Benzodiazepine addiction is a huge part of the opioid epidemic in America. These powerful drugs are intended to treat anxiety and insomnia, but they can create addictions with deadly consequences. More than 30 percent of drug overdoses that involve opioids also involve benzos.
For someone who wants to get sober from benzos, withdrawal is one of the first steps in the process. It’s incredibly painful, but there’s no way around it. The addict has to go through it to achieve long-term relief and freedom from their benzo addiction.
Benzo withdrawal treatment is a complex process with many moving parts. There are several schools of thought regarding how to handle addicts going through benzo withdrawal, and there are best practices that apply across all of these approaches.
We’ve compiled this guide to the various benzo withdrawal treatments to give you an insight into this complex but necessary process. Read on to find out more about the whats of benzo addiction and the hows of benzo withdrawal.
What Are Benzos?
“Benzo” is a nickname for a class of drugs known as benzodiazepines, which we referenced above. There are several different kinds of benzos on the market, including alprazolam, diazepam, and clonazepam. The brand names of these drugs are Xanax, Valium, and Klonopin, respectively.
Benzo History Lesson
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.
Benzo Chemistry Lesson
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.
The Effects of Benzos on the Body
Benzos have strong sedative effects on the people who use them, but sedation is not the only physical effect of BZD. Benzo users also experience muscle relaxation and decreased anxiety. In cooperation with this calming effect, many users also experience short-term amnesia.
While it is easy to see the positive connotations that come with the physiological effects of benzos, effects like amnesia give us an insight into how quickly these drugs can become damaging to our bodies.
Medical Uses of Benzos
Thanks to their ability to calm and sedate people, BZDs have a wide variety of uses. Primarily, doctors prescribe them to treat seizures, anxiety, and insomnia.
Benzos can also treat withdrawal states and drug-associated agitation, coincidentally enough. It may seem ironic that benzos might help with benzo withdrawal, but we’ll talk more about that seeming paradox later.
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 percent of people who died of an opioid overdose in 2015 also tested positive for BZDs.
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?
Here are a few of the signs a benzo user has crossed the line to become a benzo addict. They:
- 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 Benzo Withdrawal?
So what is the experience of withdrawal like for a benzo addict? What are the specific sensations and feelings? Knowing these things can help you relate to the addict in your life as they begin their journey toward recovery, and it can encourage you to use your own medications only as prescribed to avoid experiencing these symptoms.
Similarities to Alcohol Withdrawal
Benzo withdrawal is actually quite similar to withdrawal from alcohol.
Addicts can suffer seizures and hallucinations. If hallucinations occur, they usually develop within 12 to 24 hours of stopping the substance and dissipate within 24 to 48 hours.
Another similarity to alcohol withdrawal is the experience of delirium tremens, also known as DTs. The DTs are a famously brutal experience in the alcoholic world, and the same goes for benzo addicts. DTs can include fever, disorientation, agitation, abnormally rapid heart rate, high blood pressure, and a lot of sweating.
The DTs form a classic picture of withdrawal that many people will recognize from Hollywood portrayals of the experience. These portrayals can be quite accurate, so it’s understandable that an addict might steer clear of getting sober for fear of experiencing these DTs. This is especially true given the fact that symptoms of DTs can last for up to a full week.
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.
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.
On some level, all 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.
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.
As we’ve already hinted at, 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.
Tips for How to Handle Benzo Withdrawal
Finally admitting to a benzo addiction or helping your loved one do the same is daunting. It involves a lot of self-searching and honesty. It helps to remember that, no matter who you are or what your life situation, you don’t have to do it alone.
It can also help to keep a few things at the forefront of your mind. With these tips in your back pocket, it should be easier to stay on track and remember the goal, which is sobriety.
1. Go to a doctor who understands.
The Ashton Manual is the gold standard for understanding how to get off of benzos. You should study it yourself, but you’ll need the help of a doctor too.
Many doctors are not familiar with the Ashton Manual, and when you have a doctor who doesn’t fully understand the benzo withdrawal process, they can do more harm than good. You especially don’t want a doctor who tapers you off the medication too quickly, as this can have disastrous effects.
2. 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
3. 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.
There’s No Substitute for Time
Benzo addiction is powerful, and benzo withdrawal treatment must be multifaceted to combat the power of the addiction. Medications, therapy, and detox can all help relieve the painful and sometimes life-threatening symptoms of benzo withdrawal.
One of the most important aspects of benzo withdrawal treatment is time. It takes a lot of time to get sober, so it’s important to be patient with yourself or your loved one throughout the process. Sobriety is a long-term goal, and patience will keep you from making unwise decisions for short-term relief.
Check out our benzo withdrawal treatment services for more help with this issue.