Benzos withdrawal symptoms can develop following long-term use. Here is what you need to know and what is the timeline of the detox symptoms to ensure a safe and effective detoxification experience.
Benzodiazepines, also known as “benzos,” are a class of central nervous system depressants typically prescribed by healthcare providers for anxiety, sleep disorders, depression, and seizures.
Doctors often use this form of treatment to help patients; however, benzodiazepine addiction is a serious risk.
Benzo addiction may cause behavioral health issues and life-threatening symptoms.
Two of the most common benzos found on the illicit market are clonazepam and alprazolam. (1)
Other commonly abused benzos include:
Symptoms of Benzodiazepine Withdrawal
If you take benzos for longer than three to four weeks, you will likely experience benzo withdrawal symptoms if you suddenly stop. The greatest concern for those who will experience withdrawal symptoms is among patients who have been using benzos for over six months. (2)
Once benzo addiction develops, you increase your risk of significant consequences — dependence, overdose, and mortality.
To develop these symptoms, you need to develop physical dependence. However, psychological dependence can also be challenging to overcome. Withdrawal symptoms from benzos can be different for each person. Some people have mild to moderate symptoms, while others have severe withdrawal symptoms.
Common Benzo Withdrawal Symptoms Include:
- Muscle spasms
- Headaches
- Heart palpitations
- Sweating
- Increase in blood pressure
- Tremors or trembling
- Muscle pain and aches
- Dizziness
- Shooting pains in the neck and spine
- Visual disturbances, including blurred vision
- Confusion
- Delusions and paranoia
- Hallucinations
- Psychosis
- Seizures
- Nausea
- Weight loss
- Anxiety and panic attacks
- Irritability
- Poor memory
- Sensory hypersensitivity
- Depression
- Depersonalization
Millions of People Are Impacted By Benzodiazepine Usage
According to one study conducted by PubMed, 30.6 million adults (12.6%) in the USA reported using benzo medications.
25.3 million (10.4%) of adults were taking them as their doctor had prescribed, while 5.3 million (2.2%) were misusing them. (3)
Misuse of any benzo occurs when people use them against the advice of their doctor, or without close medical supervision. The research further states that benzodiazepine use without a doctor’s prescription was the most common type of misuse.
The sad part is that, very often, friends or loved ones were found to be the most common source of unprescribed medication.
Why Do People Take Benzodiazepines?
This class of medication is often used to slow down activity in the brain and nervous system. (4)
Benzos are most often used to treat:
- Anxiety disorders
- Depression
- Insomnia
- High stress
They can also be used to treat some mental illnesses and seizures.
However, as with any excessive substance use, benzodiazepines are well known to be highly addictive and dangerous if misused.
Reach out for help from a benzos detox center like Zinnia Health, your friends and family, your doctor, or support groups.
What Causes Benzos Withdrawal?
Benzo withdrawal symptoms develop because of both a physical dependence and a psychological dependence.
It is well-understood that people who use high doses of benzos regularly over an extended period may experience benzodiazepine withdrawal syndrome when they stop or reduce use. (5)
In many cases, users begin abusing benzos to help ease the symptoms of an underlying mental health condition. You must seek ongoing support to address your mental health if you relate to this scenario.
Why Does Benzo Dependence Occur?
Thanks to an increased understanding of physiology and pharmacology, many benzos’ mechanisms of action are now well-understood. (6) Although benzos offer immense therapeutic value and are often well-tolerated, the risk of side effects, addiction, and toxicity must be considered.
Benzos influence GABA receptors to produce a calming effect. GABA is the brain chemical that produces a calming effect, offering anti-seizure and anti-anxiety benefits.
How benzos interact with GABA receptors is incredibly complex, as several types have been identified.
Benzos with high lipid solubility have higher absorption rates and faster onset. Varying effects depend on which receptors are activated and where.
For example, the anxiolytic effects of benzos are mediated through receptors located in the limbic system.
Not all benzos interact with the same receptors, so when you start mixing benzos (or benzos with other substances of abuse), this process becomes complicated.
Why Is Post-Acute Withdrawal Syndrome Important?
