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Benzodiazepines are one of the most commonly used controlled drugs across the world. While many individuals swear by their potent effects and benefits, experts warn against their long-term use, mainly because of the high addiction potential associated with it. Despite the repeated warnings, a large majority of people fall victim to its addiction and are unable to stop using them without experiencing strong and highly unpleasant benzo withdrawal symptoms.
If you or someone you know has been abusing these drugs for a long time and require benzo withdrawal help, there are ways to tackle the situation safely and effectively.
An Overview of Benzodiazepine Withdrawal
The use of benzodiazepines has recently become widespread. Between 1996 to 2013, the number of people abusing these prescription medications rose by a whopping 67 percent. The abuse is now prevalent among all age groups, affecting teenagers and the elderly at the same rate. Surveys conducted in 2016 reported that more than half a million people in the United States were abusing benzodiazepines and other sedative drugs.
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While benzodiazepines are highly potent and beneficial, they carry high habit-forming potential. Anyone taking them daily without any gaps is at risk of developing dependence and tolerance. Once you become physically dependent on benzos, your body cannot operate normally without having these drugs in the system. In such circumstances, stopping or reducing the dose all of a sudden leads to a group of highly uncomfortable symptoms called benzo withdrawal symptoms.
Withdrawing from benzodiazepines is extremely difficult and potentially dangerous. People who attempt to do it on their own may feel extremely anxious and on edge for weeks to come. The process also causes high levels of irritability and hypersensitivity to everything. Physical symptoms, such as hand tremors and headaches, worsen the situation.
Despite all the hardships, it is possible to manage benzo withdrawal under expert supervision through various techniques. These evidence-based techniques aim to cause gradual dose reduction to ensure that the associated withdrawal symptoms stay in control. Remember that it is critical to involve a healthcare provider in the process to make it safer and more effective.
What are the Most Common Benzo Withdrawal Symptoms?
Benzodiazepine withdrawal hits different people differently. However, some of its most common signs include the following:
- Abdominal cramps
- Blurry vision
- Physical symptoms of anxiety, such as a fast heartbeat, chest tightness, muscle tension, trembling and sweating
- Problems with concentration
- Pain in neck and face
- Panic attacks
- Loss of interest in sex
- Increased sensitivity to noise, light, smell, and touch
- Loss of appetite
- Mild to moderate depression
- Eye soreness
- Sore tongue
- Ringing in ears
- A metallic taste in the mouth
- Tingling in feet and hands
- Unsteady legs
- Weight loss
Some people may experience more severe symptoms of benzo withdrawal, which may include:
- Memory loss
- Burning sensations in the skin
- Muscle twitching
- Derealization (feeling like being out of touch with reality)
- Depersonalization (feeling detached from surroundings)
Stages of Benzodiazepine Withdrawal
Benzodiazepine withdrawal can have different types, depending on the symptoms and when they appear.
Early withdrawal symptoms, also called rebound symptoms, tend to arise immediately as an individual stops using benzodiazepines. During this stage, they may also experience re-emergence of the condition for which they were initially taking benzos. For example, if someone was taking a benzodiazepine to control insomnia and anxiety, the symptoms of these issues may come back.
The symptoms of acute benzodiazepine withdrawal begin to appear a few days following the last dose. Most of these symptoms last five to twenty-eight days and can be extremely difficult to tackle. Acute withdrawal includes some of the most dangerous benzo withdrawal symptoms, such as suicidal ideation and behavior, and requires close monitoring to ensure safety.
Also known as post-acute withdrawal symptoms (PAWS), protracted withdrawal does not affect everyone undergoing a benzo detox. It is mainly seen in people who have been using these drugs for longer than recommended, misusing them, or have formed a dependence on them. The symptoms of PAWS are likely to linger on for up to 12 months or even longer. These symptoms include insomnia, depression, loss of sex drive, poor concentration, mood swings, and anxiety.
Because of its long duration, PAWS can be extraordinarily disruptive and trigger severe distress. Many rehabs offer supported counseling and other targeted therapies to control these symptoms and improve the overall quality of life.
Factors That Influence Withdrawal From Benzodiazepines
Withdrawal symptoms from benzodiazepines can hit anyone who uses these drugs, including those prescribed by a doctor to use them for a medical condition. However, certain factors significantly increase the risk and severity of these symptoms. These factors include:
The length of use and dosage
People who have been taking benzos for months at a higher dose than prescribed are much more likely to experience withdrawal symptoms. Such people are also more likely to continue experiencing them for longer than others.
As per the National Institute on Drug Abuse, benzodiazepines are extremely addictive and have a high risk of misuse. This risk of misuse increases the potential of experiencing withdrawal.
