What is Clonazepam?

Clonazepam belongs to the benzodiazepine family of drugs that includes alprazolam (Xanax), diazepam (Valium), flurazepam (Dalmane) and lorazepam (Ativan), etc. It is an anti-anxiety drug that enhances how the neurotransmitter GABA (gamma-aminobutyric acid) affects the brain. GABA works by inhibiting excessive brain activity that is believed to cause anxiety and other psychiatric disorders. Clonazepam is used mainly for the treatment of panic disorders and the prevention of particular types of seizures.1

Clonazepam comes in tablet form, a wafer that dissolves in the mouth, an oral solution and an injectable solution. It is marketed under the brands Klonopin and Rivotril®. It takes up to 60 minutes for it to take effect and its sedative action can last for several hours.2

Brief History of Clonazepam

Back in the 1950s, anxiety and other conditions that require sedation were treated mainly with barbiturates. Barbiturates, however, have a very high potential for abuse, addiction, and accidental overdose. Therefore there became a need for a safer class of medications.

In 1956, Polish-Jewish chemist Leo Sternbach who was then working for Hoffman La Roche accidentally discovered chlordiazepoxide (Librium), the first benzodiazepine in the market. It was finally approved and made available in 1960. It was closely followed in 1963 by Valium, generally regarded as the improved version of Librium. By 1964, Hoffman La Roche thru Leo Sternbach has developed and patented Clonazepam (Klonopin). By 1975 the company has made it available mainly as a treatment for epileptic seizures.

Klonopin steadily rose in popularity since its introduction to the market. Unfortunately, it has also become a popular DOA (drug of abuse). It is actually one of the most abused drugs after opioids because it is widely prescribed for anything from panic attacks to weight control. Its spread as a DOA is reminiscent of the rise of Valium as the sedative of choice for an entire generation of frustrated suburban wives bored with their lives.3

Street Names for Clonazepam

People who use Klonopin for non-therapeutic purposes often obtain the drug illegally and therefore find the need to call it other names. Friends and family members of known Klonopin users will find it helpful to know what the street names are in order to tell if their loved one may be abusing the drug.

  • K-Pin – the most popular street name for Klonopin
  • Benzos – because Klonopin belongs to the benzodiazepine family
  • Downers – a common street name for CNS depressants like Klonopin
  • Super Valium – because Klonopin effects are similar to those of Valium
  • Pin – from Klonopin
  • Klons – from Klonopin
  • Tranks – short for tranquilizers

Clonazepam Drug Type

Clonazepam is a central nervous system depressant, downer or tranquilizer. It affects the brain by slowing down its activity, which helps induce sleep or cause deep relaxation. Depressants are typically prescribed for sleep disorders and anxiety. Other substances of the same type include:

DEA Drug Class

The Controlled Substances Act lists clonazepam as a Schedule IV drug. Schedule IV substances fall under the following criteria:4

  • have current medical application in the U.S.;
  • have a low potential for abuse;
  • may cause limited physical or psychological dependence.

Other examples of Schedule IV drugs include:

  • Acetaminophen
  • Alprazolam (Xanax)
  • Carisoprodol (Soma)
  • Chlordiazepoxide (Librium)
  • Diazepam (Valium)
  • Lorazepam (Ativan)
  • Midazolam (Versed)
  • Naloxone/Pentazocine
  • Oxazepam
  • Phentermine (Ionamin)
  • Temazepam (Restoril)
  • Tramadol
  • Triazolam (Halcion)

Uses for Clonazepam6

  • Klonopin is also widely used to stop seizures and control the often harsh withdrawal symptoms of drug or alcohol addiction during detox treatment. Klonopin metabolizes slower compared to other benzodiazepines so it does not have to be taken as frequently.
  • Recreationally, Klonopin is used for its long-acting calming or tranquilizing effects. People battling stress and anxiety on a day to day basis turn to the drug to escape the pressure and achieve some semblance of peace.

Side Effects of Clonazepam

The most common side effect of Klonopin is sedation but there is one serious adverse reaction that patients and those close to them should be made aware of. Anti-epileptic drugs such as Klonopin have been linked with an increased risk of suicidal thoughts and behavior. Patients beginning anti-epileptic therapy should be closely observed for behavioral changes. Common side effects of clonazepam use include:

  • Amnesia
  • Changes in sexual desire
  • Confusion / Disorientation
  • Depression
  • Dizziness / Unsteadiness
  • Fatigue / Weakness
  • Headache
  • Irritability
  • Lack of inhibition
  • Rash
  • Sleep disturbance

Other serious side effects of clonazepam use may include:

  • Blood disorders
  • Fainting
  • Increased heart rate
  • Liver enlargement
  • Low blood pressure
  • Respiratory depression

Clonazepam, Pregnancy & Breastfeeding7

The benzodiazepine family of drugs is associated with congenital malformations when taken by pregnant women during the first trimester. Klonopin should be avoided by pregnant women for the duration of their pregnancy but especially during the first trimester.