Post-acute withdrawal syndrome (PAWS) is a key reason why ongoing addiction treatment and support are so important. (7)
Some users can experience symptoms, such as:
- Depression
- Anxiety
- Sleep issues (for weeks, months, or years)
These symptoms are not necessarily true pharmacological withdrawal symptoms. However, they are related to long-term benzo use. The duration of this syndrome is highly dependent on the individual.
Research suggests a gradual dosage reduction or tapering off of the medication, followed by counseling, therapy, and cognitive behavioral therapy (CBT). (8)
How Long Does Benzos Withdrawal Take?
A key consideration is a benzo’s half-life, which is the estimated time needed to reduce the concentration of that benzodiazepine in the plasma by half. (6) It takes approximately five half-lives for a drug to be eliminated from your body.
So, if you take a dose within this period, drug accumulation is likely. In some cases, active metabolites are produced.
For example, diazepam, a long-acting benzodiazepine, produces a range of metabolites that increase the drug’s duration of action.
Here are the half-lives of different types of benzos:
- Short-acting benzos have an average half-life of one to 12 hours
- Intermediate-acting benzos have an average elimination half-life of 12–40 hours
- Long-acting benzos have an average half-life of 40–250 hours
Short vs Fast Acting Benzos Withdrawal Timeline
The onset and duration of benzos withdrawal syndrome will depend on the specific benzo you’re taking. (5)
- Short Acting Benzos
- If you are taking short-acting benzodiazepines (alprazolam, oxazepam, and nitrazepam), withdrawal symptoms typically occur within one to two days of last use, with symptoms peaking around 7 to 14 days before gradually subsiding.
- Long Acting Benzos
- If you’re taking long-acting benzos (diazepam, clonazepam), withdrawal symptoms are less severe between two and seven days, with symptoms peaking around day 20 before subsiding after a few weeks.
Benzo Withdrawal Timeline Expectations
It can sometimes be challenging to differentiate between withdrawal symptoms and the original anxiety. Understanding a rough benzos withdrawal timeline will help you develop a better plan as you work alongside a professional care team.
As hard as it may be right now, recovery is possible. Just remember that it is a process. Once you have a clear objective and a routine, you will start to feel more settled. The benzos withdrawal period is a small window of time.
Once you overcome the physical symptoms of withdrawal, you will benefit from greater clarity, allowing you to focus on your psychological well-being. The price of not seeking treatment could be dangerous, even fatal.
If you’re someone who often mixes benzos with alcohol, this increases your risk of overdosing.
If this is the case for you, please do not go through the benzos withdrawal period alone. Complications can quickly arise, threatening not just your recovery process but your life.
How To Safely Detox From Benzos
A benzo tapering schedule is typically the first line of defense. A patient should never abruptly stop taking benzodiazepines.
To best address your symptoms, you will need to be assessed. Upon your assessment, a customized plan will be required.
An individualized approach helps ensure a comfortable, safe benzo withdrawal process.
The overall strategy will depend on several factors, including:
- The detoxification setting
- The severity of dependence and tolerance
- The total drug combinations used
- The user’s mental health history
Gradually reducing benzodiazepine dosage is particularly useful when dependence has developed among those who:
- Only take benzos
- Became dependent after taking doses within the therapeutic range
- Are currently being treated in a medical environment
Example Benzo Tapering Schedule
The individual benzo tapering strategy will vary. However, a dosage reduction of 10 to 15 percent each week is common. (9) A tapering period of six to twelve weeks is ideal for outpatient detoxification.
Faster reductions are possible but require more intensive clinical contact and support.
Inpatient vs Outpatient Withdrawal Help
If you have an uncomplicated benzodiazepine dependence and tolerance, you may be able to detox on an outpatient basis. (9)
However, those who can relate to the below criteria benefit from a multidisciplinary team approach.
For this method to work, people often need ongoing educational, psychiatric, psychological, and counseling help.
Although anyone withdrawing from benzos can benefit from ongoing clinical support, it is particularly critical that you seek professional help if you:
- Are on very high doses (e.g., over 50 milligrams of diazepam per day)
- Are abusing multiple substances of abuse
- Suffer from neurological disorders and seizures
An ongoing treatment plan will be required to achieve long-term changes. For example, someone with an anxiety disorder may begin to experience overwhelming symptoms that feel as though they’ll be permanent.
