Tranquillisers, minor tranquillisers, tranx, downers, benzos
Diazepam (Valium), vallies, blues
Alprazolam (Xanax)
Lorazepam
Temazepam, jellies, eggs
Flunitrazepam (rohypnol), roofies, R2
Phenazepam, kronic, bonsai
Nitrazepam, Oxazepam, Chlordiazepoxide (Librium), Lorprazolam
What are Benzodiazepines?
Benzodiazepines are a class of sedative medicines and are among the most commonly prescribed drugs for anxiety and insomnia. They can be short-acting or long-acting.
Short-acting benzodiazepines, such as temazepam and flunitrazepam (Rohypnol), are typically prescribed as sleeping tablets (hypnotics). Longer-acting forms, including lorazepam and diazepam (often known by the brand name Valium), are commonly used to treat anxiety (anxiolytics). Diazepam is one of the most widely prescribed benzodiazepines in the UK.
These medicines usually begin to take effect within 30 to 90 minutes, which makes them useful for the short-term relief of acute anxiety symptoms.
Benzodiazepines are also used in a range of other medical settings. These include:
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As muscle relaxants
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Before medical or surgical procedures to reduce anxiety
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To treat seizures, including epilepsy
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In the management of acute mania
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To manage symptoms of alcohol withdrawal
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As part of treatment for opioid withdrawal
Alongside legitimate medical use, benzodiazepines are also used non-medically and recreationally in the UK.
Street benzodiazepines
In addition to prescribed medicines, there are “street benzodiazepines” that are not licensed for medical use in the UK. Some may be licensed in other countries, while others are illicitly manufactured or sold as research chemicals (often grouped under new psychoactive substances).
Public Health Scotland’s Rapid Action Drug Alerts and Response (RADAR) system has warned about the detection of new and emerging benzodiazepines in the illicit drug market. These include substances such as ethylbromazolam, as well as the re-emergence of drugs like clonazolam. They found that high levels of prescribed benzodiazepines, including diazepam and temazepam, also continue to be found in the illegal drug supply.
How they work
Benzodiazepines increase the levels of a brain neurotransmitter called GABA (Gabba Amino Butyric Acid). GABA has a calming effect on the brain.
History
Tranquillisers were first manufactured in the 1960s as non addictive drugs which could be used to treat anxiety and insomnia. They were developed as a safer alternative to barbiturates which had proven to be addictive and could be highly dangerous in overdose.
Although many people, particularly women, suffered side effects and dependence, the prescribing of tranquillisers continued to grow for over 20 years. It was not until the late 1970s that these problems were openly acknowledged. Prescriptions for tranquillisers fell from just over 30 million in 1979 to around 11 million in 2012, then to 1.4 million in 2019 (see prevalence section below).
Benzodiazepines have a long history of recreational use. They are taken for their relaxing and sedating properties.
Effects/risks
Benzodiazepines (sometimes referred to as tranquillisers) are depressant drugs. They slow down brain activity, which can reduce anxiety but may also slow reactions and impair thinking.
Common short-term effects include:
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Drowsiness and sedation
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Slowed reactions
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Poor concentration and memory problems
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Dizziness or vertigo
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Headaches
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Reduced libido
While benzodiazepines can relieve anxiety and tension and may create a sense of calm or detachment, they can also impair judgement and coordination. Effects usually begin within around 30 minutes of taking the drug and may last several hours, depending on the specific medicine and dose.
“It’s like a dream state. It gets you away from it all. It cushions you so you don’t worry or care anymore. You don’t really know what is going on”.
Tolerance and dependence
Current clinical guidance recommends that benzodiazepines are prescribed for short-term use only, usually no longer than two to four weeks. This is because tolerance can develop, meaning higher doses are needed to achieve the same effect.
Tolerance can develop after just 6 months of use, but it is possible to become physically dependent sooner. One study estimates that up to 44% of chronic users become dependent.
Withdrawal
Stopping benzodiazepines suddenly, particularly after prolonged or high-dose use, can be dangerous.
Withdrawal symptoms may include intense anxiety, nausea, insomnia, irritability, dizziness and headaches. In more severe cases, especially where high doses have been used, withdrawal can lead to confusion, hallucinations, and seizures. For this reason, benzodiazepines should not be stopped abruptly. Gradual dose reduction under medical supervision is usually recommended.
Withdrawal symptoms can last for several weeks and, in some cases, longer.
“Temazepam took over my life. It creeps up on you and is very addictive. I started using to bring me down from acid trips to make me feel normal. I liked them and started to use more and more. And that’s when the problems really started because I couldn’t leave them alone”.
