Benzodiazepine Withdrawal Guide

About 12.5% of U.S. adults use benzodiazepines, and 2.1% misuse the drugs at least once. If you use benzodiazepines for purposes other than what it’s intended for, you have a higher risk of developing dependence. You may start to feel like you need a higher dose of the benzos at more frequent intervals to derive the desired effects.

At this phase, you can lose control over the drug use and experience strong withdrawal symptoms whenever you try quitting. Luckily benzodiazepine addiction is a treatable condition. Here is a detailed benzodiazepine withdrawal guide to getting you started.

What Are Benzodiazepines?

Benzodiazepines are sedative medications that treat anxiety, panic disorders, insomnia, muscle spasms, and acute alcohol withdrawal. You should only take them on a short-term basis, preferably for two to four weeks. Benzodiazepines work by altering the function of a brain chemical known as gamma-aminobutyric acid. Naturally, the body releases GABA in moments of high stress to signal the brain to slow down contemplations, reasoning, and emotions.

Benzodiazepines artificially increase GABA levels to block some signals in the central nervous system. The drug helps the user achieve a state of relaxation, which reduces anxiety. Benzodiazepines affect the brain’s natural reward system when taken for long periods of time. It increases dopamine production, which creates a temporary state of calmness and contentment. This reduces the neurotransmitters the brain naturally produces, so you become reliant on the drug to feel normal.

Dangers of Benzodiazepines Abuse

Any person who abuses benzodiazepines has a higher risk of addiction. If your loved ones express any of these behaviors, they could be addicted to benzodiazepines and need professional assistance.

• Purchasing benzodiazepines illegally
• Using another person’s drugs
• Forging prescriptions
• Taking higher benzodiazepines doses than prescribed
• Experiencing intense cravings for the drug
• Being unable to stop taking the drug
• Becoming hostile when questioned about the drug use
• Continuing to take the drug despite the adverse physical and mental effects

Your body develops tolerance after taking higher doses of benzodiazepines for a long time. The medication stops working as effectively as it used to, and you will need a higher amount to derive similar effects. This can prompt you to increase the dose to an unsafe range resulting in an overdose.

Combining benzodiazepines with other sedatives like alcohol and opioids increases the risk of overdose. The drugs intensify each other’s euphoric effects, slow down brain activity to a great extent, and can cause slow breathing, unconsciousness, and even death. Call for emergency help if your loved one experiences the following benzodiazepine overdose symptoms.

• Dizziness
• Blue fingers
• Tremors
• Uncoordinated movement
• Unresponsiveness

Benzodiazepine Withdrawal

Around 40% of people who take benzodiazepines for more than six months experience some withdrawal symptoms if they suddenly stop using it or decrease its dosage. Once you cut off the drug, your brain will need to make adjustments like lowering the levels of neurotransmitters produced, which results in undesirable physical and mental effects. Common benzodiazepine withdrawal symptoms include:

• Headache
• Anxiety
• Heart palpitations
• Tremors
• Excessive sweating
• Muscle pain
• Dizziness
• Disorientation
• Delusions
• Nausea
• Diarrhea
• Rebound insomnia
• Irritability
• Poor memory

Are Benzodiazepine Withdrawal Symptoms Deadly?

The drug withdrawal period is potentially dangerous and physically and emotionally painful, so someone looking to quit using will require high professional support and care. Quitting benzos without professional supervision could lead to life-threatening effects. In severe cases, the individual may experience hallucinations, psychotic reactions, suicidal ideation, and violent behaviors that can lead to self-harm or threaten the life of those around them. They may also experience intense cravings, which increases the risk of relapse.

When not well handled, benzodiazepine withdrawal seizures could lead to death. People who misuse other drugs alongside benzodiazepines and those with underlying mental health issues experience more intense withdrawal symptoms. For older adults, abrupt cessation of benzodiazepines can cause delirium, heart attacks, and falls.

Benzodiazepine Withdrawal Timeline

The withdrawal timeline may vary from one client to another based on their dosage, type of benzodiazepines taken, length of use, and health factors. Short-acting benzos like Ativan and Xanax leave the body system faster, so withdrawal symptoms may occur after 48 hours. Drugs like Klonopin, Valium, and Librium take longer to leave the system, so the withdrawal symptom may appear a day or two after the last use. Here is a general idea of the benzodiazepine withdrawal timeline.

Six to Eight Hours

People who initially took benzodiazepines to treat anxiety and insomnia experience rebound effects six to eight hours after stopping use.

One to Two Days

During this time, you may experience high discomfort due to anxiety and insomnia. Other symptoms during this phase include appetite loss, cramps, severe dizziness, raised body temperature, and increased heart rate.

One to Two Weeks

The withdrawal symptoms intensify within the first two weeks. The client may experience seizures and hallucinations, especially if they decide to quit cold turkey.

Within a Month

Most symptoms start to fade within a month, but the client may still struggle with some psychological effects like anxiety.

Over a Year

People with heavy benzodiazepine dependency experience post-acute withdrawal symptoms months or years after quitting. They include poor concentration, reduced sex drive, insomnia, depression, and persistent anxiety. These symptoms may affect your quality of life, but therapy can help you manage them better.

How to Safely Stop Taking Benzodiazepine

The best way to quit benzos with minimal withdrawal symptoms is by tapering the dose. This means slowly decreasing the amount to create a more manageable withdrawal process. Consult your doctor to develop a personalized taper schedule based on your lifestyle, environmental stressors, and personality.

