If you suffer from anxiety or depression, a doctor may prescribe a benzodiazepine. Benzodiazepines, also known as benzos, can treat a myriad of anxiety disorders, insomnia, alcoholism, muscle spasms, and even seizures.
But there’s one huge disadvantage of taking benzos – they’re extremely addictive. As you start taking benzos, your tolerance will increase. To experience the same effects, you’ll have to keep taking more medications. Doctors are well aware of the addiction risk and will only prescribe the minimum amount the patient needs. Unfortunately, this often isn’t enough. The patient will resort to purchasing benzos on the street.
If you want to recover from benzo addiction, you’ll suffer from withdrawals. Here’s what to expect from benzodiazepine withdrawal.
What Are Benzos?
Benzos are a class of painkillers. They are man-made medications prescribed to treat various conditions. In 1954, an Austrian scientist named Leo Sternbach discovered chlordiazepoxide, the first benzodiazepine. These drugs, also known as BZDs, hit the market for clinical use in the 1960s. Since then, more than 50 different benzos have become available across the world.
Benzodiazepines are psychoactive and sedative drugs. Benzos are only available by prescription, which is why many people who struggle with benzo abuse ‘doctor shop’ in order to maintain their supplies. Benzodiazepines target the central nervous system (CNS) and affect the way the brain interprets signals.
These drugs are often used in minor surgery, such as tooth extractions or minor wound repairs. Outside of the operating room, individuals may use them for conditions like panic attacks, insomnia, generalized anxiety, and sometimes epileptic seizures. Benzos enhance gamma-aminobutyric acid, or GABA, a particular neurotransmitter in the brain that calms down the neurons responsible for anxiety, insomnia, seizures, or stress.
Doctors only prescribe benzodiazepines for short periods. However, the effects of these drugs are extremely strong. For many patients, the effects are also pleasurable, causing ‘highs’ or other desired effects such as long, uninterrupted sleep. Therefore, patients often overuse their prescriptions and become desperate for more once the prescription runs out. They may lie about losing pills or say their doctor meant to call in a refill but forgot. Many people don’t realize they’re addicted to benzodiazepines until their bodies already need the substance to feel normal.
The Chemistry of Benzos
Before we take a look at the bigger picture, let’s dive into the literal microscopic details of BZDs. These compounds are organic bases that have a benzene ring, which is how they get their name.
Benzos differ in their potency, how long they last, how fast they are metabolized, and how fast our systems can eliminate them. All of these things are the result of side chains, which react with a specific brain receptor in different ways depending on the compound.
The brain receptor benzos affect is the gamma-aminobutyric acid A, or GABA-A, receptor. GABA is the top neurotransmitter when it comes to inhibiting the central nervous system. Benzos ability to bind with the GABA-A receptor, thereby increasing the brain’s demand for GABA, is what makes these drugs such powerful sedative-hypnotic agents, as they are called in the medical community.
Basically, all of the disorders benzos treat are caused by excessive nerve activity in the brain. Benzos help relieve this activity by enhancing the activity of gamma-aminobutyric acid, or GABA.
GABA is a neurotransmitter that helps communicate different signals within the brain. Benzos tell GABA to stop nerve activity; GABA communicates this to the nervous system.
It doesn’t seem that harmful, right? But benzos are more potent and harmful than you expect. Benzos have the power to rewire your brain; your brain will become dependent on the medication and your natural GABA won’t function as efficiently without the medication.
Users also experience a high from benzos. Benzos are what’s known in the drug world as a downer. Rather than feeling energetic from stimulants (cocaine), users feel relaxed and sedated. This also causes a euphoric feeling.
Alarming Statistics: Benzo Addiction by the Numbers
With such powerful sedative and calming effects, it’s no wonder so many people get addicted to benzos or that the numbers of people using BZDs have greatly increased in recent decades. Between 1996 and 2013, the number of adults who filled a prescription for a benzodiazepine went from 8.1 million to 13.5 million, which is an increase of 67%.
The quantities of benzos consumed have increased three times over during that time as well. High-dose benzos taken with opioids can be a deadly combination. Both classes of drugs sedate users and also suppress breathing.
Nonetheless, doctors continue to prescribe these drugs together. 23% of people who died of an opioid overdose in 2015 also tested positive for BZDs.
