Benzodiazepines (benzos) are central nervous system (CNS) depressants commonly prescribed to treat conditions such as anxiety, panic disorders, seizures, insomnia, muscle spasms, and alcohol withdrawal syndrome.
Benzos are prescribed under several brand names, including Ativan (lorazepam), Klonopin (clonazepam), Valium (diazepam), and Xanax (alprazolam). Although these drugs are considered to be relatively safe when used as prescribed, they have the potential for addiction and can be dangerous when misused. Benzos can pose significant risks to those who abuse them, and discontinuing use early on can mitigate some of the short- and long-term dangers associated with the use of these drugs.
What Is Benzo Withdrawal?
Extended benzodiazepine use or abuse often results in physical dependence—a state in which a person’s body becomes accustomed to the presence of a drug such that it can no longer function normally without it. When a person is dependent on benzos, and use is reduced or discontinued, the body will encounter a range of unpleasant effects known as withdrawal.
Symptoms of benzo withdrawal vary from mildly unpleasant to life-threatening. The severity of withdrawal is often related to the average dose of the benzo previously used and how rapidly use is halted. Users who suddenly quit benzos after a prolonged period of use are at higher risk of intense withdrawal symptoms than those patients who are weaned off gradually.
Is Benzo Withdrawal Hazardous?
Benzo withdrawal can be dangerous or even fatal, particularly for those with a severe dependence and/or co-occurring mental health conditions. Serious symptoms induced by benzo withdrawal may include both psychosis and seizures. If left untreated, seizures may be progressive, increasingly difficult to control, and potentially fatal.
Owing to this danger, it is critical that those attempting to quit benzos receive help from a physician, addiction specialist, or substance abuse treatment program that can safely guide them through the recovery process.
Suddenly discontinuing benzo use can also result in rebound effects, in which symptoms previously managed by the drug return with greater intensity. Users may suffer from symptoms such as rebound anxiety and insomnia at a level of severity comparable to or greater than those experienced before the user began using the benzo to treat such symptoms.
Benzo users who encounter rebound symptoms may be compelled to immediately relapse in an attempt to relieve the unpleasant and disturbing effects of withdrawal. Although many of the symptoms of benzodiazepine withdrawal are uncomfortable, treatment options are available to manage many of them, thus making the process safer and more tolerable for those entering recovery.
Benzo Withdrawal Symptoms
Symptoms of benzo withdrawal may include any or all the following:
- Nausea and vomiting
- Heart palpitations
- Panic attacks
- Irritability and agitation
- Muscle pain
- Muscle stiffness
- Poor concentration
- Sensory distortions
In instances of severe withdrawal, dangerous complications can develop, such as seizures and psychosis. Users who previously experienced seizures and/or have combined benzos with other prescription drugs or alcohol may be at an increased risk for developing seizures during withdrawal.
Some benzo users may encounter what is known as a protracted withdrawal, or post-acute withdrawal syndrome (PAWS). This condition can persist for several months or longer and include chronic anxiety, depression, and sleep disturbances.
Withdrawal from benzos can range in severity and duration between individuals. The intensity of the withdrawal depends on several factors, including the person’s health, the dose typically used, and the speed at which the medication is decreased when using the taper down method.
Medications for Withdrawal
Medications may be employed in the treatment of benzo withdrawal to help wean users from the drug, treat withdrawal symptoms, and relieve discomfort. A doctor may gradually taper a patient off benzos over a period of weeks or months, rather than suddenly discontinuing use.
For example, if a patient is currently taking a benzo with a relatively short half-life such as Ativan (lorazepam), the physician or addiction specialist may first prescribe one with a longer half-life, such as Klonopin (clonazepam). This change can help relieve symptoms during detox and better facilitate the weaning process.
Other medications that may be used to manage benzo withdrawal include the following:
- Anticonvulsants, such as carbamazepine and valproate
- Sedative antidepressants, such as trazodone
- Anti-hypertensive drugs, such as clonidine or propranolol, for those who experience severe autonomic consequences as part of benzo withdrawal (e.g., hypertension and accelerated heart rate)
Of note, the administration of these medications does not completely neutralize the risk of dangerous withdrawal symptoms, such as seizures. To reduce the risk of complications, patients should be closely supervised during detox by medical providers or addiction professionals to ensure safety.
While medications may be beneficial and even vital during the withdrawal process, it is important to understand that addiction treatment requires more than the administration of medication. Instead, medication is just one essential therapeutic component that should be employed in conjunction with psychological treatments, such as behavioral therapy and counseling.
Benzo Withdrawal and Addiction Treatment
Detox is the process of clearing toxic substances from the body. Because benzo withdrawal is associated with both distressing and potentially severe symptoms, medical monitoring is typically the safest course of action. Many people dependent on benzos also abuse other drugs or alcohol, which can increase the risk of dangerous complications during withdrawal.
Benzo detox can be conducted in a hospital environment or an addiction treatment facility. Medical providers who specialize in addiction in a detox facility begin by evaluating the severity of the patient’s condition and deciding on the best treatment plan for the individual. Medical providers may also:
- Monitor heart rate, blood pressure, and temperature.
- Gradually taper down the dose.
- Prescribe medications to relieve discomfort.
- Prescribe medications to reduce the risk of seizures.
- Encourage enrollment and participation in further treatment.
Although a safe detox is an essential step in the treatment process, long-term recovery necessitates learning coping skills to deal with a life free from drug use.
Programs offered by Midwood Addiction Treatment after detox completion and/or residential treatment include the following:
Partial-Hospitalization Programs (PHP) are an option for those who have either completed residential treatment or require an outpatient setting. Our PHP offers intense and comprehensive treatment comparable to a residential program, but is set in a comfortable clinical environment during the day, and includes the option of a relaxing, safe, and supervised home-like residence in the evenings.
Outpatient Treatment Programs offer weekly individual and group therapy and counseling with flexible time outside of treatment to attend to work, school, family, and adjust to living in the real world without drugs or alcohol.
Psychotherapy can be provided by an addiction counselor, therapist, or psychologist. Patients will attend individual therapy sessions at least once per week. Cognitive-behavioral therapy (CBT), for example, is a common and effective strategy used to address benzo addiction.
The theoretical basis for CBT is the notion that there is a connection between a person’s feelings, thoughts, and behaviors. CBT was developed to help people identify and understand the thoughts and beliefs that factor into negative emotions such as anger, worry, and depression. CBT also helps people understand how these emotions contribute to negative and unhealthy behaviors, such as drug and alcohol abuse, in order to foster positive lifestyle changes.
Midwood Addiction Treatment offers comprehensive, evidence-based treatment programs that promote sobriety and provide people with the tools and support they need to begin experiencing the fulfilling lives they deserve, free from drugs and alcohol. Contact us today to find out how we can help!