Benzodiazepines, such as Xanax, Ativan, and Valium, can be very addictive due to their often-pleasurable side effects 1. Namely, they produce feelings of relaxation and at high doses, euphoria. Even though benzodiazepines or “benzos” are therapeutic when taken as prescribed for a short period of time, some people may take benzodiazepines illegally in order to get high. Chronic benzodiazepine abuse can lead to addiction, a condition characterized by compulsive drug-seeking behaviors despite negative consequences. When an addicted individual abruptly stops taking benzos or decreases the dose, withdrawal symptoms are likely to occur. Withdrawal due to benzodiazepine addiction often results in a wide range of unpleasant and potentially fatal symptoms. Detox and substance abuse treatment can help you manage withdrawal symptoms safely and empower you to start the path to a clean and sober lifestyle. This article covers the following information:
- Benzodiazepine withdrawal symptoms.
- Benzodiazepine withdrawal timeline.
- Post-acute withdrawal syndrome.
- Benzodiazepine withdrawal treatment.
- Medication for benzodiazepine withdrawal.
- How to find a treatment program.
Benzodiazepine Withdrawal Symptoms
Benzodiazepine withdrawal affects everyone differently. The severity and length of withdrawal symptoms will depend on several factors, including the dose used, length of use, whether additional substances were used, and your own physiological makeup. If you are addicted to benzodiazepines, you may experience what’s known as an acute withdrawal syndrome when you suddenly stop using. Like alcohol withdrawal, withdrawal symptoms from benzodiazepines can be life-threatening. A benzodiazepine detox program can help you manage the symptoms associated with this syndrome and help safely eliminate the drug from your body. Potential benzodiazepine withdrawal symptoms include 2,3:
- Excessive sweating.
- Rapid heart rate.
- Heart palpitations.
- Insomnia or sleep disturbances.
- Nausea or vomiting.
- Panic attacks.
- Increased anxiety.
- Hand tremors.
- Psychomotor agitation, or repetitive movements.
- Grand mal seizures.
You don’t have to deal with benzodiazepine withdrawal symptoms on your own. Call our helpline today at 1-888-241-8971 to talk to an addiction support specialist about detox options.
Benzodiazepine Withdrawal Timeline
The withdrawal timeline varies based on the specific benzodiazepine used. Benzodiazepine withdrawal symptoms may emerge within a few hours to a few days after cessation of or reduction in benzo use, depending on the duration of action of that particular drug. Someone who is addicted to a short-acting benzodiazepine may experience withdrawal symptoms within several hours after use is stopped, while withdrawal symptoms associated with an addiction to a long-acting benzo may not occur for a couple days after cessation of use 3. For example, Ativan withdrawal symptoms may appear within 6-8 hours of quitting, peak in severity on the second day, and show significant improvement by the fourth or fifth day 3. Conversely, Valium withdrawal syndrome may be more delayed; the symptoms may not appear for a week or so and tend to peak in intensity after about 2 weeks. Withdrawal symptoms generally dissipate within 3 to 4 weeks 3. However, some people, especially those who have used for long periods of time, may experience prolonged withdrawal symptoms that last for months. In rare cases, withdrawal symptoms can even last for years 4.
Post-Acute Withdrawal Syndrome
Also referred to as protracted withdrawal, post-acute withdrawal syndrome (PAWS) is a condition characterized by persisting symptoms that can last for weeks or months after the acute withdrawal period has ended. People with PAWS may exhibit a range of symptoms that resemble anxiety or mood disorders 5. Sometimes it can be difficult to discern whether the individual is experiencing post-acute withdrawal syndrome, symptom reemergence, or symptom rebound. Symptom reemergence, which is the return of insomnia or anxiety symptoms similar to those the individual originally suffered from, occurs since many people are prescribed benzodiazepines to manage underlying insomnia or anxiety in the first place. Symptom rebound is an amplified return of acute withdrawal symptoms, which are generally the opposite of the acute effects of benzos. Typically, protracted withdrawal symptoms are new symptoms that the client has not previously presented with and they may fluctuate in intensity 4. Some of the more common protracted withdrawal symptoms associated with benzodiazepine addiction include 4,5:
- Increased anxiety.
- Panic attacks.
- Obsessive-compulsive behaviors.
- Cognitive impairment.
- Pessimism or apathy.
- Cravings for benzodiazepines.
You may experience a flare-up of these symptoms in the presence of stressful life circumstances, but some people experience intensified protracted withdrawal symptoms without any specific cause or trigger.