Benzo addiction is becoming more common than ever. It’s currently an epidemic. Here are some more alarming benzo statistics. The most commonly used benzos are:
- Xanax (49 million prescriptions)
- Ativan (27.6 million prescriptions)
- Klonopin (26.9 million prescriptions)
- Valium (15 million prescriptions)
- Restoril (8.5 million prescriptions)
Benzo dependence starts quickly. Addiction can start with a dose as little as 4 mg a day and for as long as 12 weeks. Users risk withdrawal symptoms when they take benzos, even as little as 2 mg a day for eight weeks.
43% of benzo users experience withdrawal symptoms – regardless of whether they’re addicted or took benzos as prescribed.
Identifying Some Common Benzos
Unless you ask your doctor, you likely don’t know you’re taking benzos. There’s no medication called benzodiazepine. Rather, there’s a variety of medications that fit this drug classification. There are more than 15 different benzos that are prescribed in the United States. Here are the most common benzos and their generic name:
- Xanax (alprazolam)
- Librium (chlordiazepoxide)
- Klonopin (clonazepam)
- Tranxene (clorazepate)
- Valium (diazepam)
- Prosom (estazolam)
- Dalmane (flurazepam)
- Ativan (lorazepam)
- Versed (midazolam)
- Serax (oxazepam)
- Restoril (temazepam)
- Halcion (triazolam)
- Doral (quazepam)
As long as you follow the doctor’s orders, these medications should not be dangerous. If you’re taking benzos temporarily, your doctor will put you on a small dose and will ween you off. This way, you won’t experience withdrawals.
If you’re taking these medications constantly, your doctor will put you on a small dose to minimize your risk of dependence. If you want to get off the medication, your doctor will ween you off to prevent withdrawals.
What Does Benzo Addiction Look Like?
Have we painted a clear enough picture of the problem? Benzos effectively rewire the very chemistry of your brain, and the very reasons doctors prescribe them are some of the same reasons people become addicted to them.
Benzo addicts come from all walks of life. These drugs do not discriminate in who they ensnare in addiction. It’s hard to fight their pull.
According to the Royal College of Psychiatrists, four out of every 10 people who take benzos every day for more than six weeks will become addicted to them. That’s a staggeringly high ratio.
So how can you tell if your prescription has become an addiction or if your friend or family member needs professional help?
Individuals who struggle with benzo abuse may:
- Feel bad if they don’t take the medication
- Crave the medication
- Have trouble sleeping
- Experience dizziness
- Get agitated easily
- Feel tense
- Experience blurry vision
- Are sensitive to light
- Need to take more and higher doses to achieve the same effect
- Have a metallic taste in their mouth
- Experience what feel like electric shocks in their limbs
- Start to experience withdrawal if they try to stop the medication
What is Benzodiazepine Withdrawal?
When you use any addictive substance and suddenly stop, you’ll experience withdrawal symptoms. Your body relies on that substance and will react terribly if you stop using the substance.
Benzos are no different. You become dependent on benzos and you’ll show both mental and physical withdrawal symptoms. The symptoms you experience depends on your level of addiction.
Most users use benzos as a party drug. When these users stop taking benzos, they will feel slight discomfort or a little sick. But true addicts, those who constantly pop benzos, may experience life-threatening withdrawal symptoms.
Your withdrawal experience also depends on other factors. This includes how much you took right before you stopped and how suddenly you stopped. For example, if you took a high dose and stopped cold turkey, you’ll experience violent withdrawal symptoms.
You don’t even have to be an addict to experience withdrawal symptoms. Withdrawal symptoms can occur if you miss a dose or when their doctor starts to ween them off.
Why is Benzo Withdrawal Dangerous?
Withdrawal is a natural and sometimes painful part of drug addiction recovery. However, some withdrawal processes are much more dangerous than others, and benzodiazepine withdrawal is one of the most dangerous you can go through. If you are addicted to benzodiazepines like Xanax or Valium, do not try to quit cold turkey and do not do so alone. Due to the extreme dangers of benzo withdrawal, one should always detox in the presence of a detox medical professional.
Because of the drug’s high dependence risk, benzo withdrawal is usually dangerous. Most people who use benzos have a pre-existing health condition; not only will their health issues return, but they can develop a myriad of other ailments.
Most people are surprised to learn benzodiazepine withdrawal is more dangerous than withdrawal from drugs like heroin or cocaine. The effects of benzodiazepines are not as potent as these substances, yet this actually makes them more serious. That is, a patient might get the initial desired effects from a prescribed dosage of benzodiazepines. Over time, though, those effects will be less potent, so the patient will take more pills to get the initial high. Patients often don’t realize how much they’re taking or how close they might be to overdosing.
