Benzodiazepines are vital for anxiety treatment, but misuse and dependency are rising in Qatar. The country’s recognition of addiction as a chronic condition enables treatment programmes that not all nations offer.

Behind closed doors and in quiet conversations, benzodiazepine use in Qatar is emerging as a significant topic in mental health care.

As dependency can develop gradually, awareness is growing about how these medications are prescribed, used, and, at times, misused.

With new treatment approaches and expanding support systems, pathways to recovery are becoming more accessible.

What are benzodiazepines?

Benzodiazepines are a class of drugs commonly used for anxiety and panic disorders, as well as insomnia and muscle spasms. As brain depressants, they induce sedation, promote sleep, and reduce anxiety.

They work by slowing down the brain and nervous system, enhancing the effect of gamma-aminobutyric acid (GABA), a natural brain chemical that produces a calming effect.

Commonly prescribed benzodiazepines include Alprazolam (Xanax), Diazepam (Valium), Lorazepam (Ativan), and Clonazepam (Klonopin).

In Qatar, these drugs are classified as controlled substances, requiring valid prescriptions with proper documentation. Local pharmacies typically dispense them only following psychiatric referral and in tightly regulated quantities.

Addiction risks and effects

In 2020, the U.S. Food and Drug Administration (FDA) updated its boxed warning on all benzodiazepines to highlight the risks of abuse, misuse, addiction, physical dependence, and withdrawal.

People struggling with misuse often display noticeable behavioural changes. Some individuals resort to “doctor shopping,” visiting multiple physicians to obtain overlapping prescriptions.

Psychosocial effects are also common. Users frequently report increased anxiety, irritability, depression, mood swings, and sudden hostility — factors that can fracture relationships and deepen isolation.

Others may forge prescriptions or take higher doses for longer than the prescribed duration. Over time, this can lead to social withdrawal and an inability to meet responsibilities at work, school, or home.

According to Consultant Psychiatrist Dr Carl Henrik Blomgren of the International Medical Centre (IMC), one of the first signs of dependency is needing to increase the dose to achieve the same sedative effect.

“They stay  quite long in the body,  and they usually also metabolise into different kinds of structurally similar compounds in the body. What this means  is that you actually can build up a concentration after a while,” Dr Blomgren told Doha News.

 “Even though the primary effect is gone, you will still have it in the system. So, if you take it more and more often, you will not realise that you’re actually building up a base concentration in your body,” he said.

“Dependencies begin to transform into addictions when those struggling with misuse become compulsive, and when the need to seek out this medication begins to dominate their day-to-day life,” he added.

Long-term use, particularly among older patients, can cause memory impairments, including deficits in long-term or episodic memory.

“One other major concern is fall risks,” Dr Blomgren adds. “My main concern with benzodiazepine addiction is mainly the fall risk and also the delirium. You can actually get severe mental reactions by taking it for a long time.”

A gendered pattern of addiction

According to Professor Jallal Toufiq, the Chief Medical Officer at the Naufar Centre, benzodiazepine addiction is the only substance use disorder more prevalent among women globally — a trend reflected among patients in Qatar. He attributed this to accessibility and the least stigma surrounding benzodiazepines.

“I think it’s more easily accessible than the other drugs. It’s not illicit. They don’t have to take risks to go and get it,” Toufiq told Doha News.

“It’s often prescribed and misused, and also because it’s a tablet. They don’t need to sniff, they don’t need to inject.”

Physical dependence can develop quickly. Rapidly increasing tolerance requires higher doses to achieve the same effect.

“The risk of addiction increases with long-term use and what we call recreational misuse,” Professor Toufiq continues.

“Benzodiazepines lead to cognitive impairment and have significant mental health effects, including memory problems, impaired learning and concentration, emotional blunting, and a reduced ability to feel pleasure, because they are downers. They may also increase the risk of suicidal thoughts, particularly in people with severe depression.”

Though rarely fatal on their own, overdoses can be deadly when combined with respiratory conditions like asthma or sleep apnea.

“If someone with sleep apnea takes benzodiazepines, they might stop breathing during sleep and not return to normal breathing — potentially leading to respiratory failure. These are some of the serious side effects associated with benzodiazepine intoxication or misuse,” Toufiq explained.

Qatar’s response to substance abuse

In 2015, an Emiri decision recognised addiction as a chronic disease, paving the way for specialist treatment centres like Naufar.

The move was instrumental in reducing stigma, shifting perceptions of addiction from “deviant behaviour” to a treatable medical condition.

Naufar offers inpatient and outpatient programmes tailored to substance use disorders, including benzodiazepine dependency.

Professor Toufiq emphasised that the drug itself is not inherently dangerous — the issue lies in misuse, the way it is prescribed and monitored, and a lack of public understanding.

Benzodiazepines are on the World Health Organisation’s list of essential medicines.

“They render a huge service to the population, whether for psychotic conditions, neurological conditions, for anaesthesia, for pain management, in a lot of conditions. I cannot imagine, for example, the management of epilepsy without benzodiazepines in many cases. I cannot see the management of severe anxiety and anxiety disorders without benzodiazepines,” Toufiq said.

He emphasised the importance of striking a balance between access and control.

“Addiction is really a medical condition, and it’s a brain condition. It’s a chronic brain condition with relapses,” he added.

“It’s not deviant behaviour, and it’s not a crime. It’s a condition that needs to be treated as any other chronic condition, and I’m happy Qatar has [recognised] that because not all countries do.”