Benzodiazepine Withdrawal Treatment
Trying to quit the use of benzodiazepines alone can be very challenging and, in some cases, dangerous due to withdrawal symptoms, such as seizures. Luckily, you don’t have to manage the situation on your own. Participating in a detox program followed by a substance abuse treatment program can help you withdraw from benzos safely, quit using benzodiazepines, and build coping skills to promote long-term sobriety. Typically, the first step on the road to recovery is detoxification. Detox is the process of clearing the substance from the body. Doctors and other healthcare providers usually supervise short-term detox programs, which might last a few days to a couple weeks, depending on withdrawal symptoms. Detox is only the first step in the recovery process, although an extremely important one. To cement your sobriety, you should enter a comprehensive drug treatment program as soon as detox is complete. Drug treatment programs offer a variety of therapeutic modalities, such as individual therapy, group counseling, relapse prevention skills classes, and ongoing medical care. Some of the treatment options you might consider include:
- Inpatient: This is a residential treatment option that can last a few weeks to a few months. You live at the recovery center for the duration of treatment and receive 24/7 care and supervision. Many patients find the structured environment to be beneficial while recovering from benzodiazepine addiction.
- Partial hospitalization: People who require intensive support 5 days a week, for several hours each day, but need to return home at the end of the day may benefit from this form of treatment. Some people enter partial hospitalization programs, or day treatment, after they complete inpatient treatment.
- Intensive outpatient: You live at home but participate in treatment a few days per week at an outpatient recovery center. Most intensive outpatient programs (IOP) focus on group counseling, education, and skill development 6.
- Support groups: People in recovery may supplement their treatment by participating in recovery groups such as Narcotics Anonymous (NA) or Pills Anonymous (PA).
- Luxury treatment: This form of residential treatment involves luxurious amenities, such as spa treatments and gourmet meals, in addition to more standard forms of treatment. These treatment centers are typically located in beautiful and desirable locations, such as by the beach or in the countryside.
- Executive treatment: For professionals in highly demanding careers, executive treatment allows you to continue working while recovering from benzodiazepine addiction. These facilities often offer posh amenities and services similar to luxury treatment centers.
- Population-specific treatment: Some treatment programs have experience in addressing the unique needs of specific populations, providing those in recovery with a comfortable and familiar environment. Some of these populations may include veterans, teens, LGBT, men-only, and women-only.
To obtain further information on your addiction treatment options, call our helpline today at 1-888-241-8971 to speak to an treatment placement advisor.
Medication for Benzodiazepine Withdrawal
Many detox or treatment programs will create a schedule for you to gradually taper off of benzodiazepines, which can help to mitigate unpleasant withdrawal symptoms. Some programs may also provide you with supportive medications to help you through the benzodiazepine withdrawal process. Some of the medications that you might take during detox include 7:
- Another benzodiazepine: Long-acting benzodiazepines, such as chlordiazepoxide and clonazepam, can be effective in detoxification.
- Phenobarbital: This long-acting barbiturate can help alleviate benzo withdrawal symptoms.
- Anticonvulsants: Anticonvulsants, such as valproate and carbamazepine, can help prevent seizures.
- Antidepressants: Sedating medications, such as imipramine and trazodone, can help to manage the anxiety associated with benzodiazepine withdrawal.
Aftercare is a crucial part of the recovery process. Once you complete a formal treatment program, you are still vulnerable to relapse. Aftercare can help prevent relapse by keeping you aware of potential triggers, consolidating your newly learned coping skills, and providing you with ongoing support. Some of the aftercare options you might consider include:
- Sober living homes: This is a type of alcohol- and drug-free halfway house where you transition from a treatment program to everyday life. You live with others who are also in the recovery process and receive regular drug tests to help ensure ongoing sobriety.
- 12-step programs: Based on the 12 steps of recovery originally formulated by Alcoholics Anonymous, 12-step groups provide support and fellowship from others in recovery. You work through the 12 steps with the guidance of a sponsor who is further along in the recovery process.
- Alternative support groups: SMART Recovery, LifeRing, Women in Sobriety, and other support groups have a different approach than 12-step groups; they often emphasize empowerment and self-reliance.
- Individual therapy: Working individually with a qualified counselor can help you to continue building upon the coping skills you learned in treatment.
- Group counseling: This option offers the camaraderie and support of a group of people in recovery. Your group works through issues together with the assistance of a group counselor.
Find a Treatment Program Today
You don’t have to suffer from a benzodiazepine addiction. If you want to learn more about your detox or recovery options, call our helpline today at 1-888-241-8971 to speak to a caring and compassionate support specialist.
- 1. Center for Substance Abuse Research. (2013). Benzodiazepines.
- Pétursson, H. (1994). The benzodiazepine withdrawal syndrome. Addiction, 89(11), 1455-9.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Washington, D.C.: American Psychiatric Publishing.
- Substance Abuse and Mental Health Services Administration. (2010). Substance Abuse Advisory: Protracted Withdrawal.
- UCLA Dual Diagnosis Program. Post-Acute Withdrawal Syndrome (PAWS).
- Center for Substance Abuse Treatment. (2006). Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration.
- Center for Substance Abuse Treatment. (2006). Quick Guide for Clinicians: Based on TIP 45: Detoxification and Substance Abuse Treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration.