Klonopin Use and Abuse

Top 15 Essential Questions and Answers

Klonopin Use and Abuse

Top 15 Essential Questions and Answers

Introduction

In 2013 and 2014, Klonopin ( and it’s generic name, clonazepam) ranked 13th in the list of top 15 drugs involved in overdose deaths, causing 946 and 1,130 deaths, respectively. Likewise, in 2015, clonazepam ranked 12th, causing 1,328 deaths.1 In the illegal market, one pill of Klonopin is available for just $5 to $10.

The addiction potential of Klonopin is less than narcotics such as hydromorphone (Dilaudid), methadone (Dolophine), and meperidine (Demerol). Nonetheless, easy availability and low cost make it a potential candidate for abuse.

If your doctor has prescribed Klonopin for you, make sure to use the medication only as prescribed. The best way to do it is to understand its effects, side effects, and addiction potential.

What is Klonopin?

Klonopin is a brand of a drug known as clonazepam but is also available in generic versions. This drug is available only on a doctor’s prescription.

Clonazepam is a type of benzodiazepine with a long half-life. Drugs with long half-lives stay in your body for longer periods. Thus, they have reduced dosing frequencies. This means you will have to take them less often compared to drugs with short half-lives.

Examples of benzodiazepines include alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium), and temazepam (Restoril).

Klonopin acts on your central nervous system (CNS). It increases the activity of a brain chemical called gamma-aminobutyric acid (GABA). GABA blocks certain activities in the brain and helps you stay calm. Reduced GABA levels can cause the body to enter into an excited state. This may lead to anxiety, panic attacks, and convulsions.

This drug is available in the form of oral tablets. Both conventional tablets and dispersible tablets are available. The strength of the drug ranges from 0.125 mg to 2 mg.

Is Clonazepam a Controlled Substance?

Clonazepam is a schedule IV controlled substance.2
Schedule IV controlled substances are typically less addictive than Schedule II and III substances, such as narcotics. Other benzodiazepines in Schedule IV include alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), and triazolam (Halcion).

What are the Street Names for Klonopin?

Pin and Kpin are the most commonly used street names for Klonopin. However, people may also use other terms, such as:

  • Benzos: for drugs that belong to the benzodiazepine class
  • Downer: because Klonopin has CNS depressant effects
  • Tranks: derived from the term "tranquilizers" or "tranquilizing agents"
  • Nerve pills: refers to the action of Klonopin on the brain cells (nerves)
  • Candy: refers to the pill form of the drug

What is Klonopin Used For?

Klonopin, along with alprazolam (Xanax), diazepam (Valium) and lorazepam (Ativan), ranks among the top 100 most commonly prescribed medications in America.3

Doctors prescribe clonazepam to treat panic disorder (anxiety attack) and seizures. Your doctor may also prescribe this drug to treat conditions other than approved by the FDA. This is called off-label use.

The off-label uses of Klonopin include the following conditions:4

Shakiness due to a brain disorder (essential tremor)

Abnormal behaviors that occur during sleep (parasomnia)

Burning sensations in the mouth (burning mouth syndrome)

Involuntary movements of the lips, tongue, face, and limbs (tardive dyskinesia)

Doctors typically prescribe Klonopin for short periods only. In some cases, they may prescribe it on an “as-needed” basis. That said, you should keep in mind that only your doctor can determine how long you should take it.

One out of every four persons using benzodiazepine takes the long-acting forms of the drug, such as Klonopin.5 Between 1996 and 2013, the number of benzodiazepine prescriptions increased by more than 60%, from 8.1 million to 13.5 million.6 Women are twice as likely as men to get a benzodiazepine prescription.

How Long Does It Take for Klonopin to Work?

Usually, Klonopin reaches the peak concentration in the blood 1 to 4 hours after you take it. Clonazepam and its breakdown products (metabolites) reach their peak concentrations 2 hours after a 2 mg dose is taken.

Benzodiazepines including Klonopin, are fast-acting drugs. It means these drugs usually provide immediate effects. Several factors can affect how long a drug takes to work, such as:

Age

Digestive health

General health

Dose of the drug taken

How Long Does Klonopin Last?

Klonopin is a long-acting benzodiazepine. After a single dose in adults, its effects can last up to 12 hours.7

How Long Does Klonopin Stay in Your System?

The elimination half-life of Klonopin ranges from 30 to 40 hours,8 meaning it takes 30 to 40 hours for half of the ingested drug to leave your body. For example, if you take a 1 mg tablet, 0.5 mg of the drug will leave your body within the next 30 to 40 hours. That way, it would take approximately two weeks for the entire drug to leave your system after the last dose. However, in people with liver disease, the drug may stay in the system for longer periods.

How Long Does Klonopin Stay in Urine?

