Dealing with withdrawal is never easy, but it can be especially tricky for patients recovering from a benzodiazepine addiction. Due to the nature of the drug, withdrawal can be severe or even deadly. That’s why medically supervised detox is so important.
This article will review what’s involved in benzodiazepine withdrawal, so you can better understand the complex nature of this addiction.
What is Benzodiazepine?
Benzodiazepine is a depressant often used to treat anxiety, insomnia, seizures, and alcohol withdrawal. The drug depresses the central nervous system and enhances GABA’s effects, slowing brain activity. Popular prescription brands include Xanax, Valium, and Ativan.
Why Do Withdrawal Symptoms Occur?
Withdrawal symptoms are one of the main reasons people struggle to overcome addiction. After using a drug for some time, the body becomes used to its presence, altering normal functions and brain chemistry.
Without the drug, the body is imbalanced and can no longer function properly. The individual may experience symptoms that vary by the drug of choice, but commonly include:
- Insomnia
- Irritability
- Mood swings
- Headaches
- Nausea and vomiting
Patients know that taking more of the drug can relieve these symptoms, and relapse is common. However, medically supervised detox can help. The provider will offer medications that reduce cravings and relieve other symptoms, increasing the chances of success.
The Unique Nature of Benzodiazepine Withdrawal
Detox typically involves going cold turkey. Patients will stop using the drug altogether and manage symptoms as best they can. Clinics will supervise the withdrawal stage, making patients as comfortable as possible and ensuring they don’t relapse.
Benzodiazepine addiction is a bit different. Abruptly discontinuing doses can cause severe and potentially fatal symptoms, such as:
- Seizures are a common withdrawal symptom in people who have been taking benzos for some time and may be deadly.
- Delirium and hallucinations may occur and can lead to self-harming behavior.
- Anxiety and depression are also common due to the brain changes that occur during withdrawal and could cause suicidal ideation.
Therefore, clinics often integrate a tapered approach, allowing the patient to withdraw gradually rather than abruptly. The process must be supervised to ensure patients don’t overdo it and potentially experience severe withdrawal symptoms, or don’t taper enough and relapse.
What is Benzodiazepine Withdrawal Like?
A PubMed study outlines the benzo withdrawal timeline as follows:
- 1-4 days: The individual will experience ‘rebound’ anxiety, a temporary but intensified return of anxiety symptoms. Insomnia is also common.
- 10-14 days: The person will experience full-blown withdrawal with symptoms such as hand tremors, sweating, insomnia, difficulty concentrating, headaches, tension, nausea, muscular pain, weight changes, palpitations, and perception changes.
- 14 days and beyond: The person will continue experiencing anxiety until a treatment is administered.
The study also mentions that symptoms are more severe in people who have been taking benzos for some time and in those who used short-acting drugs.
The Various Approaches to Benzodiazepine Withdrawal
An American Family Physician study explores various approaches to withdrawal, which may be integrated in recovery as follows:
- Using the same medication for tapering: Patients will continue using benzos in increasingly lower doses until they successfully detox.
- Switching to a Longer-Acting Equivalent: Diazepam can substitute for benzos, offering a longer-acting option that reduces dosing frequency.
- Using Adjunctive Medications to Mitigate Withdrawal Symptoms: Providers may use anticonvulsants to reduce seizure risk, beta-blockers to control heart rate, blood pressure, and tremors, clonidine to treat agitation and sweating, antidepressants to manage mood, and sleep aids and antihistamines for their sedative effect.
The withdrawal timeline will also vary. A quick taper may last 8 to 12 weeks, although the provider may choose to slow down the process if symptoms become severe. Longer tapers can last six months, a year, or even two years. However, longer tapers can cause patients to focus too much on the process, leading to anxiety.
Given all the options, patients must remain under supervision. Professionals may need to adjust the process as they go to achieve the ideal outcome.
A Mental Approach to Benzodiazepine Addiction
Managing benzo withdrawal symptoms is an integral part of treatment, but it goes beyond the physical. Patients must also address the underlying cause of their addiction and develop coping skills to prevent relapse.
Benzos are often prescribed to treat anxiety. Therefore, patients usually undergo therapy to learn how to cope with anxiety healthily, without drug use. The following techniques are typically integrated.
- Cognitive Behavioral Therapy (CBT): This therapy changes how people think and believe, helping them achieve a more positive outlook.
- Dialectical Behavioral Therapy (DBT): Helps people process and regulate intense emotions.
- Trauma-Informed Therapy: Recognizes the impact of trauma on a person’s life and helps them heal through empowerment and by prioritizing safety and trust.
- Acceptance and Commitment Therapy: This modern approach helps people accept complex thoughts and feelings rather than struggle against them, enabling them to lead a more meaningful and peaceful life.
- Eye Movement Desensitization and Reprocessing (EMDR): Typically used to treat PTSD, this therapy involves recalling unpleasant memories while following guided eye movements. It helps the brain reprocess the memory, replacing negative beliefs with more positive ones.
A provider may also recommend lifestyle changes that support a healthier lifestyle. For example, they may suggest engaging in deep breathing and meditation to ease anxiety. A healthy diet and exercise also help manage stress and support recovery goals.
Success Rates of Benzo Recovery
Benzo recovery is difficult, but statistics show high recovery rates as follows:
- 50% of 50 participants involved in a UK study had fully recovered after 10 months to 3.5 years. Overall, 70% had good outcomes while only 8% withdrew or relapsed.
- A two-year study of long-term benzo users showed high success rates in people who combined CBT with tapered withdrawal, with a relatively low 33.3% relapse rate.
- A primary care-based study found that 18% of participants achieved complete withdrawal after 12 months with a structured intervention, while only 5% recovered with a non-structured approach.
How BlueCrest Detox Helps with the Recovery Process
Benzodiazepine withdrawal can be challenging. BlueCrest Detox offers effective recovery assistance.
Patients can check into our luxurious, private residential facility for medically-supervised detox. We follow up with mental and physical therapies, customized to your lifestyle and holistic needs. Our expert team is available 24/7 to ensure a safe and successful recovery.
Contact us when you’re ready to start your detox journey.
FAQs
What is protracted Benzodiazepine Withdrawal (PWS)?
PWS occurs when people who were addicted to benzos experience prolonged withdrawal symptoms, lasting longer than the typical 6-18 months. According to a Psychiatric Clinic of North America study, they occur in 10-15% of patients, and are more likely in those who have used benzos for a prolonged period of time. It is treated with ongoing care, and symptoms eventually go away.
Should Medically Supervised Detox for Benzos Happen in an Inpatient or Outpatient Setting?
While it is possible to do outpatient detox, managing withdrawal symptoms at home while stopping in for medications and therapy, inpatient treatment may be more successful, especially in the early stages of detox. It ensures severe symptoms are managed and decreases the risk of relapse. Patients may switch to an outpatient setting as symptoms subside.
How long does benzo belly last?
Benzo belly is a withdrawal symptom some people experience due to the digestive changes they experience during recovery. It is related to bloating, abdominal pain, constipation, gas, and nausea. The symptom can last for weeks or even months, but may improve with a healthy diet, exercise, and stress management.
What does benzo withdrawal do to the brain?
People who have taken benzos for some time will struggle during withdrawal as the brain tries to counteract the sedative effects. It will feel overstimulated, and anxiety may occur.
Which benzo is easiest to withdraw from?
Diazepam or valium may be the easiest benzo to withdraw from. As a long-acting drug, it does not require frequent dosing. Additionally, the drug can easily be cut in half, as it’s scored down the middle, contributing to easy tapering.
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