Editing Benzodiazepine (section)

===Recreational use===
{{Main|Benzodiazepine drug misuse|Drug-related crime}}
[[File:Xanax 2 mg.jpg|thumb|Xanax ([[alprazolam]]) 2 mg tri-score tablets]]
Benzodiazepines are considered major addictive substances.<ref name=pmid10622686>{{cite journal | author = Lader MH | title = Limitations on the use of benzodiazepines in anxiety and insomnia: are they justified? | journal = European Neuropsychopharmacology | volume = 9 | issue = Suppl 6 | pages = S399–405 | year = 1999 | pmid = 10622686 | doi = 10.1016/S0924-977X(99)00051-6 | s2cid = 43443180 }}</ref> Non-medical benzodiazepine use is mostly limited to individuals who use other substances, i.e., people who engage in polysubstance use.<ref>{{cite web |url=http://www.exchangesupplies.org/conferences/NDTC/2009_NDTC/speakers/chris_ford.html |title=What is possible with benzodiazepines |author=Chris Ford |year=2009 |publisher=Exchange Supplies, 2009 National Drug Treatment Conference |location=UK|archive-url=https://web.archive.org/web/20100501121221/http://www.exchangesupplies.org/conferences/NDTC/2009_NDTC/speakers/chris_ford.html |archive-date=1 May 2010 |url-status=dead }}</ref> On the international scene, [[Benzodiazepine drug misuse#Legal status|benzodiazepines are categorized]] as [[Convention on Psychotropic Substances#Schedules of Controlled Substances|Schedule IV]] controlled drugs by the [[INCB]], apart from [[flunitrazepam]], which is a [[Convention on Psychotropic Substances#Schedules of Controlled Substances|Schedule III]] drug under the [[Convention on Psychotropic Substances]].<ref>{{cite web|url=http://www.incb.org/pdf/e/list/green.pdf |title=List of psychotropic substances under international control |access-date=17 December 2008 |publisher=International Narcotics Control Board |year=2003 |url-status=dead |archive-url=https://web.archive.org/web/20051205125434/http://www.incb.org/pdf/e/list/green.pdf |archive-date=5 December 2005 |author-link=International Narcotics Control Board }}</ref> Some variation in drug scheduling exists in individual countries; for example, in the United Kingdom, [[midazolam]] and [[temazepam]] are [[Controlled Drug#Schedule 3 - CD No Reg|Schedule III controlled drugs]].<ref>{{cite web |url= https://bnf.nice.org.uk/guidance/controlled-drugs-and-drug-dependence.html |title=Controlled drugs and drug dependence |author-link=National Institute for Clinical Excellence |date=3 January 2020 |publisher=British National Formulary |location=United Kingdom }}(Note: The ''[[British National Formulary]]'' is only accessible in the UK. A [https://bnf.nice.org.uk/medicines-guidance/controlled-drugs-and-drug-dependence/ cached copy] is available from Google.)</ref>

British law requires that temazepam (but ''not'' midazolam) be stored in safe custody. Safe custody requirements ensures that pharmacists and doctors holding stock of temazepam must store it in securely fixed double-locked steel safety cabinets and maintain a written register, which must be bound and contain separate entries for temazepam and must be written in ink with no use of correction fluid (although a written register is not required for temazepam in the United Kingdom). Disposal of expired stock must be witnessed by a designated inspector (either a local drug-enforcement police officer or official from health authority).<ref>Home Office (2005). [http://www.homeoffice.gov.uk/about-us/home-office-circulars/circulars-2005/048-2005/ Explanatory memorandum to the misuse of drugs and the misuse of drugs] {{webarchive |url=https://web.archive.org/web/20101216234732/http://www.homeoffice.gov.uk/about-us/home-office-circulars/circulars-2005/048-2005/ |date=16 December 2010 }} (supply to addicts) (amendment) regulations 2005. No. 2864. Accessed 20–10–03</ref><ref>{{cite web |url=http://www.homeoffice.gov.uk/publications/drugs/drug-licences/controlled-drugs-list?view=Binary |format=PDF |title=List of drugs currently controlled under the misuse of drugs legislation |date=25 October 2010 |access-date=30 January 2011 |publisher=UK Government Home Office |archive-url=https://web.archive.org/web/20110218033313/http://www.homeoffice.gov.uk/publications/drugs/drug-licences/controlled-drugs-list?view=Binary |archive-date=18 February 2011 |url-status=dead }}</ref> Benzodiazepine use ranges from occasional binges on large doses, to chronic and compulsive drug use of high doses.<ref>{{cite book | vauthors = Karch SB |title=Drug Abuse Handbook |url=https://books.google.com/books?id=F0mUte90ATUC |edition=2nd |year= 2006 |publisher=CRC Press |location=US |isbn=978-0-8493-1690-6 |page=217 }}</ref>