Although there is no specific tapering schedule to follow, the doctor may reduce the initial dose by 25% after every two weeks until the lowest possible amount. Alternatively, they can cut the daily dose by 25% in the first week, then lower it further by 25% in the second week, then by 10% in the following weeks until discontinuation. You might still experience withdrawal symptoms, but your doctor can slow down or pause the taper if the effects become intolerable.

Medical Detox

Medical detoxification entails flushing out drug toxins from the body to allow healing under professional supervision. The detox process starts with a comprehensive analysis of the client. Your doctor will perform some tests to understand the severity of your condition. They also assess your mental health condition, social difficulties, and other life struggles. This information guides them in creating a personalized treatment plan that addresses your specific needs. During detox, your doctor may administer some medicines to help you cope with the withdrawal symptoms. They include:

• Flumazenil – Flumazenil attaches to the same pleasure receptors of the brain as benzodiazepine, blocking their effects.

• Buspirone – A client struggling with anxiety may use buspirone as they taper down their benzo dose. Buspirone helps manage anxiety without causing physical dependence.

The doctor may also administer anticonvulsants like carbamazepine and valproate for clients experiencing multiple seizures and beta-blockers to reduce tremors. If your blood pressure goes too high during detox, you can use clonidine to manage it. Those struggling with excess vomiting and nausea may use ondansetron. Besides the medication, a doctor will continually monitor you to negate the risk of dangerous withdrawal symptoms. Based on the severity of your addiction, you might consider any of the below treatment options.

Inpatient Treatment Program

Clients who take over 10 mg of benzodiazepine require an inpatient detox program. For this option, you reside within the treatment facility for proper medical care and 24/7 monitoring. The main goal of the inpatient program is to take the client away from a drug abuse-triggering environment and give them a safe space to focus on getting sober. This is also a perfect option for people who have previously relapsed.

Outpatient Treatment Program

Clients with mild to moderate benzodiazepine addiction can consider the outpatient program. You reside at home but visit the treatment facility for a few hours daily for checkups and medical assistance. This option allows you to take care of your family, work, or attend school while still working on recovery. The outpatient program only works for very committed people with a strong support system at home.

Partial Hospitalization

Consider partial hospitalization if you still need high-level care but wouldn’t wish to reside at the treatment facility. For this option, you attend treatment sessions about five to seven days a week and head home in the evening.

Long-Term Treatment for Benzodiazepine Addiction

Besides detox, you need a comprehensive treatment plan to address addiction’s psychological aspects and break the drug use cycle. Continue with the treatment steps below to work on long-term sobriety.

Therapies

Half the people who struggle with addiction have a co-occurring mental health issue. You might relapse even after detox if you fail to address the psychological factors that trigger drug use, like stress. This is why you should consider therapy after detox to develop strong coping mechanisms for your mental health issues and manage cravings.

At the rehab facility, you will undergo individual counseling where you meet face-to-face with your counselor to discuss personal matters that you wouldn’t share in public. You also participate in group therapy to share your challenges with people struggling with similar issues. Group therapy allows you to develop healthy relationships with people working towards a common goal.

Substance use disorder also affects the emotional and behavioral patterns of your family. It might lead to violence, fear, conflicts, abuse, and broken relationships. You, therefore, need to attend family therapies to heal your loved ones’ traumas, improve communications, and give them a chance to participate in your treatment actively. Other therapy approaches include:

Motivational Interviewing

The therapist holds constructive conversations with the client to strengthen their motivation and commitment to sobriety. This gives the client more control over their recovery, promoting long-term sobriety.

Dialectical Behavior Therapy

Dialectical behavior therapy teaches the client mindfulness, emotional regulation, and interpersonal effectiveness to help manage severe psychological disorders.

Contingency Management Therapy

Using this method, the therapist gives clients tangible incentives when they achieve certain milestones like staying off drugs for a certain period, which effectively reduces drug use.

Cognitive Behavioral Therapy

Cognitive-behavioral therapy increases the chances of a successful benzodiazepine withdrawal. The client learns to recognize unhealthy behaviors, thoughts, and emotions to help avoid and manage triggers.

Aftercare

After completing your treatment program, your doctor should guide you in the right aftercare plan to prevent relapse. Most rehab centers organize alumni programs to give those who completed treatment a chance to interact, share their challenges, and receive support. Ensure that you participate in such activities to derive the motivation you need to keep up with your recovery goals. Join support groups in your local community to learn new coping strategies and get support from people who understand your situation. You may also choose to continue with therapy to help manage your daily life stressors.

If you come from a trigger-filled home, move into a sober living home after rehab. These are controlled residences for people working on recovery that promote drug abstinence. There are a set of rules that you must follow in these homes, and you should expect random drug tests to promote accountability. Sober home safely reintegrates you into your daily life. You can return to school, find a job to pay your bills and reestablish personal responsibilities.

Start Your Recovery Journey Today

Benzodiazepines are useful for short-term treatment of mental health issues, but misusing the drugs can lead to addiction and intense withdrawal symptoms whenever you try quitting. If you’re unable to control your benzo use, seek professional assistance. Your doctor will develop an effective treatment plan to flush the toxins out of your body with minimal discomfort. They will also help you understand your triggers and the causes of your addiction and equip you with the proper knowledge to avoid relapse. The sooner you seek assistance, the higher your chances of recovery.