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Abuse of Klonopin can lead to addiction and physical dependence. People who have become dependent on the drug should work with a physician or addiction treatment program to gradually reduce the dose (taper), as stopping abruptly can be dangerous and even life-threatening.
How Is Klonopin Used?
Clonazepam, also known by the brand name Klonopin, is a prescription sedative medication used to treat panic disorder and seizure disorders. Specifically, it is aimed at treating Lennox-Gastaut syndrome, akinetic, and myoclonic seizures.1Klonopin is in the benzodiazepine class of drugs and is believed to achieve its effects by enhancing the activity of the neurotransmitter gamma-aminobutyric acid (GABA), which is the main inhibitory neurotransmitter in the brain.1
What Are the Effects?The intended effect of Klonopin is to reduce the occurrence of seizures or panic attacks. Despite its therapeutic benefits, use of the drug may have some side effects, including:2Feelings of tirednessDepression (mostly found in adults).Irritability.Dizziness.Coordination and balance issues.Problems with concentration.Memory and attention problems.Nausea.Loss of appetite.Serious side effects include:3Increased heart rate.Low blood pressure.Respiratory depression.Difficulty breathing.Drowsiness.Impaired speaking.Loss of consciousness.Loss of pleasure (anhedonia).Depressed mood.Suicidal ideation.According to the National Alliance on Mental Illness (NAMI), many drugs may interact with Klonopin.Concurrent use of ketoconazole, itraconazole, nefazodone, fluvoxamine, and cimetidine may increase the blood levels and effects of clonazepam.3Concurrent use of carbamazepine, phenytoin, and phenobarbital may decrease levels of the drug, making Klonopin less effective.3
Combining Klonopin and other benzodiazepines, alcohol, and opioids can lead to slowed breathing, coma, and death.
Likewise, combining Klonopin with alcohol, sleeping pills, opioids, anti-anxiety medications, antipsychotic medications, other anticonvulsants, antidepressants, and antihistamines can cause increased drowsiness. Combining Klonopin and other benzodiazepines, alcohol, and opioids can also lead to slowed breathing, coma, and death.3In addition to experiencing adverse side effects, it is possible to overdose from taking too much clonazepam—and this risk is increased when it is combined with alcohol and other drugs. If you observe someone experiencing an overdose, call for emergency medical help right away.
Signs and symptoms of overdose include:1Poor reflexes.Confusion.Extreme drowsiness.Coma.Flumazenil is a drug that can partially or completely reverse the effects of a clonazepam overdose. However, it is used in emergency settings as a part of overdose treatment and not as a substitute for it. By blocking the benzodiazepine effect of clonazepam, flumazenil administration could result in seizures in susceptible patients—so it will be administered by the emergency team with caution.1
How Long Does It Stay in Your Body?Due to its long half-life of 20-50 hours, clonazepam stays in the body for a longer time than other drugs with relatively shorter half-lives. The half-life of a drug refers to the amount of time it takes a person’s body to eliminate half of the dose.4
The following are some general timeframes for how long Klonopin will show up on different types of tests based on case studies.
It is important to note that Klonopin may not show up on common urine tests. The test may be able to show that the drug is present, but it may not be able to determine the amount.5In one study, traces of clonazepam’s major metabolite 7-aminoclonazepam were detectable on a urine test for up to 3 weeks after a single 3mg dose, and one of the participants in the study tested positive 28 days after the last dose. However, the Mayo Clinic states that long-acting benzodiazepines such as clonazepam may be detected in the urine for up to 30 days.6,7In one study, 7-aminoclonazepam was detectable in the hair of 6 out of 10 participants after they took a single 3mg dose. In 2 participants, it was detectable for 28 days. In 2 participants, it was detectable on the 21st day, and in 2 participants, it was detectable on the 28th day.8Saliva tests have a detection window of up to 5 and 6 days following last use.9
Individual factors can affect the result of a test, including:5,7Age.Gender.Health.Weight.pH of urine.Urine concentration.When the last dose was taken.Amount taken.Frequency of use.
How Do You Detox From Klonopin?Klonopin is a Schedule IV controlled substance, which means it has some potential for abuse and physical or psychological dependence. Physical dependence can develop after just 2 weeks of taking the drug daily, explains the National Alliance on Mental Illness (NAMI). It is possible to develop some amount of physiological dependence even when taking the drug exactly as directed by your doctor.3
If you have been abusing Klonopin, a medical detox program can help ensure a safe withdrawal.
NAMI warns that clonazepam use should not be stopped abruptly or without talking to your doctor first. If stopped too abruptly, unpleasant side effects are likely to occur, and some can even be life-threatening. Withdrawal symptoms include:3,10Anxiety.Insomnia.Irritability.Dizziness.Sweating.Nausea.Vomiting.Changes in blood pressure.Increased heart rate.Hallucinations.Tremors.Seizures.Withdrawal symptoms may not develop for more than a week, reach peak intensity during the second week, and fade during the third or fourth week.10If you have been taking the medication under the care of a physician, you can work with them on a tapering schedule to gradually reduce the dose. The recommended tapering schedule is to decrease the dose by 0.125mg every 3 days until you are no longer taking the drug. However, talk to your doctor to determine the best dose for you.1If you have been abusing Klonopin, a medical detox program can help ensure a safe withdrawal. These programs can help you safely taper off the drug—as well as any other drugs you have been using—and treat any complications that arise.
How Easy Is It to Become Addicted to Klonopin?
People who become addicted to Klonopin and develop significant physical dependence might require the safety and supervision of a medical detoxification program followed by formal addiction treatment. There are many options available for addiction treatment, including inpatient and outpatient programs. Programs often include individual and group therapy, skill-building sessions, addiction education, medical services, and continuing care plans.
Effective treatment programs recognize that no single treatment will work for everyone, and treatment plans should be individually tailored and continually reviewed and updated. Treatment must also address any co-occurring substance use or mental health disorders in order to prevent relapse.12 For example, people who started taking Klonopin for panic disorder and began abusing it need treatment for their panic disorder and substance abuse. Otherwise, they may begin abusing substances again if their panic symptoms resurface.
If you’re ready to get help for an addiction to Klonopin or another substance, begin exploring your options today.
<1>. Food and Drug Administration. (2017). Klonopin Tablets (clonazepam).
<2>. Epilepsy Foundation. Clonazepam.
<3>. National Alliance on Mental Illness. (2019). Clonazepam (Klonopin).
<4>. Epocrates. Clonazepam.
<5>. University of Rochester Medical Center. Benzodiazepines (Urine).
<6>. Negrusz, A. et al. (2003). Elimination of 7-aminoclonazepam in urine after a single dose of clonazepam. Analytical and Bioanalytical Chemistry, 376(8).
<7>. Moeller, K., Kissack, J., Atayee, R., and Lee, K. (2017). Clinical Interpretation of Urine Drug Tests: What Clinicians Need to Know About Urine Drug Screens. Mayo Clinic Proceedings.
<8>. Negrusz, A. et al. (2002). Deposition of 7-Aminoclonazepam and Clonazepam in Hair Following a Single Dose of Klonopin. Journal of Analytical Toxicology, 26, 471-478.
<9>. Nordal, K., Oiestad, E.L., Enger, A., Christophersen, A.S., and Vindenes, V. (2015). Detection Times of Diazepam, Clonazepam, and Alprazolam in Oral Fluid Collected From Patients Admitted to Detoxification, After High and Repeated Drug Intake. Therapeutic Drug Monitoring, 37(4), 451-460.
<10>. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
<11>. Longo, L., and Johnson, B. (2000). Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. American Family Physician, 61(7), 2121-2128.
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