Benzodiazepines, or “benzos,” are central nervous system depressants commonly prescribed to manage a variety of conditions, including anxiety, panic disorders, muscle spasm, seizures, alcohol withdrawal, and insomnia 1. They are also sometimes used to manage alcohol withdrawal symptoms.
Benzodiazepines are manufactured and prescribed under several brand names, including Valium (diazepam), Ativan (lorazepam), Klonopin (clonazepam), and Xanax (alprazolam) 2. While these drugs can be relatively safe when taken as prescribed, they have the potential to be both dangerous and addictive when abused 2.
Between 2004 and 2011, the number of benzodiazepine-related emergency room visits increased by almost 150%.
In 2015, more than 5 million Americans over the age of 12 had misused benzos within the past year 3. This number is especially alarming given the serious medical complications that may arise from abusing this type of drug. Between 2004 and 2011, the number of benzodiazepine-related emergency room visits increased by almost 150% 4. Benzodiazepine abuse is also a major risk factor for potentially fatal overdose. Between 2003 and 2009, the number of deaths due to Xanax, a popular benzodiazepine, increased by 233.8% 5.
It is clear that benzos pose risks to those who misuse them. Quitting benzodiazepines can reduce some of the short- and long-term dangers associated with these drugs; however, those attempting to detox from benzos should understand that it can be challenging because of the uncomfortable and serious withdrawal symptoms that may result. Understanding the withdrawal process and the options for treatment can help ensure a safer recovery process.
What Is Benzo Withdrawal?
Ongoing benzodiazepine use and abuse often leads to physical dependence—the state in which a person’s body becomes hooked on a drug and has trouble functioning without it.
At the point that use is decreased or ended, the body goes through withdrawal. Symptoms of benzo withdrawal range from slightly uncomfortable to life-threatening 2.
The severity of withdrawal depends on the average dose of benzos being previously taken and how suddenly they are stopped 2. Users who abruptly quit benzodiazepines after a sustained period of use are at higher risk of severe withdrawal symptoms than those who gradually taper their dose.
Is Benzodiazepine Withdrawal Dangerous
Benzodiazepine withdrawal can be dangerous, especially for users with severe dependence and those with pre-existing health issues. Serious symptoms caused by benzo withdrawal can include psychosis and seizures 6. Left unmanaged, withdrawal seizures may be progressive, difficult to control, and potentially lethal.
It is important for those attempting to quit a benzodiazepine to get help from a program that can safely usher them into the recovery process.
Suddenly quitting benzodiazepines may also cause a rebound effect, where old symptoms previously treated by the drug return with greater severity 7. Users may experience symptoms such as rebound anxiety and insomnia at a level of intensity similar to what was experienced before starting use of the drug 7.
Benzodiazepine users who experience rebound symptoms may contemplate immediate relapse, in an attempt to mitigate the unpleasant withdrawal syndrome. While many of the symptoms of benzo withdrawal are uncomfortable, treatment options are available to manage many of them—making it more safe and tolerable for those in recovery. It is important for those attempting to quit a benzodiazepine to get help from a program that can safely usher them into the recovery process. To find a program and get help now, call 1-888-744-0069Who Answers? today.
Signs and Symptoms
Symptoms of benzo withdrawal may include one or more of the following 2,6:
- Muscle pain and stiffness.
- Poor concentration.
- Sensory distortions.
- Heart palpitations.
- High blood pressure.
In cases of severe benzo withdrawal, serious complications may develop, including seizures, delirium tremens, and psychosis 6. Users with a history of seizures and those who mix benzos with other prescription drugs and/or alcohol may be at higher risk for seizures during withdrawal 7.
Some benzodiazepine users may experience a protracted (or prolonged) withdrawal, also known as post-acute withdrawal syndrome, which may last for several months or more 2. Common symptoms of protracted benzodiazepine withdrawal include 2:
- Chronic anxiety.
- Sleep difficulties.
Withdrawal from benzodiazepines may range in intensity and duration from person to person and is typically dependent upon several factors including the detoxing individual’s health, the original dose, and the rate at which the medication is tapered down.
Can Medications Help Me Detox from Benzos?
Medications may be used in the treatment of benzodiazepine withdrawal in order to taper users from the drug, treat withdrawal symptoms, and reduce discomfort.
Your doctor may gradually taper you off your benzodiazepine over a period of weeks or months, rather than abruptly stopping the drug 8. If you are currently taking a benzodiazepine with a shorter half-life like Ativan (lorazepam) or Xanax (alprazolam), your doctor may first prescribe one with a longer half-life, such as chlordiazepoxide or Klonopin (clonazepam) to help ease your symptoms during detox and to facilitate the tapering process 8.
Other drugs that may be used in managing severe benzodiazepine withdrawal include 8:
- Anticonvulsants such as carbamazepine and valproate.
- Sedating antidepressants such as trazodone.
- Antihypertensive medications such as clonidine or propranolol for those who experience severe autonomic consequences as part of the benzo withdrawal syndrome (e.g., racing heart, hypertension, profuse sweating).
Administration of these medications does not altogether negate the risk of dangerous withdrawal symptoms like seizures 8. In order to reduce the risk of complications, you should be carefully monitored during withdrawal by medical professionals to ensure your safety.
While medications may be beneficial and even necessary during withdrawal, understand that addiction treatment does not solely entail the use of medication or stop when the withdrawal period is completed. Medications are, however, an important therapeutic adjunct when combined with psychological treatments like cognitive and behavioral therapies. Treating benzodiazepine addiction involves both detoxing users from the drug and treating the underlying addiction.