Urine tests for Klonopin may be necessary if a person has signs and symptoms of substance abuse. Urine tests (also called toxic urine screen or urine toxicology screen) can detect the breakdown products (metabolites) of Klonopin in the urine sample.

Studies reveal that more than 98 percent of ingested clonazepam is metabolized in the body. This means less than 2 percent of the unchanged drug is found in urine. The major metabolite of Klonopin is 7-aminoclonazepam.

However, you should keep in mind that standard urine tests might not detect Klonopin in the urine sample. In such situations, specialized tests may be necessary.

Detectable amounts of 7-aminoclonazepam may be present in urine within 3 to 4 weeks after the last dose.9
Typically, the concentration of 7-aminoclonazepam in urine reaches its peak a day after administration.

Several factors can affect the detection time of Klonopin. These include:

Dose of the drug

Weight of the person

Duration of the drug use or abuse before the test

pH of the urine

How Long Does Klonopin Stay in Hair?

Analysis of hair samples reveals that detectable amounts of 7-aminoclonazepam may be present in your hair 3 weeks after the last dose.10
Most notably, you may test positive even if you had only a single dose of the drug in the past three weeks.

What are the Side Effects of Klonopin?

In addition to the desirable effects, a drug may cause other unwanted effects. Some side effects may go away on their own as treatment progresses. However, some may be severe and require you to stop taking the drug.

Drowsiness and loss of voluntary control of muscle movements are the most common side effects of Klonopin. These side effects may affect up to half of those who take the drug. Other side effects include:

  • Racing heartbeats
  • Rashes
  • Loss of hair
  • Facial swelling
  • Loss of appetite
  • Diarrhea/constipation
  • Nausea
  • Dry mouth
  • A decrease in the number of blood cells that carry oxygen
  • Changes in the number of blood cells
  • Swelling of the liver
  • Muscle weakness
  • Headache
  • Slowed breathing
  • Breathing difficulties
  • Mood changes
  • Depression
  • Seeing or hearing things that are not there
  • Nightmares
  • Speech problems
  • Excessive sleepiness
  • Changes in weight
  • Irregular periods
  • Delayed or decreased ejaculation

Life-Threatening Side Effects

Rarely, clonazepam may cause potentially life-threatening effects. Thus, it has a black box warning. Prescription drugs that carry serious or potentially life-threatening risks must have a black box warning on the label.11

Dangers From Narcotics

Clonazepam may cause dangerous effects if you take it with narcotic drugs. If you take clonazepam with a narcotic drug, your doctor will monitor you to avoid such effects. Narcotic drugs include hydrocodone, codeine, and tramadol.

Cancer Risk

Long-term use of clonazepam may increase the risk of cancer.12 Animal studies suggest that prolonged clonazepam use may increase the risk of thyroid cancer.

If you experience severe or persistent side effects, talk to your doctor or pharmacist immediately.

Is Klonopin Addictive?

It is true that Klonopin is less addictive than narcotics. Nevertheless, increasing numbers of prescriptions and emergency department visits indicate the rising incidence of Klonopin addiction.

IMS Health reports that there were 29.2 million clonazepam prescriptions in the US in 2017. Likewise, in 2008, clonazepam was involved in 48,400 emergency department visits, second only to alprazolam.13

Klonopin Addiction Symptoms

The symptoms of Klonopin addiction develop because of imbalances in the levels of certain brain chemicals. Over time, these imbalances can affect both the mind and the body.

The common symptoms of Klonopin addiction include:

Excessive sleepiness

Slowed response

Depression

Psychosis

Memory problems

Restlessness

Increased aggression

Nausea and vomiting

Klonopin Addiction, Abuse and Withdrawal Symptoms

Many people use the terms addiction, tolerance, abuse, and dependence interchangeably. However, they are not the same.

Addiction

According to the National Institute on Drug Addiction (NIDA), addiction is a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.14

Scientists understand addiction is a brain disorder. This is because addiction changes certain brain functions related to regulating reward and self-control. In some cases, these changes may last even after the substance abuse has ended.

Tolerance

Tolerance develops when a person needs a higher dose of the drug to experience the effects they used to get with a lower dose. Thus, people who have developed a tolerance take more and more of a drug to get the desired effect.

Abuse

People who abuse Klonopin take the drug for experiencing pleasurable effects. They use the drug in larger amounts or for longer periods than recommended.

Klonopin abuse signs may include:

Intense cravings that do not go away

Continued use of the drug in spite of negative health effects

Inability to quit abusing the substance alone

Deteriorating performance at work

Legal or financial problems due to drug use

Dependence

Dependence develops when a person cannot function normally without using a drug. Within a short period after stopping the drug, a person develops a group of physical and mental symptoms called withdrawal symptoms. Withdrawal symptoms can be mild or fatal.

