Benzodiazepines are prescription medications that can cause severe physical dependence and withdrawal with stopped use, after as little as one month of drug use.
Risk factors for benzodiazepine withdrawal include:
- taking a benzodiazepine for more than one month
- crushing, snorting, or injecting benzodiazepines
- taking benzodiazepines more often or in higher doses than prescribed
Seeking out a detox program for benzodiazepine withdrawal is highly recommended for anyone who’s taken benzodiazepines (benzos) for a very long time. This is to prevent potential dangers.
What Is Benzodiazepine Detox?
Benzodiazepine detox is the process of getting rid of the benzodiazepines in your system. This can occur by gradually reducing how much you take, or by stopping cold-turkey (not recommended).
Who Needs Benzo Detox?
Benzodiazepine detox is recommended for anyone who’s physically dependent on benzos, either through chronic use for a medical reason or chronic drug misuse.
Types of benzos that may require detox include:
- alprazolam (Xanax) detox
- lorazepam (Ativan) detox
- diazepam (Valium) detox
- chlordiazepoxide (Librium)
- clonazepam (Klonopin) detox
- triazolam (Halcion) detox
- temazepam (Restoril) detox
Physical dependence on benzos can develop in as little as a few weeks after starting the use of the drug. The longer you take it, the more severe your dependence on the drug will become.
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Signs And Symptoms Of Benzodiazepine Withdrawal
Early signs of benzodiazepine withdrawal can develop within hours of your last dose and can be either physical, mental, or psychological in nature.
Physical benzodiazepine withdrawal symptoms may include:
- neck and back pain
- ringing in your ears
- muscle twitches
- tremors (shaking of the hands)
- difficulty sleeping
- blurred vision
- loss of appetite
Mental and psychological benzodiazepine withdrawal symptoms:
- difficulty concentrating
- rebound anxiety
- seeing or hearing things that aren’t there
- memory troubles
- panic attacks
Many symptoms of benzodiazepine withdrawal are flu-like in nature. These can become severe if you try to detox alone, or if you try to stop taking benzodiazepines very suddenly and all at once.
Benzodiazepine Detox Timeline
Benzodiazepine withdrawal symptoms can begin within as little as six hours to 12 hours after your last dose. The acute withdrawal period may last up to 30 days.
Days 1-3: Physical symptoms such as headache, tremors, and some psychological symptoms of withdrawal, such as rebound anxiety, may begin to set in.
Days 4-7: Withdrawal symptoms may reach their initial peak during this period. This may cause significant physical discomfort and some psychological distress.
Days 8-14: Physical symptoms may peak and decline in waves, while additional psychological symptoms, such as hypersensitivity and depression, may persist.
Days 15-30: Physical symptoms may begin to decline after the first two weeks of detox. Some symptoms, such as gastrointestinal, cognitive, and mental health-related symptoms may linger.
Days 30+: Some psychological and cognitive side effects may linger past the acute withdrawal phase. This is a sign of what is commonly referred to as protracted withdrawal.
Protracted Withdrawal From Benzodiazepines
Protracted withdrawal, also known as post-acute withdrawal syndrome (PAWS), is a form of withdrawal that can extend beyond the acute detox period.
With benzodiazepines, this form of withdrawal may last for a few weeks, or up to 12 months after your last use of a benzodiazepine drug.
Symptoms of protracted withdrawal may include:
- rebound anxiety
- difficulty concentrating
- numbness or tingling sensation
Protracted withdrawal may be treated through a combination of behavioral therapy, medicine, or benzodiazepine maintenance therapy with a long-acting benzodiazepine drug like diazepam.
Risks And Dangers Of Benzodiazepine Detox
Benzodiazepines are known to have the potential to cause one of the most severe forms of drug withdrawal, along with alcohol. Seeking medical support for detoxification is critical.
Seizures and other serious symptoms can occur after the abrupt cessation of a benzodiazepine in anyone who’s taken this type of substance for at least one to six months.
Other serious risks and potential side effects include:
- thoughts of suicide
- thoughts of harming oneself or others
- rebound anxiety
Severe benzo withdrawal is a high risk for people who have a history of benzodiazepine abuse, in addition to those who have been taking a high dose of benzos for a very long time.
Preventing Severe Benzodiazepine Withdrawal
Severe symptoms of benzodiazepine withdrawal can be prevented by gradually tapering the dosage of a person’s benzodiazepine drug over the course of several weeks.
If someone has been taking a short- or intermediate-acting benzo (e.g. Xanax), a doctor may also recommend switching to a long-acting benzo (e.g. diazepam) during this tapering process.
Depending on your treatment goals, the end goal of this may be to taper off benzodiazepines completely, or to be maintained on a low dose of a long-acting benzodiazepine.
Types Of Benzodiazepine Detox
Benzodiazepine detox is a process that can occur in a few different settings:
- detox center
- inpatient or residential rehab center
- on an outpatient basis with a clinician
For people with substance use disorders, entering a detox center or an inpatient treatment center for detoxification is highly recommended, due to a risk for serious withdrawal and drug relapse.
Trying to get off benzodiazepines at home, or without clinical support, is more likely to lead to relapse. For people with addiction issues, relapse can pose serious health risks.
Finding A Benzo Detox Program
Getting off a benzodiazepine drug can be one of the most difficult experiences of a person’s life, according to people in recovery.
If you’re looking for a detox program for yourself or a loved one who is addicted to benzodiazepines, we may be able to help.
Call our helpline today to connect with a specialist who can help you find a drug rehab program that’s right for you.
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- American Family Physician — Addiction: Part 1. Benzodiazepines - Side Effects, Abuse Risk and Alternatives
- Comprehensive Handbook of Drug and Alcohol Addiction — Protracted Withdrawal Symptoms from Benzodiazepines
- U.S. National Library of Medicine: MedlinePlus — Alprazolam
- U.S. National Library of Medicine: NCBI — Management of benzodiazepine misuse and dependence