Benzo Detox and Withdrawal
Benzodiazepines, also known as “benzos,” are often misused for their sedative effects or to increase the high of other drugs taken with it. It’s possible to become physically dependent on benzos, which causes withdrawal to begin when someone stops using these drugs.
Benzodiazepine withdrawal is often accompanied by physical and mental side effects as the body adjusts to lower doses or complete discontinuation of drug use. The withdrawal process takes time, however, and suddenly stopping benzodiazepine use can be dangerous.
Medical detox helps reduce the risks associated with withdrawal, and it is typically the first step in benzo addiction treatment and recovery. Learning about benzo withdrawal symptoms and the detox process can be an empowering step in finding an effective treatment program and beginning the recovery journey.
Symptoms of Benzo Withdrawal
Benzodiazepines work by increasing the effects of GABA, a neurotransmitter responsible for slowing down certain signals in the brain. When someone is addicted to benzos and suddenly stops using them, signals in the brain speed up and lead to withdrawal symptoms.
Benzodiazepine withdrawal can vary from mild to severe, depending on the dose and frequency of misuse. The physical and mental symptoms that can occur during the process are collectively known as benzodiazepine withdrawal syndrome. Some of the symptoms include:
- Sleep disturbance
- Weakness or dizziness
- Psychosis or delirium, in severe cases
Some benzos, such as alprazolam (Xanax), can have more unpleasant withdrawal symptoms compared to other types. Switching to a different type of benzo before beginning detox can improve the withdrawal process. Antiseizure medication can also be prescribed to reduce the risk of withdrawal seizures.
Some people also experience post-acute withdrawal syndrome (PAWS). PAWS following benzo withdrawal can last for months or years and can cause:
- Anxiety or depression
- Memory or cognitive problems
Benzo Withdrawal Timeline
The benzodiazepine withdrawal timeline depends on several factors, including
- The current dose: Generally, high doses alter the central nervous system more and cause worse withdrawal symptoms.
- Type of benzo being used or abused: Short-acting benzos cause more severe symptoms than long-acting benzos. This is because long-acting benzos leave the body more slowly, so withdrawal is not as “abrupt.”
- The length of use: Withdrawal symptoms occur in people who have been using the drug for three to four weeks or longer.
- The frequency of use: More frequent usage will have a greater impact on GABA and often translates to higher usage overall. Therefore, frequent usage means worse symptoms.
- Whether benzos have been used with other drugs or alcohol: A person who abuses multiple drugs may have multiple sets of withdrawal symptoms.
Withdrawal can start within one to four days after reducing or stopping use. There are no specific timelines for benzo withdrawal since dose and tolerance vary from person to person. However, In general, most symptoms will subside within two weeks, but some may linger without ongoing treatment.
The initial process of withdrawal is just the first step in recovery. Therapy and aftercare can continue for months or years after withdrawal symptoms end.
Can Benzo Withdrawal Kill You?
For anyone who has taken benzos for at least one to six months, stopping suddenly can be dangerous. Other risk factors for adverse withdrawal symptoms include:
- Starting at doses higher than 10 mg
- Other substance use
- A severe, pre-existing dependence
Patients who are withdrawing from benzos are also at risk of seizures, which can have long-term effects or lead to death. Benzodiazepines can actually be prescribed to treat seizures, and they work by slowing down excessive electrical signals in the brain. By stopping benzos, those electrical impulses may increase and lead to rebound seizures.
Detox is a process in which a person’s body eliminates benzos and other drugs from its system. Benzo detox can be unpleasant, but professional detox programs can help reduce risks, relieve withdrawal symptoms and make the process more comfortable.
Medically Assisted Detox
In some cases, the fear of unpleasant withdrawal symptoms can be a barrier to recovery. As a result, many people feel safer or more comfortable completing the detox process in a medically supervised environment. Medically assisted detox can take place in a hospital, detox facility or rehab center. In these settings, clients are monitored and receive ongoing care for withdrawal symptoms as they detox from benzodiazepines.
The cornerstone of benzodiazepine withdrawal involves switching the person to a long-acting benzodiazepine like diazepam and then slowly tapering. This strategy reduces or eliminates withdrawal symptoms so that other medications are not typically needed.
Tapering off Benzos
The process of detoxing is much safer and more tolerable when the benzodiazepine dosage is reduced gradually, which is known as tapering. Tapering should be done in increments, but the exact procedure will depend on a person’s usual dosage. For example, the benzo taper process for someone taking 10 mg per day may involve gradually tapering to 5 mg per day, then 2.5 mg per day, then stopping completely.
During detox, people are often converted to a long-acting benzodiazepine like Valium (diazepam). Long-acting benzos leave the body slowly and cause less noticeable withdrawal symptoms as a result. The benzo may be converted to an equivalent amount of diazepam; for example, someone taking 8 mg of Xanax per day would be converted to 80 mg of diazepam. The dosage can then be slowly reduced over a period of several weeks.
Each reduction in dosage should be spaced at least one week apart. However, each stage of tapering can still take several weeks, and the process should always be overseen by a medical professional. The total time to complete the taper may take several months.
Finding a Benzo Detox Center in Washington
The process of detoxing can be challenging, so being close to your home and the support of your loved ones can be comforting. Located in Vancouver, Washington, The Recovery Village Ridgefield provides easy access to medical detox services for people struggling with benzos in Seattle, Washington, and Portland, Oregon.
If you struggle with benzo addiction, The Recovery Village Ridgefield is here to help. We provide individualized treatment plans that address addiction as well as co-occurring mental health disorders like anxiety or depression. Contact us today to speak with a representative about benzo addiction treatment programs that can work well for you.
- Ait-Daoud, Nassima; et al. “A Review of Alprazolam Use, Misuse, and Withdrawal.” Journal of Addiction Medicine, March 12, 2018. Accessed July 18, 2019.
- Brett, Jonathan; Bridin, Murnion. “Management of benzodiazepine misuse and dependence.” Australian Prescriber, October 1, 2015. Accessed July 18, 2019.
- World Health Organization. “Withdrawal Management.” 2009. Accessed November 30, 2021.
- Janhsen, Katrin; et al. “The Problems of Long-Term Treatment With Benzodiazepines and Related Substances.” Deutsches Ärzteblatt International, January 2015. Accessed December 9, 2021.
- Longo, Lance; Johnson, Brian. “Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives.” American Family Physician, April 2000. Accessed December 9, 2021.
- Semel Institute for Neuroscience and Human Behavior. “Post-Acute Withdrawal Syndrome (PAWS).” Accessed December 9, 2021.
- Pétursson, H. “The benzodiazepine withdrawal syndrome.” Addiction, November 1994. Accessed December 9, 2021.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.
Every recovery begins with a call.
Contact The Recovery Village today.360.605.1883