Treatment of benzodiazepine dependence usually involves gradual dose reduction and administration of specific drugs. The treatment goals are the complete resolution of symptoms, patient education (to prevent relapse), and assistance with cross-dependence to other sedatives or alcohol if necessary.

Benzodiazepine addiction treatment is a comprehensive program that helps individuals who are addicted to benzodiazepines. The program provides counseling and therapy, as well as medication-assisted treatment.

Benzodiazepines include medications such as alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam, oxazepam, and temazepam.

Benzodiazepines are generally safe and effective when used appropriately to treat anxiety symptoms, and they can also be very addictive and dangerous if misused. In the United States, it is estimated that about 4% of adults have abused these drugs at some point in their lives, and they now rank as the second most commonly used class of drugs after marijuana.

Benzodiazepines become a problem when people overuse them and develop a tolerance to the medication’s effects. People who take benzodiazepine drugs for more extended periods than recommended may develop a physical dependence on the medication.

Long-term use of benzodiazepines can cause serious side effects, including memory loss, depression, and an increased risk of developing Alzheimer’s disease or similar dementias. A person who has developed a physical dependence on benzodiazepine drugs will experience withdrawal symptoms if they stop using the medication abruptly instead of tapering off slowly.

Must Read: Benzodiazepines: Uses, types, side effects, and risks

Benzo Withdrawal Symptoms

Benzodiazepine withdrawal symptoms can be uncomfortable and challenging, but most people can detox successfully by attending a supervised medical detox program. These programs monitor the addict’s vital signs and provide medications to ease withdrawal symptoms.

Benzodiazepine abuse can lead to addiction, a serious concern for people who take these drugs daily. People with benzodiazepine addictions may find it very difficult to stop taking the medication without professional help; in some cases, treatment in a residential facility may be the safest option.

Benzodiazepine addiction is best treated with a combination of medication and behavior therapy. Doctors have found that certain medications, including antidepressants and anticonvulsants, can help people recover from benzodiazepine addictions by alleviating withdrawal symptoms and reducing cravings for the drugs.

Benzodiazepine addiction is a treatable condition, and many people who overcome it led healthy and productive lives.

The Risks of Benzodiazepine

There are many negative consequences of Benzo abuse and addiction, especially in the United States, where millions of individuals take these drugs each year. An overdose is fatal if a user’s breathing or heart rate falls so low that it stops altogether. When combining these potentially poisonous chemicals with other Central Nervous System (CNS) depressants like alcohol, which is often done while taking Benzodiazepines, the risk of a deadly overdose rises dramatically.

Benzodiazepine Side Effects, Adverse Reactions, And Other Risks

Abuse of benzodiazepines can produce dangerous side effects, both during and after usage or abuse. These adverse effects may appear immediately after the “high” has worn off.

• Mental confusion
• Anxiety
• Blurred vision
• Headaches
• Forgetfulness
• Irritability
• Fatigue

Long-term Effects of Benzodiazepines Abuse

Benzodiazepines are extremely difficult to quit because they influence brain function and cognitive function.

• Disinhibition
• Impaired concentration and memory
• Drowsiness Increased reaction time
• Ataxia Loss of coordination
• Amnesia
• Permanent cognitive deficits
• Motor vehicle crashes
• Muscle stiffness
• Depression
• Sexual Dysfunction
• Dementia
• Hip fracture

Many of the severe adverse effects of stopping use are due to the drug’s dependence on the brain’s new chemicals. Without the medication, the brain’s neurological network cannot communicate and process information, which causes it to malfunction.

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Recognizing A Benzodiazepine Addiction

Benzodiazepine abuse can happen gradually, without users or loved ones realizing anything is wrong. Even when individuals take the medicines within the advised “safe window” of usage, Benzodiazepine addiction may develop. When a prescription runs out or a user looks for more potent effects, unusual behaviors or indications of dependency on benzodiazepines may appear that signal Benzodiazepine addiction.

If you or a loved one experiences any of these symptoms, you should contact a doctor:

• Unauthorized use of another person’s medicine.
• Obtaining numerous drugs from several doctors.
• Forging prescriptions.
• Theft or Taking medication without their knowledge
• Purchasing benzodiazepines fraudulently, such as by purchasing them from a street vendor.
• Consuming more benzodiazepines or for a more extended period than planned.
• Spending a significant amount of time obtaining, utilizing, and recovering from benzodiazepines.
• Cravings and symptoms of withdrawal.
• Increasing the amount of the benzo to get the same result is necessary.
• At home, in the workplace, or at school, displaying poor performance.