Klonopin also gets into breastmilk so it is best for nursing moms to avoid using the drug for as long as they are breastfeeding their newborn.

Clonazepam Abuse & Addiction

While it may not be easy for family members and friends to know for sure if their loved one is abusing drugs, there are always signs and symptoms to watch out for. If the family member is a known user of Klonopin for a legitimate medical condition, it follows within reason that this person may develop some form of dependence on the drug even if they use it as prescribed especially if they’ve been on it for at least 30 days.

Psychological addiction is when the user enjoys the “high” from using Klonopin, leading to cravings that drive the person to use it just to experience that same high and not for the medical reason for which it was prescribed.

Physical dependence is when the user’s body develops a tolerance for the drug because of the regular use. Tolerance results in the need to use more of the drug to achieve the same effect.

Using Klonopin beyond the dosage prescribed by the doctor is indicative of abuse. Trying to obtain Klonopin without a valid prescription, or doctor-shopping to obtain multiple prescriptions for Klonopin is also characteristic of someone who is developing or has already developed dependency/addiction.

Clonazepam Withdrawal Symptoms

Physical Symptoms

  • Diarrhea
  • Dizziness
  • Drowsiness
  • Hallucinations
  • Memory loss
  • Nausea & vomiting
  • Panic attacks
  • Rapid heartbeat

Behavioral Signs

  • Anxiety
  • Confusion
  • Difficulty concentrating
  • Disinterest in hobbies
  • Financial irresponsibility
  • Irritability
  • Weak performance (at school or at work)

Clonazepam Overdose

Overdosing on Klonopin can be very dangerous, especially when taken with alcohol or other drugs. If an overdose is suspected, seek emergency medical help. Symptoms of a clonazepam overdose include:

  • Dizziness
  • Confusion
  • Slow reflexes
  • Muscle weakness
  • Fainting
  • Coma

Clonazepam Abuse Treatment

All is not lost. There are treatment programs for people who have developed Klonopin addiction or dependency, but treating any addiction is a highly individualized process and should be done by trained professionals.

Withdrawal from benzodiazepines like Klonopin can be harsh and dangerous. Detoxification supervised by medical practitioners is a critical first step. After the detox process, treatment will continue either by outpatient arrangement or a residential program in rehabilitation facilities. For either case, the patient will receive group and individual therapy sessions.

Medication is often included in the program to help the patient cope with the withdrawal symptoms. This is where regular clinical drug testing will come in, as a monitoring tool that rehab counselors can use to check their patient’s adherence to the medication program.

Testing for Clonazepam

As clonazepam has anxiolytic properties, it is often prescribed in the management of addiction to some drugs and/or alcohol. Many addiction clinics test for clonazepam using saliva drug tests. The problem there is that clonazepam, like other benzodiazepines, is quite challenging to detect in saliva. Clonazepam’s primary metabolite 7-aminoclonazepam (ACL) has been found to be superior to CLON for detection of clonazepam in oral fluids.

Screening Cut-off and Detection Time for Clonazepam

In drug testing, the cut-off level marks the point at which a drug metabolite is detected without a doubt that it might be a false positive. A negative result, of course, does not mean that the sample is drug-free, only that the concentration level may be too low that it falls below the established cut-off.

Specimen

Concentration Cut-off Level

Detection Time

Saliva

100 ng/ml 

3-days


Sources:

1https://www.medicinenet.com/clonazepam/article.htm#what_is_clonazepam,_and_how_does_it_work_(mechanism_of_action)

2 https://blackbearrehab.com/klonopin-addiction/recreational-use-issues/

3 https://www.prescriptiondrugabuse.org/Klonopin-History.htm

4 https://www.dea.gov/druginfo/ds.shtml

 5https://www.pharmacy.umaryland.edu/media/SOP/medmanagementumarylandedu/ControlledSubstanceList.pdf

6https://www.medicinenet.com/clonazepam/article.htm#what_are_the_side_effects_of_clonazepam

7https://www.medicinenet.com/clonazepam/article.htm#what_else_should_i_know_about_clonazepam

8 https://blackbearrehab.com/klonopin-addiction/what-are-street-names-for-clonazepam/

9 https://www.msacl.org/2015_US_Long_Abstracts/201412191303_66455.pdf

For Further Reading:

https://casapalmera.com/top-8-drug-categories/

http://www.treatment4addiction.com/drugs/society/csa/



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