At this time, a support team can provide the guidance and reassurance needed to continue making lasting changes. When a medication-assisted approach is taken, several options are available depending on the user’s needs and history.
For example, for those addicted to short-acting benzos, such as alprazolam, or those using benzos with alcohol, chlordiazepoxide may be prescribed.
Clonazepam is another commonly suggested benzo that can help protect against withdrawal seizures. Once you have eliminated all substances, you can focus on your psychological dependence or any underlying mental health symptoms.
If you’re looking at stopping benzos, combining therapy with gradually taking less of the medication works wonders compared to only lowering your dosage bit by bit. Ongoing therapy may be necessary to maintain sobriety. (2)
Seeking the support of an accredited, professional facility is imperative. A medical team of compassionate medical professionals who understand the value of holistic healing will make all the difference.
Partner with a facility and team that focuses on evidence-based treatment strategies and offers a range of therapy options.
For example, in addition to individual and group therapy, many patients benefit from art therapy, adventure therapy, or equine-assisted psychotherapy.
Who Is At Risk of Developing a Benzo Withdrawal?
Research shows that benzo abuse and addiction are also common among those who have a history of alcoholism. (9) Also, users who do not have a history of abuse, but have a first-degree relative with a history of addiction, face an increased risk.
Legally, these benzos are a class of drug only available via prescription. However, many users obtain them illegally. They buy them on the streets or steal them from others in their household.
Data shows that most misusers got their benzos from friends or family, with only around 20% receiving their prescription from a doctor. (10)
Those who develop a benzos addiction may also get prescriptions from multiple doctors or forge prescriptions.
Other variables to consider are how long you’ve been taking the benzo(s) of your choice, the average daily dosage, and if you’ve been combining benzos with other substances, like alcohol.
Benzos have a risk of abuse, particularly among those with a history of drug use. The way you use benzos is often a telling sign.
For example, if you are regularly crushing benzos to snort, this is a major red flag, as you are explicitly using the drug to experience the corresponding high.
How Opiates Affect a Benzo Withdrawal
Commonly abused among opioid abusers, benzos can enhance one’s high.
Data shows that many patients seeking treatment for opiate withdrawal are also often typically dependent on benzodiazepines. (11)
When analyzing patients going through opiate withdrawal only versus those experiencing both opiate and benzos withdrawal symptoms, it’s been found that the latter is more severe.
Being dependent on benzos when struggling with opioids will exacerbate benzos withdrawal symptoms, making this combination complex.
Using these drugs concurrently is also incredibly dangerous, which is why you should seek professional clinical care as soon as possible.
When to Contact a Medical Professional
Whether you began taking benzos to address a sleep disorder and developed a dependence or have been abusing benzos illegally for years, you deserve a life free from the chains of addiction.
You no longer need to accept the current cycle you’re living. If benzos withdrawal continuously drives you to use, even though you want to stop, it’s time to take the next step.
Unlike withdrawing at home, when you seek the support of a professional substance abuse and mental health facility, you will receive the clinical care required to make it through this initial period.
You will gain peace of mind knowing you’re safe and well-monitored. You’ll then benefit from an individual treatment plan that is tailored to your unique needs and goals. That is a powerful thing.
Help is available. Now is the time to act. Say yes to the future you seek.
Call us today at (855) 430-9439 to learn more.
Citations
- https://www.dea.gov/sites/default/files/2020-06/Benzodiazepenes-2020_1.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308/
- https://pubmed.ncbi.nlm.nih.gov/30554562/
- https://my.clevelandclinic.org/health/treatments/24570-benzodiazepines-benzos
- https://www.sahealth.sa.gov.au/wps/wcm/connect/65dfe862-f6a1-45ae-bcef-e9e446ac2bf1/Benzodiazepine+withdrawal+-+FINAL+2019.WR+_2.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/
- https://pubmed.ncbi.nlm.nih.gov/1675688/
- https://pubmed.ncbi.nlm.nih.gov/34639523/
- https://www.jabfm.org/content/jabfp/5/2/167.full.pdf
- https://archives.nida.nih.gov/news-events/science-highlight/research-suggests-benzodiazepine-use-high-while-use-disorder-rates-are-low
- https://pubmed.ncbi.nlm.nih.gov/15380286/
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