Because of tolerance to the medication, people who are addicted to Benzos need more in order to get the same results. They might begin avoiding friends and activities they used to enjoy in order to acquire and use Benzos. These are some of the most common symptoms of dependency.

Must Read: Benzos and Alcohol

Interventions for Benzodiazepine Problems

After acknowledging a loved one’s Benzodiazepine dependency, the next step is to talk to them about it and develop a strategy to assist. Despite their struggle with stopping usage, many users cannot recognize their addiction for what it is. They might refuse the medical treatment that they genuinely require. They may claim, for example, that they do not require rehabilitation for Xanax. It’s critical to convey your worries in a kind yet firm manner.

Treatment of Benzodiazepine Withdrawal, Next Steps, and More

Someone addicted to a Benzodiazepine will likely experience physical and emotional withdrawal symptoms when quitting due to the brain’s rewired chemical structure. The severity of Benzo withdrawals is determined by how long and how much you take them. Withdrawal symptoms can be extremely dangerous at their most severe. Users who go “cold turkey” rather than taper off are more likely to have unpleasant withdrawal symptoms than those who reduce their dosage gradually over time.

Benzodiazepine Withdrawal Syndrome

Seizures, coma, and hallucinations are all possible signs of Benzodiazepine withdrawal. Muscle aches and pains, as well as suicidal ideas, are all possibilities.

When you use BZDs, it’s difficult to know how much is too much. Because of this, doctors and nurses often recommend that people undergoing treatment for addiction or withdrawal seek help through an outpatient detoxification process. Intensive treatment centers across the country provide in-patient rehabilitation programs to help individuals conquer addiction and stay clean.

Treatment and Rehab and Reducing Withdrawal Symptoms

Benzodiazepine addiction is among the most challenging habits to break. Quitting abruptly without any aid might cause severe symptoms of withdrawal.

Rehabilitation for addiction to Benzodiazepine drugs is a complex process that must start with medical supervision. The first stage is to eliminate the substance from the body through detoxification, a procedure known as cleansing. In-patient and outpatient therapies and mental health counseling are available after completing detox to assist patients in achieving total recovery.

Benzo Withdrawal and Detox

Anxiety, sweating, nausea, and sleeplessness are all signs of benzo withdrawal. A medically guided detox for substance abuse treatment can help you get well in a safe manner.

What Is Benzo Withdrawal?

After taking large dosages for an extended period, many people develop a tolerance to Benzos or Benzodiazepines. The user requires higher doses of benzos as their tolerance grows. When someone stops taking the pill, unpleasant symptoms appear. People who have been given benzodiazepines as a prescription suffers from withdrawal symptoms in the same way that people who were taking them illegally do.

Because of their addictive nature and severe withdrawal symptoms, many doctors are hesitant to give Benzodiazepines long-term therapy. The withdrawal process for substance abuse varies from person to person.

Symptoms of Acute Withdrawal

Benzodiazepines have a strong and unpleasant physical and emotional cessation effect, and if the consumer “cold turkey” quits cold turkey, they may experience life threatening withdrawal symptoms.

The most severe symptoms appear in those who have taken higher doses or used the substance for a lengthy period. The symptoms of a benzodiazepine withdrawal are highly variable and typically come and go, and they can change in intensity and occurrence throughout the withdrawal process.

The most frequent Benzo Withdrawal symptoms, commonly known as rebound symptoms, usually appear within one to four days after stopping Benzo usage, depending on the type of drug used, the amount used, and how frequently it is taken. These rebound symptoms typically last up to ten days and include:

• Sleep disturbances
• Increased tension
• Anxiety
• Panic attacks
• Difficulty concentrating
• Excessive sweating
• Heart palpitations
• Headache
• Muscular stiffness or discomfort
• Mild to moderate changes in perception
• Cravings
• Hand tremors

The most severe symptoms of benzodiazepine withdrawal and those that are less common and more serious can also appear. In situations of extreme addiction, these include:

• Hallucinations
• Seizures Psychosis or psychotic reactions
• Increased risk of suicidal ideation

Anxiety and Insomnia Related to Abrupt Withdrawal

Benzodiazepines are primarily used to cure mental disorders such as generalized anxiety disorder and sleeplessness. Many people who stop taking these drugs become anxious or restless. This is known as the rebound effect and happens during the withdrawal period.

