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Benzodiazepine Withdrawal

Benzodiazepine medications are a popular means of treating various ailments. It addresses issues that affect an overactive central nervous system. There are 15 types of medicines in circulation that have been approved by the U.S. Food and Drug Administration (FDA) that treat many common medical and mental health issues.

Benzodiazepines are classified as psychoactive drugs. They were synthesized in 1955 but didn’t gain traction until the 1970s. As the medicines grew in popularity, they became the most prescribed medication in the world. They are typically used as sleep aids or anti-anxiety medications, but they have found their place in treating epilepsy as well.

Benzodiazepines were created with the belief they could replace barbiturates, which were deemed highly addictive and dangerous drugs by physicians. Barbiturates were the original treatment for the ailments mentioned above but came with a host of deadly side effects, including addiction. Despite their success, doctors still sought alternatives that were potent enough to treat these disorders. The highly addictive medication was a top drug of abuse during these times. It lead to fallout from the healthcare industry, and physicians decided to stop prescribing them.

Benzodiazepines slowly filled that void – they are used by 40 to 50 million adults in the United States annually. They help these individuals overcome their sleep or anxiety disorders, which affect a significant portion of our population. While a majority of those prescribed these medications will use them as instructed, there is still a substantial portion of our society who will abuse them.

Benzodiazepines are still one of the most over-prescribed drugs in the United States. It causes an increased likelihood of prescribing to the wrong person who becomes addicted. The National Institute on Drug Abuse (NIDA) reports that more than four times the amount of fatal overdoses due to benzodiazepines took place in 2015 when compared to 2012.

While benzos have been used successfully for hundreds of thousands, they still possess significant risks. These risks range from addiction to death. Withdrawal symptoms are notoriously dangerous. Benzodiazepine detoxification requires you to be under the care of medical professionals to avoid serious injury.

What to Expect from Benzodiazepine Withdrawal?

When we think of dangerous withdrawal, only a few drugs come to mind. Alcohol and benzodiazepines are notorious for their deadly symptoms. Benzodiazepines fall into a category of drugs known as central nervous system (CNS) depressants. The detox symptoms can be life-threatening if they are not appropriately monitored.

Some of the most common early symptoms of withdrawal include:

  • Nausea
  • Restlessness
  • Vomiting
  • Confusion
  • Irritability
  • Fatigue
  • Fever
  • Irritability
  • Mood swings
  • Muscle pain
  • Headaches
  • Abdominal cramps
  • Elevated heart rate

As you progress through your timeline, the symptoms may become more severe. These include:

  • Hallucinations
  • Rebound insomnia
  • Rebound anxiety
  • Uncontrollable muscle spasms
  • Depression
  • Vivid nightmares and other sleep disturbances
  • Constant uncontrollable crying

As we’ve described above, abrupt cessation of benzos after an extended period of use exaggerate symptoms of insomnia or anxiety. The phenomenon, known as rebound symptoms, is a return of symptoms that are much worse than before. Rebound insomnia may cause you to stay awake for days.

You may also experience panic attacks or severe paranoia. Someone going through benzo withdrawal places themselves at more significant risk of developing severe symptoms. It commonly occurs in heavy benzo users.

Benzodiazepine withdrawal syndrome symptoms include:

  • Hypertension
  • Memory loss
  • Psychosis
  • Suicidal behavior
  • Delirium
  • Seizures

It is possible that during benzo withdrawal can experience tonic-clonic seizures, as well as delirium tremens (DTs).

Benzodiazepine Withdrawal Timeline

A frequently asked question regarding benzo withdrawal is how long the process lasts. A general timeline can guide you through the process, but it’s important to note it can vary from one person to another. There is no specific answer to this type of question, but there is a general timeline that can help guide you through this process and give you a better understanding of the journey you are about to take.

Any drug that falls into the benzo category is going to have a varied timeline of length and severity. Some of the questions that address these unique factors have been included below:

  • How the benzos were used (ingested, snorted, injected, etc.)
  • How long someone has been abusing benzos
  • If other drugs were used in conjunction with benzos
  • The dosage someone consumed, and how often they used
  • Physical health of the individual
  • If the person is struggling with co-occurring mental illness
  • If there is a history of addiction
  • If they experience withdrawal symptoms during their detox
  • If there is a tapering schedule put in place that slowly lowers their benzo intake

The type of benzo will also play a role in the timeline. Someone that abuses Ativan or Xanax will have shorter withdrawals because of a shorter half-life, while Valium or Klonopin may experience lengthier symptoms due to a longer half-life.

  • 10 to 48 hours: You may notice a peaking of your symptoms. Librium may not achieve its peak strength of withdrawal until two days after its last use.
  • Four to 10 days: Depending on the type of benzos used, withdrawal symptoms may either be at their peak or start to fade.
  • Two to four weeks: The timing now is crucial as withdrawal symptoms will either disappear or diminish significantly. Psychological symptoms may linger during this time, even for benzos with a short half-life.
  • One month and on: Withdrawal symptoms should be complete at this point, but anxiety, insomnia, and depression may remain for a considerable amount of time.

What Are the Benzodiazepine Withdrawal Treatment Steps?

During NCBI, the safety of the client is our primary point of emphasis. There is guaranteed around-the-clock monitoring by medical professionals. They will administer medications that help diminish the symptoms of withdrawal. The team will also place you on a tapering schedule that gradually weans you off benzos to avoid the risk of seizures. Anyone that has become dependent on or addicted to benzos places themselves at an elevated risk of dangerous withdrawals. They must, at the very least, consider detox.

As you progress through detox, you will start to consider your next level of care. It could be a residential treatment center or an outpatient facility that allows you to attend therapies while comfortably resting at home. A thorough assessment is needed by clinicians to determine what is best for you. Treatment must be tailored to your needs to give you a fighting chance of long-term sobriety.

Sources

National Institute on Drug Abuse. (2019, January 29). Overdose Death Rates. Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

The National Center for Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK64119/

Tonic-Clonic (Grand Mal) Seizures. (n.d.). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/epilepsy/tonic-clonic-grand-mal-seizures

López-Muñoz, F., Ucha-Udabe, R., & Alamo, C. (2005, December). The history of barbiturates a century after their clinical introduction. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2424120/

Benzodiazepines. (n.d.). Retrieved from https://www.dea.gov/factsheets/benzodiazepines

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