Withdrawal Symptoms

People who suddenly stop taking Klonopin may experience:

  • Headaches
  • Problems with respiration
  • Elevated blood pressure
  • Stomach pain
  • Nausea
  • Shakiness
  • Excessive sweating
  • Seeing or hearing things that are not there
  • Dizziness
  • Tiredness
  • Mental confusion
  • Anxiety
  • Depression
  • Severe mood swings
  • Intense cravings
  • Nightmares
  • Loss of motivation
  • Inability or reduced ability to experience pleasure
  • Seizures
  • Suicidal thoughts
  • Sleep problems
  • Muscle cramps

Klonopin withdrawal symptoms typically develop 1 to 3 days after the last dose. The symptoms peak 14 days after the last dose and can last up to several days, months, or even years.

Can You Overdose on Klonopin?

Overdose deaths involving benzodiazepines increased from 0.6 per 100,000 adults in 1999 to 4.4 per 100,000 in 2016.15
Among women, benzodiazepine overdose deaths increased by a whopping 830% between 1999 and 2017.16

Drinking alcohol or using illegal drugs with Klonopin increases the risk of accidental overdose. Besides, doing so can make your condition worse or cause more severe side effects.

The signs and symptoms of Klonopin overdose include:

Mental confusion

Loss of coordination

Slowed reflexes

Coma

Death

If you or anyone you love shows signs of Klonopin overdose, call your doctor or 911 immediately. You may also call 1-800-222-1222 to contact the poison control center.

A medication called flumazenil can reverse the effects of Klonopin overdose. However, only a doctor can determine if this medication can help you. It must be injected into a vein at a hospital.

What are the Effects of Klonopin Abuse and Addiction?

Long-term Klonopin abuse significantly increases the risk of developing an addiction, affecting almost every aspect of your life.

Health Issues

Worsening depression

Sleep problems

Psychosis

Seizures

Liver disorder

Memory problems

Increased risk of overdose

Impaired sexual performance

Personality changes

Legal Issues

Charges for illegal use of the drug or drug possession

Driving under the influence of the drug

Charges for doctor shopping, prescription misuse, or buying on the street

Social Issues

Strained relationships

Divorce

Social isolation

Financial Issues

Job loss

Debt

What is Klonopin Addiction Treatment?

Timely treatment is critical to minimizing the risk of complications and successful outcomes. Treatment aims to stabilize emotional and physical health and help support a drug-free life.

Treating Klonopin addiction may require a stay at a rehabilitation center for 30 days to 3 months. The length of stay depends on the severity of addiction and the response to treatment. Before you decide to stay at a center, make sure to talk to family members about the costs and insurance coverage.

The steps of Klonopin addiction treatment can include:

Addressing Intoxication

People often abuse Klonopin to experience its effects. Studies suggest that short-term abuse has effects similar to those of alcohol intoxication, such as slurred speech, problems with focus, and unsteady gait.

Supportive treatment may be necessary to facilitate breathing and to maintain optimal heart function. Once stability is regained, a doctor may give a drug to reverse the sedative effects of Klonopin.

Relieving Withdrawal Symptoms and Detoxification

Klonopin withdrawal symptoms are common among people who chronically abuse the drug. If left untreated, one in every five persons who have withdrawal symptoms eventually develop severe symptoms.17 Rarely, severe withdrawal symptoms can lead to death.

Detoxification or detox helps to remove the drug from your body. Drug therapy is usually the primary treatment for moderate to severe withdrawal. Because withdrawal symptoms are the opposite of sedative effects, a doctor may prescribe another sedative to treat withdrawal. It may be another benzodiazepine or non-benzodiazepine drugs, such as carbamazepine and gabapentin.

Treatment of withdrawal symptoms may require a hospital stay. This is more likely if a person has:

  • Been taking large doses of the drug
  • A history of seizures
  • Co-occurring mental illness
  • Long-term addiction treatment

Counseling

Motivational Interviewing (MI). MI is a type of talk therapy. It can help a person shift from a state of uncertainty to identifying motivations to make positive changes. In simple terms, MI motivates a person to stop drug use and attain predefined goals.

There are at least six sessions with specific tasks in each session. For example, the first session explains the objectives and rules of MI to the participants. In the sixth session, the interviewer gives and collects feedback. Each session lasts a week.

Cognitive-Behavioral Therapy (CBT). CBT is another type of talk therapy. It helps people identify triggers for drug use, life stressors, and appropriate coping skills.

Relapse Prevention Techniques. These techniques aim to practice avoiding the triggers that may cause a relapse.

What Should You Know About Klonopin Addiction Treatment?

There is no one-size-fits-all addiction treatment approach.

People with Klonopin addiction often have a co-occurring mental illness. Thus, treating mental illness is just as important as treating addiction.

Your immediate family members can help you choose a treatment program that best meets your needs.