Benzodiazepines, or “benzos,” are one of the most highly abused substances in America. According to the National Institute on Drug Abuse, “16 percent of overdose deaths involving opioids also involved benzodiazepines” in 2020.
Many who develop an addiction or dependency on this substance have done so due to exposure to prescription medication. Anxiety-related issues are the leading cause of mental health problems in America. Benzodiazepines are routinely prescribed for conditions ranging from mild anxiety and related insomnia to treatment for the experience of full-fledged panic attacks. Some concerned medical healthcare providers are even placing the risk of prescription benzodiazepine addiction on par with the opiate crisis. Substance users may be unaware of the risks of such a widely-prescribed medication.
Within the last decade, there have been several accounts of celebrity deaths associated with the presence of benzodiazepines, which highlights the cultural prevalence of the use of this substance. In many documented drug overdose cases, opioids are present along with benzos, highlighting the danger of mixing benzodiazepines with other depressants.
The ease of developing a dependence on benzos lies in the way that this substance affects the brain. Upon ingestion, receptors within the brain are signaled to bind with the chemicals, which induce a feeling of relaxation and drowsiness. The result is a sense of calm and well-being for the user. However, because an outside substance induces the process, the brain can learn, over time, that it does not need to react to stress by producing its relaxation chemical response. This leads the user to feel it is impossible to function properly without continued exposure to benzodiazepines, as they find that anxiety levels have stopped decreasing naturally. This level of biological dependency can be experienced within just a matter of weeks after the first dosage.
Initial withdrawal symptoms from benzodiazepines can include the inability to sleep and a general sense of anxiety. As withdrawal progresses, the dependent user can experience severe symptoms, such as nausea, dry heaves, muscle aches and spasms, inability to concentrate, memory lapse, irritation, heart palpitations, excessive sweating, and tremors.
Severe cases of benzodiazepine withdrawal can result in the need for emergency hospitalization. In addition, the experience of grand mal seizures can accompany withdrawal and lead to coma or even death. Multiple reports of death as a result of benzodiazepine withdrawal are emerging from recent studies.
It has been found that certain types of benzodiazepines may be more likely to induce these withdrawal symptoms, as well as to contribute to the severity and length of the experience. In general, withdrawal symptoms from shorter-acting benzodiazepines – such as Xanax and Ativan – will begin within a few hours. However, withdrawal symptoms from longer-acting benzos – such as Valium and Diazepam – can take several days to begin.
The initial symptoms of benzo withdrawal, such as insomnia and nausea, tend to last from one to four days. Following this period, the more distressing symptoms – which can include seizures and psychosis – tend to last anywhere from one to two weeks. The final stages of physical withdrawal occur after this intense period and resemble the initial symptoms. This tapering off of physical dependence can last from a few weeks to a few months.
Recovery from the psychological and emotional symptoms of benzodiazepine withdrawal can last much longer than the physical symptoms. Former benzo users can suffer from bouts of unpredictable and uncharacteristic behavior, will report experiences of depression, and tend to provide an overall lower quality of life rating. These psychological withdrawal symptoms have persisted for several months after discontinuing the drug, and the experience of discomfort sometimes prompts patients to resume their habit of using benzodiazepines.
A smaller percentage of former benzodiazepine users will experience what is known as Post-acute Withdrawal Syndrome (PAWS.) With PAWS, the symptoms of withdrawal can last for several years. In these cases, multiple factors are believed to contribute to long-term symptoms. The former user may lack the tools necessary to handle stress – depending on the substance for stress maintenance – which prolongs the experience of anxiety. The effects on the user’s ability to store and access memories may be negatively impacted by the benzos’ long-term use, resulting in an inability to institute learned coping methods. And in some cases, benzodiazepines may refuse to leave the nervous system promptly.
Substance abuse treatment programs are available to assist a recovering person in reducing the physical discomfort experienced while detoxing from benzodiazepines. Several medical treatment options are available, including benzodiazepine reduction and substitution methods. Treatment medications can be delivered orally and intravenously, including antidepressants and anticonvulsants.
Robust detox treatment programs will also include components that address the psychological and emotional concerns which tend to arise during the process. Treatment programs that combine psychotherapy with medication assistance are the most effective in reducing relapse in benzodiazepine abuse cases. This makes sense in light of the many psychological factors associated with withdrawal from this drug.
In addition to providing immediate support for withdrawal issues, a detox treatment provider can assist the recovering person in developing a plan for ongoing support and coordinating mental health services. Using local resources, the choice of abstaining from benzodiazepines can be solidified with the convenience of outpatient services. Due to the potential for long-lasting, negative effects of withdrawal from benzodiazepines, a cohesive plan for extended maintenance of sobriety provides the recovering user with the best chance of success.
If you or a loved one are struggling with addiction to benzos or other substances, reach out to Ascendant today. Our drug abuse treatment program can provide the support you need to begin your recovery journey.
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Last medically reviewed September 3, 2022