Benzodiazepines are commonly used recreationally by poly-drug users. [[Death|Mortality]] is higher among [[Poly drug use|poly-drug users]] that also use benzodiazepines. Heavy alcohol use also increases [[Mortality rate|mortality]] among poly-drug users.<ref name="Charlson_2009">{{cite journal |vauthors=Charlson F, Degenhardt L, McLaren J, Hall W, Lynskey M | title = A systematic review of research examining benzodiazepine-related mortality | journal = Pharmacoepidemiology and Drug Safety | volume = 18 | issue = 2 | pages = 93–103 | year = 2009 | pmid = 19125401 | doi = 10.1002/pds.1694 | s2cid = 20125264 }}</ref> Polydrug use involving benzodiazepines and alcohol can result in an increased risk of blackouts, risk-taking behaviours, seizures, and overdose.<ref>{{cite journal | vauthors = Bright J, Martin AJ, Richards M, Morie M |date=16 December 2022 |title=The Benzo Research Project: An evaluation of recreational benzodiazepine use amongst UK young people (18-25) |url=https://zenodo.org/record/7813470 |journal=Zenodo |doi=10.5281/zenodo.7813470}}</ref> Dependence and tolerance, often coupled with dosage escalation, to benzodiazepines can develop rapidly among people who misuse drugs; withdrawal syndrome may appear after as little as three weeks of continuous use. Long-term use has the potential to cause both physical and psychological dependence and severe withdrawal symptoms such as depression, anxiety (often to the point of [[panic attack]]s), and [[agoraphobia]].<ref name=ohop>{{cite book |vauthors=McIntosh A, Semple D, Smyth R, Burns J, Darjee R |title=Oxford Handbook of Psychiatry |edition=1st |publisher=Oxford University Press |year=2005 |page=540 |chapter=Depressants |isbn=978-0-19-852783-1 }}</ref> Benzodiazepines and, in particular, [[temazepam]] are sometimes used intravenously, which, if done incorrectly or in an unsterile manner, can lead to medical complications including [[abscess]]es, [[cellulitis]], [[thrombophlebitis]], arterial puncture, [[deep vein thrombosis]], and [[gangrene]]. Sharing syringes and needles for this purpose also brings up the possibility of transmission of [[hepatitis]], HIV, and other diseases. Benzodiazepines are also misused [[intranasally]], which may have additional health consequences. Once benzodiazepine dependence has been established, a clinician usually converts the patient to an equivalent dose of diazepam before beginning a gradual reduction program.<ref name="pmid9274553">{{cite journal |vauthors=Gerada C, Ashworth M | title = ABC of mental health. Addiction and dependence – I: Illicit drugs | journal = [[BMJ]] | volume = 315 | issue = 7103 | pages = 297–300 | year = 1997 | pmid = 9274553 | pmc = 2127199 | doi = 10.1136/bmj.315.7103.297 }}</ref>

A 1999–2005 Australian police survey of detainees reported preliminary findings that self-reported users of benzodiazepines were less likely than non-user detainees to work full-time and more likely to receive government benefits, use methamphetamine or heroin, and be arrested or imprisoned.<ref>{{cite journal |url=http://aic.gov.au/media_library/publications/tandi_pdf/tandi336.pdf |title=Benzodiazepine use and harms among police detainees in Australia |publisher=Loxley W |year=2007 |issn=0817-8542 |journal=Trends & Issues in Crime and Criminal Justice |issue=336 |access-date=10 June 2009 |archive-url=https://web.archive.org/web/20170812072936/http://www.aic.gov.au/media_library/publications/tandi_pdf/tandi336.pdf |archive-date=12 August 2017 |url-status=dead }}</ref> Benzodiazepines are sometimes used for criminal purposes; they serve to incapacitate a victim in cases of [[drug assisted rape]] or robbery.<ref>{{cite journal | author = Kintz P | title = Bioanalytical procedures for detection of chemical agents in hair in the case of drug-facilitated crimes | journal = Analytical and Bioanalytical Chemistry | volume = 388 | issue = 7 | pages = 1467–1474 | year = 2007 | pmid = 17340077 | doi = 10.1007/s00216-007-1209-z | s2cid = 28981255 }}</ref>

Overall, [[anecdotal evidence]] suggests that [[temazepam]] may be the most psychologically [[Substance dependence|habit-forming (addictive)]] benzodiazepine. Non-medical temazepam use reached epidemic proportions in some parts of the world, in particular, in Europe and Australia, and is a major addictive substance in many Southeast Asian countries. This led authorities of various countries to place temazepam under a more restrictive legal status. Some countries, such as Sweden, banned the drug outright.<ref>{{cite web|url=http://www.benzo.org.uk/ashbzab.htm |title=Benzodiazepine abuse |publisher=Benzo.org.uk |access-date=28 November 2011}}</ref> Temazepam also has certain pharmacokinetic properties of absorption, distribution, elimination, and clearance that make it more apt to non-medical use compared to many other benzodiazepines.<ref name="pmid1786493">{{cite journal |vauthors=Farré M, Camí J | title = Pharmacokinetic considerations in abuse liability evaluation | journal = British Journal of Addiction | volume = 86 | issue = 12 | pages = 1601–1606 | date = December 1991 | pmid = 1786493 | doi = 10.1111/j.1360-0443.1991.tb01754.x }}</ref><ref>{{cite journal |vauthors=Busto U, Sellers EM | title = Pharmacokinetic determinants of drug abuse and dependence. A conceptual perspective | journal =Clinical Pharmacokinetics | volume = 11 | issue = 2 | pages = 144–153 | year = 1986 | pmid = 3514044 | doi = 10.2165/00003088-198611020-00004 | s2cid = 41959044 }}</ref>