in severe and potentially life-threatening side effects. These adverse reactions include unusual movements, seizures, depression, hallucinations, and thoughts or actions of self-harm or suicide, as described in the “Oxazepam (ox az’ e pam) Capsules, USP; C-IV” medication guide, approved by the FDA in August 2023.

Is Oxazepam a high-risk medication?

Yes, oxazepam is a high-risk medication if used in a higher dosage or longer period than prescribed. However, oxazepam is classified as a Schedule IV by the Drug Enforcement Administration (DEA), meaning it has a lower potential for abuse when compared to substances listed in Schedule III, as claimed by the PubChem compound summary for “Oxazepam,” published in the National Center for Biotechnology Information and modified in December 2023.

Even though oxazepam is a Schedule IV drug, it has the potential for dependence, tolerance, and addiction, due to the pleasurable feelings it produces. The longer someone uses it, the more likely they are to become addicted.

How does Oxazepam addiction impact mental health?

Oxazepam addiction impacts mental health through a range of factors, including changes in neurotransmitter activity, disruptions in cognitive function, and the development of psychological dependence. Prolonged use and abuse of oxazepam alters the balance of neurotransmitters in the brain, affecting mood regulation and contributing to conditions such as depression and anxiety.

The sedative effects of oxazepam lead to cognitive impairments, including difficulties with memory, concentration, and overall cognitive function. These cognitive challenges further impact an individual’s mental well-being and daily functioning.

A study involving 60 healthy volunteers, highlighted in the 2016 “Meyler’s Side Effects of Drugs (Sixteenth Edition)” book chapter, titled “Oxazepam”, explored the effects of 30 mg oxazepam on implicit and explicit memory processes over time. Results indicated that oxazepam impaired cued recall performance before its plasma concentration peaked, affecting both memory tasks at the peak, and retaining impaired cued recall performance even after the peak.

Moreover, the development of psychological dependence is a common aspect of benzodiazepine addiction, including oxazepam. Individuals become reliant on the drug to cope with stress, anxiety, or other emotional challenges, leading to a cycle of dependence that significantly affects mental health.

Misusing oxazepam over an extended period leads to various mental health issues and challenges, varying in intensity from mild to severe. The severity of these conditions escalates with prolonged abuse of the drug.

In mild cases of oxazepam addiction, overdose symptoms present as drowsiness, mental confusion, and lethargy, as stated in the article titled “Serax” by the RxList, last updated in July 2023.

In more severe instances, especially when combined with other substances like drugs or alcohol, the symptoms escalate to include a hypnotic state and progress through stages one to three of coma.

What are the symptoms of Oxazepam withdrawal?

The symptoms of oxazepam withdrawal are headaches, muscle pain, extreme anxiety, tension, restlessness, confusion, and irritability, as outlined in the New Zealand Data Sheet by Medsafe on oxazepam, last revised on 28 February 2022.

When someone develops an addiction to oxazepam, reducing the dosage or abruptly stopping leads to unpleasant symptoms, commonly referred to as withdrawal symptoms. 

In extreme cases, individuals experience derealization, depersonalization, heightened sensitivity to sound (hyperacusis), numbness and tingling in the limbs, increased sensitivity to light, noise, and physical touch, hallucinations, and seizures.

What are the available treatments for Oxazepam addiction?

The available treatments for oxazepam addiction typically involve a comprehensive approach addressing both physical and psychological aspects of addiction.

The available treatments for oxazepam addiction are listed below.

• Detoxification
• Behavioral therapy
• Medication for addiction treatment (MAT)
• Gradual tapering
• Support groups
• Dual diagnosis treatment
• Aftercare and relapse prevention

1. Detoxification

Detoxification is the series of interventions designed to address acute intoxication and withdrawal, as defined in a 2006 study by the Substance Abuse and Mental Health Services Administration (SAMHSA), titled “Detoxification and Substance Abuse Treatment,” chapter “1 Overview, Essential Concepts, and Definitions in Detoxification”.

As per the SAMHSA study, the detox phase involves removing toxins from the body of a patient experiencing acute intoxication or dependence on substances of abuse, oxazepam in this case,  to reduce the physical harm associated with it.  

Detox provides a supervised environment where medical professionals facilitate a controlled and gradual reduction in oxazepam dosage. This helps minimize the intensity of withdrawal symptoms, making the process safer and more manageable.

During detox, individuals are closely monitored by healthcare professionals who intervene if severe withdrawal symptoms arise. This ensures the individual’s safety and provides necessary medical support. 