The anxiety and sleeplessness that protracted withdrawal symptoms can cause generally lasts 2 to 3 days.

The distinction between rebound effects and severe benzo withdrawal is that rebounding symptoms are the return of prior symptoms that existed before Benzodiazepine use began, whereas withdrawal symptoms are the result of the body’s efforts to adapt to the end of Benzodiazepine usage.

Duration of Substance Abuse Withdrawal

The half-lives of Benzodiazepines (the amount of time they stay in the body after ingestion) vary by brand. Because it takes less time for the drug to leave a user’s system, withdrawal symptoms from shorter-acting Benzos begin sooner than those from longer-acting ones.

The first indications of withdrawal, which generally begin within 6 to 8 hours for short-acting Benzos and 24 to 48 hours for long-acting Benzos, appear.

Benzos with a short duration are noteworthy since they cause strong and serious withdrawal symptoms when taken away. Long-acting Benzos produce less intense withdrawal symptoms, and it takes longer for them to manifest.

The more Benzos you take, the longer withdrawal lasts. In cases of mild addictions, it might only take seven days to recover from withdrawal symptoms. Other users may require up to three months to wean themselves off the drug gradually to avoid potentially fatal signs and symptoms.

Benzodiazepine Withdrawal Timeline

The withdrawal timetable for Benzos varies depending on each user. The table below is only a suggestion since most individuals’ Benzo use has to be tapered down over several weeks.

·       First 6-8 hrs.

Following abrupt drug discontinuation, the first indications of withdrawal, often anxiety and sleeplessness, can appear within a few hours. This is determined by how long it takes for the substance to leave the body. For those taking short-acting Benzos, withdrawal symptoms generally manifest after six to eight hours.

·       Days 1-4

As a result of the rebound effect, anxiety and sleeplessness peak after a few days. During this period, insomnia and anxiety are typically intense. Other symptoms that surge during this time include a rapid heart and breathing rate, perspiration, and nausea. People who took longer-acting Benzodiazepines begin to experience the first indications of withdrawal at this time.

·       Days 10-14

The symptoms of withdrawal tend to last for 10-14 days before dissipating completely. The symptoms of longer-acting Benzo withdrawal begin to peak during this time and eventually fade by the third or fourth week following the quit date.

·       Days 15+

The most severe risks linked with stopping Benzos are post-acute withdrawal symptoms, known as PAWS. After quitting, months later, there may be unpredictable periods of strong withdrawal symptoms. Tapering down Benzo usage under medical supervision might help to prevent PAWS.

Post-Acute Withdrawal Symptoms (PAWS)

Following the acute experience, post-acute withdrawal symptoms frequently persist for months or longer. PAWS symptoms include persistent anxiety, chronic sleeplessness, difficulty performing complex tasks, poor attention, loss of sex drive, and depression.

Benzo Detox

The first step in treating a benzodiazepine addiction is to get the substance out of the addict’s body. Detoxing is the process of getting rid of an intoxicant from the system, and if done incorrectly, it can have unpleasant side effects. In some cases, abruptly stopping cold turkey might be deadly. A supervising physician must be on hand to watch for potentially fatal symptoms, such as seizures and suicidal tendencies.

A grand mal seizure may occur in up to 20-30% of people who quit using these substances without receiving treatment.

A medically supervised detox provides the security and health that people who are attempting to get clean need. Medical detox also helps with the discomfort of withdrawal, lowering the risk of relapse. Detox may take many months, depending on the substance abused and usage duration.

Tapering Down Benzodiazepine Use

Tapering down from Benzodiazepines is a common aspect of drug detoxification. Reducing the dose or prescribing a less powerful Benzo are examples of taper downs. The approach taken is determined by the severity of addiction and the type of substance ingested.

Valium or Klonopin are two benzodiazepines that are often used for detox. These drugs are utilized to taper down because they are long-lasting and less powerful than other Benzos. These medicines minimize the severity of withdrawal symptoms while the user decreases their dose.