Benzodiazepines are also dangerous because they are some of the most difficult drugs to stop taking. Like most drugs, benzodiazepines significantly alter brain chemistry. However, unlike with heroin or cocaine, patients seek this chemical alteration for legitimate medical reasons. An addict is afraid if he stops taking benzos, his painful anxiety, insomnia, or panic symptoms will return. This makes it difficult, if not impossible, for an addict to stop taking benzodiazepines. However, without stopping, the addict will not recover.
Benzo Dependence and Withdrawal
If you start taking benzos recreationally, this can develop added mental and even physical issues. This includes severe depression and body pain.
If you stop taking benzos without the aid of a doctor, you won’t be able to control your withdrawal symptoms. The symptoms may also get worse, potentially becoming lethal.
In severe cases, benzo withdrawal is threatening to your mental state and overall health. Serious addicts can develop psychosis, which is an impairment of reality. You may experience hallucinations and extreme paranoia.
If you were prescribed benzos for epilepsy, quitting cold turkey can result in violent seizures. Even though without a history of seizures can develop them during benzo withdrawal.
Common Symptoms of Withdrawal
Every patient and user is different. But it’s normal to experience one or more of the following symptoms.
- Panic attacks
- Muscle aches, cramps, and spasms
- Excessive sweating
- Sensory distortions
- Difficulty concentrating
- Heart palpitations
- High blood pressure
To prevent withdrawal symptoms, recover from benzos with the aid of a doctor or at a rehab clinic. This is especially important if you have a severe dependence.
When withdrawing from benzos, some addicts also suffer from Wernicke’s encephalopathy, which comes from a depletion of the body’s B-vitamin reserves. Wernicke’s encephalopathy is a three-pronged collection of symptoms that can settle in as soon as hours into withdrawal and as late as days into the process.
The first prong of Wernicke’s encephalopathy is classic encephalopathy. The addict will suffer from apathy, inattentiveness, and deep disorientation, physically and even existentially.
The other prongs of Wernicke’s encephalopathy are oculomotor dysfunction and gait ataxia. Symptoms of the former include repetitive and uncontrolled eye movements, an inability to move both eyes in a single direction, and other eye abnormalities. Gait ataxia refers to problems with posture and the movement of the entire body.
How Long Do Withdrawal Symptoms Last?
The benzo withdrawal process depends on a number of different factors. This includes
- The exact medication you’re taking
- How long you’ve been addicted
- Your daily dose
Compared to other addictive drugs, benzo withdrawal symptoms are some of the hardest to handle. That’s because benzos are long-acting medications. But some benzo medications have less severe withdrawal symptoms.
Xanax is a short-acting medication, so withdrawal symptoms may last as short as a week. But compared to a long-acting medication such as Valium, withdrawal symptoms can last as long as three months.
All of this depends on the kind of addict you are how long you’ve been abusing benzos and how much you would take every day. For those who are suffering from severe addictions, withdrawal symptoms can last up to a year.
The Stages Of Benzo Withdrawal
Benzodiazepine addicts start experiencing withdrawal within 6-12 hours of reducing the drug. Your body will immediately feel starved, and cravings will set in. You’ll experience mild versions of your original symptoms, such as anxiety and panic. If your symptoms included seizures, ensure someone is always with you to handle them.
Withdrawal symptoms peak within 1-4 days of the recovery process. This is the time you’ll experience vomiting, sweating, aggression, and sensitivity to light or sound. Your original symptoms will peak, so use the coping mechanisms you have already learned. By day four, your withdrawal will start to calm down. Do not give in to the temptation to take more pills. This will reset your brain chemistry and restart the process.
Within the first week or so after stopping the drug, your withdrawal symptoms will dramatically decrease. Within 14 days, they should be almost or completely gone. However, some symptoms may recur during this period. Your original symptoms will recur, too, but not as strongly. Withdrawal and original symptoms can fluctuate for up to two years, so stay in touch with your clinicians.
Mitigating The Dangers Of Withdrawal
Always undergo withdrawal under professional supervision. Do not depend
on your friends or family to get you through the process. They don’t know what to expect and may inadvertently prolong your symptoms.
Know what type of benzodiazepine you’re dealing with. For instance, Xanax leaves the body more quickly than any other benzodiazepine, meaning its effects wear off fast. Stop taking Xanax, as well as other benzodiazepines, slowly. Your clinician may wean you from the drug in steps. He or she may cut your dosage by a quarter at first, then in half, and so on until you aren’t taking any.