It is essential to note that detoxification alone is not a complete treatment for oxazepam addiction. Following detox, individuals are encouraged to engage in ongoing rehabilitation programs, including behavioral therapies, counseling, and support groups, to address the psychological and behavioral aspects of addiction and promote long-term recovery.

2. Behavioral therapy

Behavioral therapy is a therapeutic approach that aims to identify and modify harmful behaviors and thought patterns contributing to addiction. It focuses on promoting positive behaviors, coping strategies, and personal growth.

Behavioral therapy, particularly cognitive-behavioral therapy (CBT), is rooted in the transtheoretical model of behavioral change in addressing addictions. As per the 2021 study by Chapoutot M. et al., titled “Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for the Discontinuation of Long-Term Benzodiazepine Use in Insomnia and Anxiety Disorders,” published in the International Journal of Environmental Research and Public Health, a key advantage of employing CBT for the treatment of benzodiazepine addiction, including oxazepam addiction, lies in its comprehensive approach.

It not only focuses on the addiction itself but also targets the underlying conditions that prompted BZD use, specifically addressing issues like insomnia and anxiety. By addressing the root causes that led to BZD prescriptions, individuals enhance their prospects of discontinuing use.

CBT can significantly improve the likelihood of successful withdrawal. This is achieved by providing patients with alternative coping strategies and offering effective substitutes for BZD consumption during recovery.

3. Medication for addiction treatment (MAT)

Medication for addiction treatment (MAT) is an evidence-based approach that combines medications with behavioral therapies and counseling to treat benzodiazepine addiction like oxazepam.

Medical professionals use supportive medications to alleviate specific withdrawal symptoms of oxazepam addiction. Medications are administered to manage anxiety, insomnia, or seizures that occur during oxazepam withdrawal.

The primary treatment for acute benzodiazepine overdose is flumazenil, a benzodiazepine receptor antagonist. However, caution is advised in multi-drug overdoses, as reversing benzodiazepine effects may exacerbate symptoms of other substances, as stated by Roth B. A. et al., in the 2007 study, titled “Sedative Hypnotic Abuse. xPharm: The Comprehensive Pharmacology Reference”.

Benzodiazepine detoxification can be approached through three protocols: reducing the amount of benzodiazepine, substituting with a longer-acting benzodiazepine, or using carbamazepine, valproate, lamotrigine, or propranolol to manage withdrawal symptoms. The use of phenobarbital is declining due to potential complications, as reported in the study.

4. Gradual tapering

Gradual tapering is a method used in the treatment of oxazepam addiction to safely and systematically reduce the dosage of the medication over some time. This process involves a structured and controlled reduction in the amount of oxazepam a person takes, allowing the body to adjust gradually to lower levels of the drug.

This approach helps minimize withdrawal symptoms that arise when discontinuing oxazepam abruptly. Medical professionals carefully monitor the individual’s response and adjust the tapering schedule based on the person’s specific needs and withdrawal symptoms. Gradual tapering supports a smoother transition, increases the likelihood of successful detoxification, and provides a more manageable path toward recovery from oxazepam addiction.

In a 3-month randomized controlled trial involving 180 individuals aiming to discontinue long-term benzodiazepine use, results indicated that tapering off, whether alone or with CBT, significantly increased the proportion of successful drug discontinuations, as reported by the RC. Oude Voshaar et al’s 2003 study, titled “Tapering off long-term benzodiazepine use with or without group cognitive-behavioural therapy: three-condition, randomised controlled trial,” and published in the British Journal of Psychiatry.

Importantly, the type of intervention and successful discontinuation did not impact psychological functioning, and tapering strategies have proven to be effective.

5. Support groups

Support groups are gatherings of individuals facing similar challenges, and they play a crucial role in treating oxazepam addiction. These groups provide a supportive community where individuals share their experiences, struggles, and successes in overcoming addiction.

Tracy K. and Wallace SP. in their  2016 study, titled “Benefits of peer support groups in the treatment of addiction,” published in the journal of Substance Abuse and Rehabilitation, defined peer support as the exchange of nonprofessional, nonclinical help between individuals facing similar conditions or circumstances, aiming at sustained recovery from psychiatric, alcohol, and other drug-related issues.

Peer support has proven to be a fundamental element in various addiction treatments, including oxazepam addiction.

6. Dual diagnosis treatment

Dual diagnosis treatment addresses individuals who simultaneously experience substance abuse issues, such as oxazepam addiction, alongside mental health disorders.

As defined in the MedlinePlus article on “Dual Diagnosis,“ last updated in October 2019, an individual with a dual diagnosis experiences both a mental health disorder and a substance use issue. Co-occurrence of these conditions is common. Around half of the individuals who experience a mental disorder, such as anxiety or depression, at some point, will also develop drug addictions, including oxazepam addiction.