Benzo Detox Treatments

Although most people reduce their dosage until it is absolutely safe to stop taking the medication, certain medications can help with detoxification symptoms. The following are a few examples:

Buspirone is sometimes given to people who suffer from generalized anxiety disorder and have a history of substance abuse. This medicine does not produce physical dependence and can help with the emotional symptoms of opioid withdrawal. The main drawback is that buspirone takes 2-3 weeks to work. Patients in drug detoxification may start taking buspirone as they reduce their Benzo dosages.

Flumazenil is a medication that has been used since the early 1990s to treat Benzo overdoses. It has shown some efficacy in reducing long-term Benzo withdrawal symptoms, although it is mainly utilized to relieve Benzo overdose symptoms. Because flumazenil binds to the same pleasure centers in the brain as Benzodiazepines. It’s not uncommon for patients that are being treated with this medication to experience an increase in weight, feel less confident about their appearance, have more body aches and pains, or become withdrawn.

Treatment for Benzo Addiction

Detoxification on its own is seldom enough to achieve long-term sobriety. Many persons choose an inpatient rehab that includes Benzo detox since inpatient rehabilitation provides a distraction- and temptation-free atmosphere where you may heal. People who have a mild Benzo dependency may prefer an outpatient detox to an inpatient rehabilitation center. People can receive therapy without having their daily routine disrupted if they opt for outpatient treatment.

Recovery is aided by therapy and support groups. Many people addicted to Benzo continue therapy and go to meetings long after detox in order to avoid a relapse. If you’re ready to get rid of your Benzo habit, contact a treatment facility immediately for more information on rehabilitation choices.

Treatment Centers for Benzodiazepine Dependence

Benzodiazepine addictions are becoming increasingly common. Clinics all over the country specialize in treating not just Benzodiazepine addiction, but also co-occurring substance abuse problems like alcohol use disorder. Recovery specialists can create a personalized strategy to meet each person’s particular requirements.

Taking the First Step Toward Recovery

The first step toward leading a drug-free life is to remove Benzos from the system. During this detoxification stage, most people gradually taper down their Benzo dosage or switch to a less powerful Benzo like Klonopin. Narrowing down the usage of benzos prevents unpleasant effects, such as anxiety and sleeplessness, while reducing the risk of serious problems like seizures and hallucinations. Quitting Benzos cold turkey can result in grand mal seizures and has the potential to be deadly. Never quit “cold turkey” and use medically assisted detox for Benzos as needed.

In-hospital and Outpatient Benzodiazepine Rehabilitation

Treatment centers that provide both in-patient and outpatient rehabilitation are important resources for people addicted to Benzodiazepines seeking treatment. These facilities use specialized therapies such as counseling and medicine to treat the symptoms of withdrawal.

In-patient rehabilitation centers give patients a distraction-free environment in which to concentrate on their recovery. In-patient treatment has been shown to improve the chances of long-term sobriety. Depending on the patient’s addiction severity, on-site Benzodiazepine therapy programs can last anywhere from 28 to 90 days.

Addicted people can feel ill-equipped to handle the emotional and mental stresses of life without using Benzodiazepines. Specialized treatment centers offer behavioral therapy to integrate patients back into a daily routine free of Benzodiazepine abuse.

Due to the potency, addictive potential, and strong psychological withdrawals of Benzodiazepines, support groups are essential tools to ward off relapse. Relapse isn’t something to be afraid of if you’re recovering from Benzodiazepine abuse. Relapse does not have to be permanent when people return to addiction. There is always the opportunity to get your life back on track and stay sober.

Getting Help for Benzo Addiction

Seeking help for yourself or a loved one suffering from a Benzodiazepine addiction can make a difference that lasts a lifetime. Contact a treatment provider today to learn more about treatment opportunities and payment options.

FREQUENTLY ASKED QUESTIONS

What is withdrawal from benzodiazepines?

Withdrawal from benzodiazepines is the set of symptoms that occur after stopping or reducing benzodiazepine use. Withdrawal can be dangerous, but it is treatable. Symptoms may include anxiety, shaking, sweating, trouble sleeping, nightmares, nausea and vomiting, depressed moods/feelings of sadness, or thoughts of suicide. People who stop taking benzodiazepines may also experience psychosis (for example, seeing or hearing things that are not there) seizures.

