Benzodiazepine Withdrawal: A Guide On Symptoms, And Timeline
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Benzodiazepine withdrawal is a period of time that follows abstinence from the drug. During this period, the patients may experience a series of unpleasant symptoms called withdrawal symptoms. These problems occur as the body cannot adapt to a new equilibrium, following an abrupt stop of use. Long-term abuse can cause dependence. Unfortunately, this may occur even if one abuses it for a brief period of time. As a result, both the brain and the body become dependent. To make things worse, all this can happen even with prescribed use. Therefore, it is not recommended for long time use. Additionally, it is important to know that there is a probability of developing an addiction.
Table of Contents
- What Are Benzodiazepines?
- What Are The Symptoms Of Benzodiazepine Withdrawal?
- What Are The Common Patterns Of Benzodiazepine Withdrawal?
- When Do Benzodiazepine Withdrawal Symptoms Start?
- How Long Will Benzodiazepine Withdrawal Last?
- What Is The Timeline Of Benzodiazepine Withdrawal?
- How To Go Through Benzodiazepine Withdrawal Safely?
What Benzodiazepines Are
Benzodiazepines are a group of drugs known for their sedative and tranquilizing properties. They are most commonly prescribed to help with symptoms of anxiety, panic, seizure disorders, insomnia and muscle spasms or tension. They are incredibly popular and some of the most recognizable benzodiazepines include Xanax (alprazolam), Klonopin (clonazepam), Ativan (lorazepam) and Valium (diazepam). Benzodiazepines have become some of the most prescribed medications in America. With that, the abuse of benzodiazepine has increased as well. They are often abused for their relaxing and calming qualities which at high doses can cause a feeling of euphoria.
Many people begin their road to addiction with valid prescriptions from doctors they acquired for legitimate reasons. The problem is that this is a temporary solution to a bigger problem. It does not cure anxiety or insomnia it simply helps cope with it. Anxiety disorders require a specific treatment that may include therapy as well as possible medication. If someone becomes reliant on their benzodiazepine medication to help them cope with anxiety or insomnia this presents a real problem. The vast majority, if not all, benzodiazepines are not intended for long term use, because of their highly addictive properties. So often by the time their prescription runs out, people are already dependant on it to help cope. This can lead to them trying to obtain it in other ways, such as doctor shopping, forging prescriptions or other illegal activity. Once someone is addicted they may also use alternative ways of administering the narcotic, for example snorting crushed pills.
When an addict decides to quit using the drug, withdrawal symptoms come into play fast and quick. Addicts’ bodies have grown accustomed to the role benzodiazepines play in their system, and without the medication, they can start exhibiting difficult and painful symptoms. This happens because the bodies try and restore the balance back to what it was before the drug was introduced.
Benzodiazepines are some of the most difficult drugs to quit. Many addicts are scared off of doing so, the minute withdrawal symptoms arrive. Therefore, it is important to have a strong support group and not give up.
Symptoms Of Benzodiazepine Withdrawal
Symptoms vary from person to person, and drug to drug. But in general, it is fair to say that the symptoms are painful and have lasting effects. For the majority of people, it doesn’t last just a couple of days, but the process stretches out for months and sometimes even years. It mainly depends on what specific benzodiazepine one is withdrawing from. Shorter-acting ones (Xanax, for example) tend to produce intense withdrawal symptoms more quickly but are also generally over within 7 days. Longer-acting varieties, such as Valium can have acute withdrawal symptoms lasting up to a year, and it is not uncommon to have lingering effects lasting indefinitely.
Benzodiazepine withdrawal symptoms include:
- Sleep problems
- Severe stress and anxiety
- Short burst of extreme anxiety called anxiety or panic attacks
- Excessive sweating
- Problems with focus
- Loss of weight
- Racing and palpable heartbeat
- Pain in the muscles
- Changes in perception and thinking
- Seeing or hearing things that are not there. They call this hallucination.
Common Patterns Of Benzodiazepine Withdrawal
Most commonly, there are three phases of symptoms during the withdrawal from Benzodiazepines. These are:
- Within 1 to 4 days of stopping, one may experience severe sleep problems and become more stressed. These are called rebound insomnia and anxiety.
- Up to 14 days after quitting almost all the withdrawal symptoms are present.
- Rebound anxiety that does not get better with time. In this case, one or more medications is necessary to control it.
Of the three patterns mentioned above, the last one is the most unpleasant. Understandably, it requires intensive care and support.