Method of ingestion
The method of using benzos is closely linked to the beginning of withdrawal symptoms. For example, those who inject or snort benzodiazepines experience an almost immediate effect, whereas those who ingest these pills experience delayed, less severe symptoms.
Type of Benzodiazepine
Benzodiazepines are of two types: long-acting and short-acting. Short-acting benzodiazepines are more potent than long-acting alternatives. Although both types can induce withdrawal, the short-acting ones usually lead to quicker and more severe symptoms. Alternatively, long-acting benzos last longer in the body and cause delayed withdrawal symptoms.
Underlying mental or medical health issues
People with pre-existing psychological and physical disorders are more likely to misuse benzodiazepines and experience withdrawal when they suddenly stop using them.
Mixing benzos with other substances
Many people with benzodiazepine addiction tend to mix these pills with alcohol and other drugs. This phenomenon is known as poly-substance use, which severely increases the severity and timeline of the associated withdrawal symptoms.
How Long is Benzo Withdrawal? A Sneak Peak of Benzo Withdrawal Timeline
The withdrawal timeline for people detoxing from benzos is different for every individual. Below is a guideline for what to expect as you taper down your benzo use over several weeks.
First 6 to 8 Hours
The earliest signs of withdrawal, such as insomnia and anxiety, usually emerge within a few hours of stopping the use of benzodiazepines. The exact time depends on how long it takes for the drug to leave the body. In the case of most short-acting benzos, these withdrawal symptoms arise within 8 hours from the last dose.
Day 1 to 4
A few days into the benzo detox, symptoms like insomnia and rebound anxiety set in. during this time, many people experience intense discomfort and other symptoms, like faster breathing and heart rate, excessive sweating, and constant nausea. People who have been using long-acting benzodiazepines notice the very first signs of benzo withdrawal during this window.
Day 10 to 14
The symptoms of benzo withdrawal mentioned above persist for at least 10 to 14 days following the last dose before slowly fading away. People who have been using long-acting benzos may need to wait another 2 weeks for these symptoms to subside.
Day 15 Onward
While the majority of benzo abusers successfully overcome the withdrawal phase within 2 weeks, many continue to experience the lingering symptoms beyond this time. Known as post-acute withdrawal syndrome, these symptoms can sometimes continue for a year.
Seeking Professional Treatment of Benzo Withdrawal
The best way to treat benzo withdrawal is by removing the drug from the body of an addict. Known as detox, this process can become potentially dangerous if not done properly. Hence, undergoing a detox process under expert supervision in a facility that offers round-the-clock support and monitoring is recommended. In addition to helping an individual overcome the physical aspect of addiction, a medically supervised detox also helps them stay safe and prevent or lessen the discomfort of withdrawal. While most people successfully finish detox in 7 to 10 days, others may need to participate in it for weeks or even months, depending on the severity of their addiction and duration of use.
Tapering Down Benzodiazepine Use
The process of medical detoxification typically involves tapering down from benzos. Tapering down means slowly reducing the dose with time or switching to a less-potent type of benzodiazepine. For example, individuals may be switched to using valium or Klonopin instead of the benzo they are already using, as these are long-acting and less potent than others. Using these relatively weaker benzos keeps the withdrawal symptoms at bay as an individual slowly detoxes from it.
Benzo Detox Medications
While many people reduce their dose gradually until they completely stop taking a benzo drug, others may not get through this process without extra help. To support such people, experts prescribe medications that relieve withdrawal symptoms to make a recovery possible. These medications include the following:
- Buspirone: This medication can benefit people abusing benzos to control their anxiety disorder. Buspirone can relieve the emotional effects of withdrawal without causing any physical dependence. The only downside to using this drug is that it may take up to 3 weeks before kicking in.
- Flumazenil: This is a primary drug used to control benzodiazepine overdose but can also manage withdrawal symptoms to some extent. Flumazenil works by blocking the effects of a benzodiazepine drug and relieving its withdrawal symptoms as it attaches to the same pleasure centers in the brain as benzos.
How long do benzo withdrawal symptoms last?
Most people successfully overcome the benzo withdrawal symptoms within two weeks. However, those abusing long-acting drugs may require up to 4 weeks to fully overcome them. In rare cases, these uncomfortable symptoms may linger for up to a year or more.
How can I safely stop taking benzodiazepines?
To overcome benzo addiction without experiencing withdrawal, it is essential to reduce the dose gradually instead of stopping it cold turkey. A doctor can provide more specific and tailored advice regarding how to safely withdraw from benzos after considering your circumstances. Joining a detox center is highly recommended to ensure the process goes smoothly without complications.