Benzodiazepine withdrawal can be very uncomfortable, but it is rarely life-threatening when adequately managed by an individual’s doctor. This article discusses how benzodiazepine withdrawal is typically managed and what to expect during benzodiazepine withdrawal.

Benzodiazepines are sometimes used in short periods (a few weeks) for anxiety or insomnia because they quickly produce a therapeutic effect and can be discontinued without significant tolerance. This rapid onset is desirable in patients who need immediate relief from psychiatric symptoms such as anxiety or insomnia. Unfortunately, or fortunately, in this case, the benzodiazepine withdrawal syndrome is often not well-managed and can lead to high relapse rates and long-term benzodiazepine use.

Why do people continue taking benzodiazepines despite negative consequences?

Many people take benzodiazepines long-term even though there are negative consequences, such as feeling very sleepy during the day. Some people may take benzodiazepines for years despite physical health problems that develop from long-term use. These problems include cognitive difficulties, loss of memory or concentration skills, damage to the liver or other organs, poor balance and coordination, muscle weakness, and sexual dysfunction.

Why do some people have a more severe benzodiazepine withdrawal syndrome than others?

The risk of severe benzodiazepine withdrawal symptoms is partially determined by genetics. Some people are more sensitive to the effects of certain medications, and this sensitivity may be genetically based. Other factors that can impact how difficult it is to withdraw from benzodiazepines include the specific benzodiazepine is taken, how it is taken (for example, orally vs. intravenously), and whether other medications are being used with the benzodiazepine. If any other psychiatric or medical condition has developed that may influence withdrawal symptoms, this too can affect how difficult it is to withdraw from benzodiazepines.

Benzodiazepines and benzodiazepine withdrawal: what’s the difference?

Benzodiazepines are a class of medication that includes popular drugs such as Valium (diazepam) and Xanax (alprazolam). Benzodiazepines work by binding to specific sites on GABA receptors in the brain. When bound, they cause a conformational change to the GABA receptor, which results in the opening of the chloride channel and a hyperpolarization. Hyperpolarization decreases neuronal firing, which results in reduced anxiety and other psychiatric symptoms. Physical dependence develops when benzodiazepines are taken regularly for more than a few weeks (usually at least 4-6 weeks and sometimes much longer). When the medication is stopped, either abruptly or gradually after a certain period, withdrawal symptoms occur.

Abruptly stopping benzodiazepines leads to immediate withdrawal symptoms. Gradual tapering of dosage can lessen or eliminate many withdrawal symptoms but does not prevent the development of physical dependence and rebound anxiety when the medication is stopped altogether.

What are the types of benzodiazepines?

Benzodiazepine drugs can be grouped into short-, intermediate- and long-acting medications. When used for anxiety, short-acting benzodiazepines (alprazolam, triazolam) are taken three to four times a day. Intermediate-acting benzodiazepine hypnotics (chlordiazepoxide, diazepam) are taken twice a day. Longer-acting benzodiazepines (clorazepate, clonazepam) are usually only prescribed for seizure disorders.

How do long half-life benzodiazepines affect withdrawal?

Long-acting benzodiazepines can take several days to several weeks to be eliminated from the body. A short half-life means that when someone is on a long-acting benzodiazepine, they will likely begin withdrawal symptoms if they stop taking the medication in less than 2 or 3 weeks.

How do people with psychiatric conditions withdraw?

People who have severe anxiety due to another psychiatric condition, such as panic disorder or post-traumatic stress disorder (PTSD), will often want to withdraw from benzodiazepines. However, psychiatric medications are not recommended during withdrawal because it is common for people with anxiety disorders to have severe depression and/or suicidal thoughts. Withdrawal should only be made under the supervision of a psychiatrist.

The Takeaway

People who have been taking a benzodiazepine regularly for more than four weeks will need at least six months before they are entirely free of the medication. It is crucial to withdraw slowly from benzodiazepines, as people who stop suddenly are more likely to have severe withdrawal symptoms.

It takes about six months to one year before someone has adequately recovered from benzodiazepine withdrawal. Full recovery takes much longer; in some cases, it can take up to two years before people are entirely free of the medication.

Fred Strahl