When Benzodiazepine Withdrawal Symptoms May Start?
Well, it depends on the half-life of the particular Benzo taken. In essence, a Benzo with a shorter half-life shows the withdrawal symptoms earlier.
The half-life of a drug refers to the time that it takes to eliminate 50% of the initial dose from the body. For example, Xanax has a shorter half-life. Therefore, the withdrawal may begin as early as 10-12 hours after the last dose. On the other hand, Valium may take a few days to do the same. This is due to its longer half-life.
Furthermore, the method of abuse also plays a pivotal role in determining the onset of these symptoms. For instance, if injected or snorted, the drug reaches the brain virtually in no time. As a result, the withdrawal starts very early.
In the same way, taking a pill extends the withdrawal time. This is because the drug has to cross various barriers in the digestive tract before it reaches the brain.
In any case, a patient should seek professional help once experiences any of the symptoms.
How Long For Benzodiazepine Withdrawals To Last?
The period of these awful experiences may last for as long as a few months. On the other hand, mild addiction may clear within a week.
In fact, the determinant here is the degree of addiction. A mild addiction usually results in a shorter withdrawal.
Timeline Of Benzodiazepine Withdrawal
Here is an overview of the withdrawal timeline. However, each case may be a bit different. Every individual is different and so is the effect of a drug on their body.
Phase I: It usually starts 6-8 hours after the last dose. This is when the typical symptoms begin to bother a patient. They include sleep problems and increased anxiety.
Phase II: Typically, it starts after a day of discontinuation and may last up to 4 days. Rebound insomnia and anxiety reach their pinnacle during this phase. Other symptoms may include a racing heartbeat, fast breathing, and nausea.
Phase III: The symptoms continue bothering one for the next two weeks. Then, they begin to wither.
Phase IV: It may last for months. In fact, a doctor may prescribe some other medications to control the symptoms.
Factors That Determine Severity Of Benzodiazepine Withdrawal Symptoms
In addition to the individual body characteristics, various other factors also impact how severe symptoms one will develop. They may include:
- The amount taken: Higher the doses, more severe will be the symptoms.
- Duration of the Benzo therapy: The severity is proportional to the length of the therapy.
- Type of the Benzo taken: Normally, short-acting Benzos cause more severe withdrawal symptoms.
Go Through Benzodiazepine Withdrawal Safely
Despite what it may seem, withdrawing from benzodiazepines is possible, and more importantly, it can be done safely. Patients should never consider quitting a benzodiazepine cold turkey without consulting a medical professional. This can cause an even bigger shock to the system, and make withdrawal symptoms even worse than need be.
If one is considering stopping benzodiazepine medication, whether suffering from addiction or not, it is always a good idea to consult a doctor on how to do this in the best way possible. A doctor can develop and provide a schedule which will give an opportunity to slowly taper off the medication instead of quitting cold turkey. This is the best and healthiest way to go about it. A patient can gradually lower doses of benzodiazepine medication over an extended period of time, making the whole process more gradual and manageable.
Benzodiazepine Detox Centers
If someone is suffering from an intense addiction, and have been consuming large amounts of benzodiazepines over a long period of time, a help of a Benzo detox center should be considered. These are professionally staffed centers, in which one will be monitored around the clock having the vital signs checked to make sure none of the withdrawal symptoms become too intense or present a risk to one’s welfare. There a patient will also be put on a gradual tapering off schedule, but a doctor can also prescribe helpful medication to help cope with some of the more difficult withdrawal symptoms. This is the best and safest solution for anyone dealing with severe benzodiazepine abuse.
Detoxification is just the first step on a road to full recovery. Though benzodiazepines may be successfully out of one’s organism, they may still linger on the mind. Substance abuse therapy programs are where one can learn coping skills to learn how to continue living drug-free. Through cognitive behavioral therapy one can learn the connection between the thoughts and actions and how they affect each other.
- In almost all the cases, Benzodiazepine withdrawal does not cause any life-threatening symptoms. Nonetheless, they can be very bothersome.
- Do not stop taking it without consulting a doctor first. Most probably, they will recommend reducing the dose gradually. This can make the symptoms more bearable.
- Pétursson H. The benzodiazepine withdrawal syndrome. Addiction. 1994; 89(11):1455-9. https://www.ncbi.nlm.nih.gov/pubmed/7841856.
- Onyett S. R. The benzodiazepine withdrawal syndrome and its management. The Journal of the Royal College of General Practitioners. 1989; 39(321):160–163. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1711840/.
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