Overdose and additional risks
Fatal overdose from benzodiazepines alone is less common than with opioids. However, the risk increases significantly when benzodiazepines are taken with other depressants, particularly alcohol or opioids. Combining these substances can suppress breathing and increase the risk of death.
There have been reports of people fatally overdosing from benzodiazepines especially when are taken with other depressants, particularly alcohol or opioids.
Public Health Scotland’s Rapid Action Drug Alerts and Response (RADAR) system has warned that drugs sold as benzodiazepines may contain other substances. These have included nitazenes (opioids) and medetomidine (a veterinary anaesthetic). In addition, tablets purchased online or through illicit markets may appear legitimate but can vary widely in strength and content.
Deaths
Even though prescriptions for benzodiazepines have been falling, deaths where a benzodiazepine was implicated have increased over the past decade across the UK. The ONS statistics for Deaths related to drug poisoning, England and Wales published in October 2024 show that in 2023 there were 512 deaths involving benzodiazepines. Since 1993 when their records began the number of deaths has been trending upwards, reaching a peak in 2021 (538 deaths). According to recent research – Impact of ‘street’ benzodiazepines on drug-related deaths in England, Wales and Northern Ireland – while deaths following street benzodiazepine use are increasing, most benzodiazepines detected in deaths were prescribable but were often illicitly sourced.
Harm reduction
- The effect of slowing reactions and making people drowsy can make accidents more likely. It can be dangerous to drive while on tranquillisers.
- As with all drugs it is best to take benzodiazepines with people you trust rather than on your own and to start with a small dose and wait.
- Alcohol can interact with benzodiazepines so is best avoided, as is using different types of benzodiazepines together.
- Crushing down tranquillisers in a solution is very dangerous as the tablets often contain chalk which can lead to collapsed veins.
- It is best not to take benzodiazepines for more than 4 weeks due to the tolerance and dependence that can develop.
- Benzodiazepines should never be stopped suddenly. Always reduce their use gradually with your doctor’s supervision.
The law
All benzodiazepines are Prescription Only Medicines under the Medicines Act. This means they can only be legally supplied by a pharmacist in accordance with a doctor’s prescription.
They are also controlled as a class C drug under the Misuse of Drugs Act. In November 2023 the government announced that a short acting benzodiazepine drug named remimazolam will also be controlled as a Class C drug. Its legitimate medical uses will then be enabled through amendment to the Misuse of Drugs Regulations 2001.
The maximum sentence for possessing is 2 years imprisonment. The maximum sentence for supplying to someone else and for production is fourteen years and a fine.
In practice maximum sentences are rarely used, for more information please see the sentencing page on the Release website.
According to Seizures of drugs in England and Wales, financial year ending 2021, 40% of all seizures of Class C drugs involved benzodiazepines.
Prevalence
The 2018/19 Home Office survey of drug use estimated that in the last year 0.4% of adults aged 16 to 59 had taken tranquillisers in the last year.
Prescribing trends
PHE’s analysis published in September 2019 shows that 1.4 million (3%) of people received a prescription for a benzodiazepine in the UK. The latest numbers for benzodiazepine prescribing can be found on OpenPrescribing, a website where you can search for drugs to see how many items are prescribed in the UK over time.
In the US, according to statistics from the National Institute on Drug Abuse (NIDA)’s 2020 Misuse of Prescription Drugs Research Report 2.2% (or about 6.2 million people) reported misusing prescription tranquillisers or sedatives in the past 12 months.
Prevalence of recreational use
Among street drug users, benzodiazepines have long been part of the drug ‘mix’ along with heroin, crack, alcohol and more recently synthetic cannabinoids generally known as spice. Traditionally, the sources of benzodiazepines on the street have derived from diverted medical prescriptions or simply prescriptions prescribed to users themselves.
However, in recent years, a range of illicitly produced benzodiazepines have become widely available across the UK. Not all these variants are controlled under the Misuse of Drugs Act and they often contain dangerous levels of the drug. For more information see Novel Benzodiazepines: A review of the evidence of use and harms of Novel Benzodiazepines, (PDF) ACMD, 2020. In July 2020, MHRA issued an alert on Evidence of harm from illicit or fake benzodiazepines. This alert advised on the availability and harm from illicit drugs sold as benzodiazepines, particularly when used in conjunction with alcohol and other drugs with a respiratory depressant effect, including gabapentinoids and opioids.
In June 2021, The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) published an in-depth report providing a review of the current body of knowledge regarding new benzodiazepines that are monitored by the EU Early Warning System.
Read more
DrugWatch Information Sheet: Etizolam
Updated February 2026