What Is BIND, Or Benzodiazepine-Induced Neurological Dysfunction?
Benzodiazepines are classified as depressants and are frequently used in the United States and worldwide to treat and reduce anxiety, seizures, insomnia, muscle spasms, and other similar symptoms by slowing down brain and nervous system functioning. Due to their strong effects, they are typically regulated and require a prescription. Unfortunately, this class of drug is addictive. According to the National Institute on Drug Abuse, 17.1% of adults who used a benzodiazepine the previous year abused the drug, and around 2% developed an addiction.
For this reason, most professionals suggest short-term use when prescribed this class of drug. However, in some cases, when long-term use is recommended or drugs have been abused, a condition known as benzodiazepine-induced neurological dysfunction (BIND) may occur. If you or a loved one is looking for a treatment option near you, talk to a professional today at Sylvia Brafman Mental Health Center by calling 877-958-9212.
What is BIND?
Benzodiazepine-induced neurological dysfunction is a multi-symptomatic disorder resulting from neuroadaptation or neurotoxicity to benzodiazepines. Symptoms typically begin while the patient lowers their dosage and may result in physical and mental symptoms lasting a week, month, or over a year. One study showed that up to 76.6% had symptoms lasting over one year.
Symptoms of BIND include anxiety, fear, poor sleeping, lethargy, heart palpitations, nerve sensations, stomach pain, and more. People with BIND also commonly experience adverse life circumstances, such as new or increased difficulties with marriage, work, and relationships.
Withdrawal vs BIND
BIND is a condition that has only recently been recognized as different from traditional benzodiazepine withdrawal. Typically, withdrawal involves removing the drug from the body, usually lasting up to 28 days. Benzodiazepine withdrawal symptoms can be mild to severe, including shaking, seizures, hallucinations, cramping, anxiety, and dizziness. It was once thought these effects were just the return of old problems. However, new research shows a different situation when symptoms occur during and after stopping benzodiazepines.
BIND involves new symptoms that last beyond the usual withdrawal period. As the brain adjusts, a person may face a new or worsened set of side effects. Recently, these ongoing symptoms are being more clearly linked to past benzodiazepine use rather than ignored. This condition, known as bind benzo withdrawal, contributes to the understanding of benzodiazepine withdrawal syndrome.
People often ask, “Can benzo withdrawal cause seizures?” Yes, it can. The benzo withdrawal timeline can vary, but symptoms of benzodiazepine withdrawal, such as benzo withdrawal psychosis, can appear. Understanding the signs of benzo withdrawal, including benzodiazepine seizure withdrawal, can reveal how serious this condition is.
The benzo withdrawal syndrome raises questions like “can Xanax withdrawal cause permanent damage?” and “how long do benzo withdrawal symptoms last?” These symptoms, such as lorazepam withdrawal symptoms and benzos withdrawal symptoms, underscore the complexity of interdose withdrawal and the need for awareness around these issues.
Underlying Mechanisms
One of the proposed reasons for BIND is due to disrupted homeostasis. For example, when someone’s system begins to regulate the drug, it lowers gamma-aminobutyric acid (GABA) receptors, known for its naturally calming effect. The downregulation of these receptors leads to a nervous system that is highly sensitive to everyday stimuli and impaired functioning of the neurotransmitters that regulate muscle tone, emotional well-being, blood pressure, and more.
Increased chemicals like glutamate can further alter the synaptic activity and lead to raised excitability, the opposite effect than desired for most benzodiazepine users. This can also create hippocampal changes, resulting in decreased memory and learning ability, excess neuroinflammation, and lowered brain neuroplasticity.
This is all without mentioning the original reason the user went on the medication, which may be anxiety or other psychological or physiological problems. Without proper treatment for the core issue, users may feel unequipped to handle increased stress levels after quitting, only intensifying the effects.
Risk Factors for BIND
Some populations may be more vulnerable to BIND. By assessing these risk factors, patients and doctors can work together to discuss whether longer-term benzodiazepine use is the proper treatment.
Elderly individuals may be in a higher danger due to age-related neurological changes and decline. This is like other populations with neurological conditions such as Alzheimer’s and dementia. Children and adolescents are also highly vulnerable due to the critical developmental period their brain is undergoing that may be disrupted by continued drug use.
Other potential at-risk groups include anyone who already suffers from addiction, people already taking central nervous system depressants or other drugs, those who do not metabolize drugs well, and anyone prescribed or taking a higher dose of benzodiazepines than average.
How to Help Prevent BIND
One of the best ways to prevent BIND is through high-quality patient screening before prescribing benzodiazepines and, when prescribed, using them for the shortest time possible and at the lowest dose to get the desired effects.
Patients should also be educated on alternative or complementary therapies to treat anxiety, sleep disorders, and other conditions frequently diagnosed in these patients. Whether it’s a substitute medication or natural aids like relaxation techniques and treatment, a complete picture of options and risks is necessary. They should also be made explicitly aware of the impact of long-term use and the possibility of new symptoms arising after withdrawal.
Once prescribed, many patients will also benefit from cognitive assessments that can monitor neurological changes and inform users if they are at an even greater risk for adverse side effects before they begin or worsen.
If a patient is already taking benzodiazepines, they can help prevent severe withdrawal and potentially BIND by gradually reducing the dosage before quitting, under their doctor’s supervision, of course.
There are several tapering methods. The most common is simply reducing the medication dosage until it is the smallest available and then gradually no longer taking the drug by alternating the days they take it. Some medical professionals suggest swapping the current benzodiazepine for another with fewer withdrawal symptoms. This is only recommended if done under the watchful care of a professional and with their recommended prescription. Substitution of prescription drugs with alcohol or street drugs can exacerbate the problem.
Managing BIND
Sadly, few studies have been done on pharmacological ways to manage and treat BIND. Each patient’s chemical makeup, personal history, and drug tolerance will yield different outcomes. However, by identifying the issue of benzodiazepine dependence and preparing for daily life full of everyday stressors, triggers, and potential side effects, patients can work with their doctor and mental health professional to find the best tapering strategy and coping mechanisms to reduce and manage their chances of BIND.
Luckily, due to the newly increased awareness and acceptance of the condition, more patients may now be able to seek relief after diagnosis. As official diagnoses increase, more research can be anticipated, hopefully leading to innovative ways to manage, prevent, and improve BIND symptoms.
Finding The Right Treatment for You
Located in Tamarac, Broward County, just outside Fort Lauderdale, Florida, The Sylvia Brafman Mental Health Center provides dedicated treatment for a range of mental health disorders and substance addiction issues as part of our holistic programs. Whether you’re seeking help for anxiety, depression, or a co-occuring addiction and mental diagnosis, our team of experts is here to support you along your journey.
We accept insurance from multiple major providers like Aetna, Cigna, Florida Blue, NYSHIP, and many others. For those without insurance coverage, we offer private pay options to ensure you can access the care you need. Contact us today to discuss the costs of various treatments, including therapy, IOP, residential treatment, private rehab, and both short-term and long-term rehab. Your health is our priority, and we are committed to finding the right solution for your individual needs.
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