Dual diagnosis treatment employs a comprehensive strategy that combines medical interventions, counseling, and therapeutic modalities to address both aspects of the dual diagnosis.

7. Aftercare and relapse prevention

Aftercare and relapse prevention are crucial components of treating oxazepam addiction. Aftercare involves ongoing support and interventions that individuals receive after completing a formal addiction treatment program. This includes ongoing counseling, support group participation, and follow-up medical care to help individuals maintain their recovery.

According to Nicholas Guenzel and Dennis McChargue’s article on “Addiction Relapse Prevention,” last updated in July 2023 in StatPearls, a significant issue in addiction treatment is the notable recurrence of relapses shortly after even the most rigorous interventions.

Preventing relapse is a fundamental objective in addiction treatment, but there’s no one-size-fits-all solution due to the variable nature of recovery. Early identification of patients at risk is crucial, and primary care clinicians, specialized nurses, and pharmacists play key roles in counseling, risk assessment, monitoring, and intervention.

When should you seek treatment for Oxazepam addiction?

You should seek treatment for oxazepam addiction when you observe signs of dependence or problematic use. If there are indications of increasing tolerance, higher doses, persistent cravings, or difficulties in fulfilling daily responsibilities due to oxazepam, timely professional intervention becomes imperative.

The onset of withdrawal symptoms during attempts to decrease or discontinue oxazepam use indicates the development of dependence, underscoring the importance of early treatment. Seeking help in the early stages allows for more effective intervention, potentially preventing the progression of addiction and addressing the issue before it exacerbates.

Can Oxazepam addiction be treated without medication?

Yes, oxazepam addiction can be treated without medication, and many individuals have successfully recovered through non-medication-based approaches. The treatment for oxazepam addiction often involves a combination of therapeutic and behavioral interventions.

As stated by Carroll KM. and Schottenfeld R. in the 1997 study, titled “Nonpharmacologic approaches to substance abuse treatment” and published in the Medical Clinics of North America, nonpharmacologic interventions can improve addiction treatment outcomes, even when effective pharmacologic treatments are utilized.

Nonpharmacologic treatments work synergistically with pharmacologic approaches, often targeting different symptoms and problem areas to provide a comprehensive approach to recovery.

How is Oxazepam addiction prevented?

Oxazepam addiction is prevented through careful prescribing practices, patient education about the risks of dependency, regular monitoring and follow-up, avoidance of long-term use, gradual tapering off the medication, consideration of alternative therapies, and screening for risk factors.

Healthcare providers ensure that the medication is prescribed only for legitimate medical reasons and in appropriate doses and durations. As Brett J. and Murnion B. highlighted in their 2015 study, titled “Management of benzodiazepine misuse and dependence” and published in the Australian Prescriber, to prevent oxazepam addiction it is advisable to prescribe limited amounts of oxazepam, typically 1–2 weeks’ supply.

Additionally, healthcare professionals conduct regular check-ins with patients using oxazepam to assess its continued necessity, potential side effects, and any signs of misuse or dependence. This ongoing monitoring helps identify issues early on.

Can offering alternative therapies prevent the need for Oxazepam use?

Yes, offering alternative therapies can prevent the need for oxazepam use in specific situations. Non-pharmacological interventions, including cognitive-behavioral therapy, relaxation techniques, mindfulness, and lifestyle adjustments, prove effective in addressing the issues associated with oxazepam abuse.

The 2016 study, titled “Nonpharmacological Alternatives to Benzodiazepine Drugs for the Treatment of Anxiety in Outpatient Populations: A Literature Review,” published in the Journal of Psychosocial Nursing and Mental Health Services, pointed out that natural, non-chemical anxiolytic treatments can be safely recommended for benzodiazepine addictions like oxazepam.

Therapies, such as mindfulness, meditation, and yoga have been studied as viable alternatives, with increasing evidence supporting their safe recommendation for patients dealing with anxiety and other mental conditions.

These methods concentrate on tackling the underlying causes of symptoms and cultivating coping mechanisms, eliminating the reliance on benzodiazepines.

Can healthcare providers limit Oxazepam prescriptions to prevent addiction?

Yes, healthcare providers can limit oxazepam prescriptions to prevent addiction. By adopting careful prescribing practices, providers control the dosage, duration, and frequency of oxazepam prescriptions.

As per DailyMed’s drug label information on “OXAZEPAM capsule, gelatin coated,” last updated in August 2023, limiting the prescribed amounts and durations of oxazepam, particularly when it is used with opioids, is crucial for preventing severe sedation, respiratory depression, coma, and potential fatality.