Understand the withdrawal symptoms are myriad and often painful. Withdrawal usually happens in stages, so don’t convince yourself you can take more benzodiazepine than you thought just because you feel well. What starts as mild anxiety, a small headache, or infrequent muscle cramps will progress to symptoms like shaking, sweating, vomiting, and aggression. In many cases, your original symptoms will return. Do not give up. Stay connected to your clinicians and other professionals. They can provide immediate coping mechanisms.
Benzo Withdrawal Treatment Methods
There are many ways to go about administering benzo withdrawal treatment. Some of these treatments are aimed at the purely physical aspects of benzo withdrawal. Other treatment options are designed to support long-term sobriety.
Here is a rundown of withdrawal treatments that offer relief of various types to benzo addicts.
Generally speaking, benzo withdrawal treatment starts with a period of detoxification. This is a painful but necessary part of the process of getting sober. Some addicts resist entering detox because they are afraid of the symptoms of withdrawal that rear their heads in detox, which we mentioned earlier.
To safely recover from benzo addiction, a benzo detox is necessary. This helps rid your body of your benzo dependence and will remove any existing substance from the body. For best results, individuals should go through benzo detox with the aid of a professional. It’s important to seek assistance from your doctor or a rehab facility.
This is a form of treatment that often accompanies detox. Medication-assisted treatment is always administered under the watchful eye of at least one if not several medical professionals.
Again, it is possible to treat benzo withdrawal with small doses of benzos at first. This is because it can be dangerous and even deadly to stop taking benzos cold turkey. Doctors administering medication-assisted treatment will often offer benzos to addicts in tapering doses, getting them off the drugs as quickly and safely as possible.
When it comes to medications used to treat benzo withdrawal, medical professionals have found few that are more effective than BZDs themselves. Antipsychotics, selective serotonin reuptake inhibitors or SSRIs, antihistamines, and beta-blockers are all inferior forms of withdrawal treatment.
The onset of withdrawal symptoms depends on the half-life of the particular benzodiazepine. These half-lives range from 10 hours to 200 hours. Doctors usually taper doses by 1-20% over six weeks or more before switching to longer-acting medication solutions.
Once the most immediate and dangerous symptoms of withdrawal are under control, it can take months for an addict to fully wean off of benzos.
Cognitive behavioral therapy, or CBT, often forms one arm of a treatment program once addicts are through the most painful stages of withdrawal.
CBT is an evidence-based practice that uses exposure techniques to untrain the benzo addict’s mind. By exposing the addict to their triggers in a safe environment under the supervision of a therapist, the addict learns to face the triggers that cause their cravings and choose alternatives to their drug of choice in those moments.
CBT is especially helpful for treating benzo withdrawal in combination with the other aspects of a good rehab program, which include highly structured days, medical assistance, and other forms of therapeutic support. Many of these programs are covered by insurance.
What to Expect Before Your Detox
Before detox can actually occur, the medical professionals need to learn who you are and what kind of benzo addiction you have. They will evaluate crucial information such as:
- Your addiction severity
- Your current health
- Your daily dosage
- The reason you started taking benzos (as a prescription or recreationally)
- How long you’ve been abusing benzos
- If you’ve had past treatment or relapsed
From this information, your medical professional can put together a sobriety and detox plan. This may include one of the following
- Inpatient or outpatient rehab care
- Regular doctor visits
It’s best you follow your doctor’s orders to sober up from benzo addiction.
More About the Benzo Detox Process
When you seek medical help for your benzo detox, a medical professional will ensure you experience as little withdrawal symptoms as you can. They will take measures so you can detox peacefully.
One of the first things a medical practitioner will do is ween you off the medication. Rather than stopping benzos cold turkey, decreasing your dosage will help minimize your risk of dangerous withdrawal symptoms.
How long this process lasts depends on how long you have been using benzos, what kind of benzos you are dependent on, and so forth. If you followed your doctor’s orders without taking more medication, this process is a lot shorter. But if you used a high daily dosage for a long time, weening off the medication will take longer.
Benzo Detox Medications
You can take medication to help your withdrawal symptoms. But this all depends on the withdrawal symptoms you’re experiencing.
A common medication prescribed is Phenobarbital. This treats epilepsy and seizures. If you used benzos for seizures, this medication will help control your seizures. If you’re suffering from muscle spasms, you’ll probably take carbamazepine or valproate.