Withdrawal and Addiction Treatment
Detoxification, or “detox,” is the process of safely removing substances from the body. Because benzo withdrawal is associated with both distressing and dangerous symptoms, it is often the safest course for those detoxing from a drug in this class to be treated under close medical supervision. Many people addicted to benzos also abuse other drugs and/or alcohol 8, which can increase the risk for complications during withdrawal—so it is even more important for those using multiple substances to seek professional help.
Benzodiazepine detox may take place in a hospital setting or a treatment facility. Medical and mental health professionals in a detox facility may:
- Evaluate the severity of the problem.
- Monitor vital signs like pulse, temperature, and blood pressure.
- Gradually taper the dose of the drug.
- Prescribe medications to reduce discomfort.
- Prescribe medications to reduce risk of seizures.
- Encourage participation in further treatment.
While safely detoxing is an important step in the treatment process, long-term recovery requires learning how to cope without drugs. Treatment programs available after completion of detox include:
- Residential treatment, which offers intensive therapy and temporary housing in a drug and alcohol-free environment. Residential treatment often takes place in a home- or dorm-like like facility and may offer other amenities, such as exercise programs, skills training, and day trips.
- Outpatient treatment, which offers weekly individual, group, and family therapy with time outside of treatment to work, go to school, and adjust to living life without drugs.
- Psychotherapy, which can be provided by an addiction counselor, therapist, or psychologist. Individual psychotherapy sessions may be attended once or more per week.
Cognitive behavioral therapy (CBT) is a common approach to treating benzodiazepine addiction. CBT assumes that there is a relationship between a person’s thoughts, feelings, and behaviors. The goal of CBT is to help people identify the thoughts and beliefs that contribute to negative emotions like anger, sadness, and worry, and to understand how these emotions contribute to negative behaviors such as drug use. CBT also helps people develop a plan for coping with negative thoughts and feelings without turning to substances for relief.
Benzo withdrawal can be an uncomfortable and risky process, but receiving the proper care can set the stage for long-term recovery. To find a program that will help you get off benzodiazepines for good, call us now at 1-888-744-0069Who Answers?.
Cravings are strong urges to use that are common when first trying to quit benzodiazepines, but they may last for months after using. Some people experience intermittent cravings even years after quitting. While cravings can feel uncomfortable, they are a normal part of the recovery process.
Cravings can involve thoughts, feelings, and/or physical symptoms. Cravings can sometimes lead to unhealthy thoughts like “these cravings are unbearable” and “the only way to cope with these cravings is to use.” Cravings cannot make you use drugs, however, and plenty of people cope with cravings each day without using. Falsely believing that cravings can make you use drugs can set you up to relapse.
Another common false belief is that cravings will last forever. Many people in recovery experience cravings that come and go. At times they may feel strong, but they do not remain at a high intensity forever.
Coping with cravings involves having realistic beliefs about what cravings entail. Keep in mind that cravings are normal—uncomfortable but not unbearable—and they are time-limited.
To manage your cravings:
- Know your triggers. Having an idea of what people, places, events, and feelings trigger your cravings can help you make a plan for managing them. Sometimes triggers can be avoided—these include certain people or places. Other times you cannot escape your triggers. This is often the case with emotions like stress and sadness. When it comes to unavoidable triggers that cause cravings, having a plan is important.
- Accept, rather than fight, cravings. Often cravings are thought of as bad, which causes people to resist or fight them. This can create more tension and distress. Instead, try accepting that you are experiencing a craving. Recognize that the craving is there, that is it is normal, and that it will remain for a period of time (but not forever).
- Seek support. Reaching out to sober support is helpful, especially in early recovery. Support groups are based on the philosophy that sober support is important for preventing a relapse. Seeking support from others provides an opportunity to talk about the struggles of early recovery.
- Use healthy distraction. Cravings can feel uncomfortable for the period of time that they are present. Finding healthy distractions can delay time until the craving passes. Healthy distractions can include exercise, reading, journaling, playing sports, listening to music, taking a bath, or spending time in nature.
- Center for Substance Abuse Research. (n.d.). Benzodiazepines.
- Longo, L. P., & Johnson, B. (2000). Addiction: Part I. Benzodiazepines- Side effects, abuse risk and alternatives. American Family Physician, 61(7), 2121-2128.
- Center for Behavioral Health Statistics and Quality. (2016). 2015 National Survey on Drug Use and Health: Detailed tables. Rockville, MD: Substance Abuse and Mental Health Services Administration.
- Substance Abuse and Mental Health Services Administration. (2013). Drug Abuse Warning Network, 2011: National estimates of drug-related emergency department visits. HHS Publication No. (SMA) 13-4760, DAWN Series D-39. Rockville, MD: Substance Abuse and Mental Health Services Administration.
- Jann, M., Kennedy, W. K., & Lopez, G. (2014). Benzodiazepines: A major component in unintentional prescription drug overdoses with opioid analgesics. Journal of Pharmacy Practice, 27(1), 5-16.
- Petursson, H. (1994). The benzodiazepine withdrawal syndrome. Addiction, 89(11), 1455-1459.
- Chouinard, G. (2004). Issues in the clinical use of benzodiazepines: Potency, withdrawal, and rebound. Journal of Clinical Psychiatry, 65, 7-12.
- Center for Substance Abuse Treatment. (2015). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.