Whether you were prescribed benzos or took benzos recreationally, you’ll likely experience depression. If you had depression prior to benzo use, expect your depression symptoms to return. If you never suffered from depression before, depression is a common withdrawal symptom. A medical practitioner will prescribe a non-habit forming antidepressant such as trazodone.
Another common withdrawal symptom is hypertension. You’ll experience profuse sweating and a racing heart. There are medications that can treat all of those symptoms. Examples include clonidine or propranolol.
How to Manage Withdrawal and Prevent Relapse
Detoxing from benzo abuse and surviving withdrawals is only the beginning of the sobriety process. After you detox, it’s normal to still have cravings even though your body is no longer dependent on the medication.
On average, these cravings last for a few months. For some, cravings can even last years or may not go away at all. This is when relapsing occurs. Relapsing is when a former addict uses a drug after sobering up. They will usually use the dose they’re used to, which often results in death.
After you overcome benzo abuse or dependence, it’s vital you prevent relapsing and control your cravings. Here are some tips to prevent relapse.
Identify Your Triggers
Former benzo addicts usually get triggers during certain situations. This can include places, people, and even memories. Identify your triggers and plan them ahead.
You may have to stop contacting certain people or stop visiting certain places that trigger a craving. Some former addicts move to a new city to have a fresh start.
Don’t Increase Your Dose
This may seem like an obvious suggestion, and it might be unnecessary if you’re working with a qualified doctor. But it’s important to remember because the symptoms of withdrawal are painful, and it can be tempting to give up and increase the dose of benzos you’re on.
Don’t do this! An increased dose will set back progress rather than aid it. When you try to taper again, the process can be even more difficult than it was the first time.
Accept Your Cravings
This seems counterintuitive; if you want to avoid cravings, why accept them? Accepting cravings gives them a positive spin. Thinking of cravings as bad incites a negative response, making you stressed and overwhelmed.
Accept your cravings, but don’t feed into them. Know they exist and accept you’ll live with them for a very long time.
Find a Healthy Distraction
One of the best actions a former benzo addict can take is replacing their addiction with healthy action. This helps keep your mind off of your cravings.
Great examples include exercise, engaging in a former hobby, being creative, starting a new career, sports, traveling, and simply focusing on your health.
Avoid Certain Foods and Supplements
In the process of weaning off benzos, you may come across recommendations to treat your symptoms with a variety of natural substances. Some of these can help. Others can exacerbate the problem.
Medical marijuana can spike your anxiety in the process of withdrawal, so only partake of it under the strict supervision of a doctor. You’ll also want to avoid foods and supplements that work on GABA receptors or otherwise inflame withdrawal symptoms.
These foods and supplements include:
- Kava Kava
- Vitamin B
- Vitamin D
- Artificial sugars or sugar substitutes
- Cane sugar
- Additives, preservatives, and coloring
- Garbanzo beans
- Monosodium glutamate, or MSG
Of course, this is not to say that you can never eat these foods or use these supplements again. In many cases, people are able to use them during the withdrawal and recovery processes. Still, it’s important to be mindful of their effects on your body and how they could be problematic in some situations.
Have a Support System
When you’re surrounded by positive people, you’ll feel less inclined to relapse. There is a myriad of drug addiction support groups. If you’re close with family and friends, ask if you can reach out if you get triggers. You can also reach out to your former doctor and therapist for support.
Benzodiazepines are a group of medications that treat anxiety disorders and seizures. Unfortunately, these medications come with a strong chance of addiction. If you’re addicted to benzos, you need to know how to recover from benzodiazepine withdrawal. Fortunately, you have options. We can help you detox from benzos and offer inpatient and outpatient options. Also, if you have difficulty affording these services, you have plenty of insurance options.
Medically assisted detox is the safest way to go through benzodiazepine withdrawal. Your doctor originally prescribed the drugs and is familiar with their effects, so he or she is the best one to help you. Your doctor will also help you navigate less common withdrawal symptoms such as gastrointestinal issues, flu-like symptoms, temporary hearing and vision loss, or Restless Leg Syndrome.
Additionally, your doctor can guide you through alternative treatments for your original symptoms. Although benzodiazepines are dangerous, you also don’t want to live with panic attacks, insomnia, anxiety, or seizures. Your doctor may prescribe less potent medications, home remedies, or other alternative therapies. He or she will work with counselors and other professionals to find your best treatment options.
Speak with an accredited addiction treatment center near you or visit https://www.samhsa.gov/ to begin your search.