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Benzodiazepines Detoxification – Withdrawal Symptoms and Phases

Last Updated: June 10, 2020

Authored by Sharon Levy, MD, MPH

Reviewed by Michael Espelin APRN

Benzodiazepines Definition

Experts categorize Benzodiazepines as psychoactive drugs for the treatment of patients with anxiety and panic attack problems. In addition, they use these prescription drugs as sedatives or tranquilizers. As a result, they produce a calming effect on the patient. Incidentally, regular use of benzodiazepines could increase the percentage of physical and psychological dependence. The common brand names of “benzos” include:

  • Ativan or Lorazepam
  • Librium or chlordiazepoxide
  • Klonopin
  • Valium or Diazepam
  • Xanax or Alprazolam

Benzodiazepines Detoxification

Detoxification is the first step for an individual with benzodiazepines overdose or addiction of  for a better life.

Benzodiazepines Withdrawal Symptoms

The withdrawal symptoms a person taking benzodiazepines will experience may vary. Of course, they are highly dependent on many factors. First, it is the number of doses they took. Second, it’s the length of usage. Third, it is the level of dependency both on the physical and emotional aspects. Here are the common withdrawal symptoms:

  • Anxiety (panic attacks)
  • Muscle pain
  • Hallucinations
  • Headaches
  • Mood swings
  • Insomnia
  • Nausea

Actually, doctors do not recommend stop taking the drugs immediately. That’s because of the rebound effect it could bring to the patient. They include anxiety, panic attack, insomnia, and feeling agitated during the withdrawal phase.

Benzodiazepines Detoxification Duration

On the average, a patient will experience the withdrawal symptoms from a week to a few months. Of course, this depends on the level of benzodiazepine addiction and length of usage of this drug. They make these drugs in two forms: short-acting and long-acting.
Firstly, the short-acting benzodiazepines will have strong and sudden benzodiazepines withdrawal symptoms. Secondly, the long-acting benzos often produce less acute symptoms and work at a slower pace. For example, individuals who might have addiction to short-acting benzodiazepines like Xanax will experience the withdrawal symptoms early. They could happen ten to twelve hours after the last dose. Meanwhile, those with severe addiction to long-acting benzos like Valium may experience the withdrawal symptoms for several days. There are instances when the withdrawal symptoms of heavy users of benzodiazepines might last for three months. Furthermore, they will need to undergo the “cold turkey detox” to taper off the drug inside the patient’s system.

Tapering Off Benzodiazepines

Tapering off the benzodiazepine drug is part of the benzodiazepines detoxification process. They use it to treat a patient with addiction. The attending doctor may prescribe lower doses of benzodiazepine for a certain period. Otherwise, he might recommend another benzo brand with lesser potency to start the tapering process. This whole process can be truly challenging. This is especially true if the patient’s brain has grown used to the effects of this drug during the intake.

Suggested Medications for Benzodiazepines Detoxification

BenzodiazepinesDoctors may prescribe medications as part of the benzodiazepines detoxification treatment program. Meanwhile, they will do the actual detox to control the intense cravings and withdrawal symptoms. Strangely enough, there are no specific medicines approved to treat benzodiazepine withdrawal. However, they do use some drugs as part of the treatment program. They include the following:
Acamprosate is a type of drug for patients with alcohol addiction. In addition, it may also be useful to patients with benzodiazepines addiction during a detox. It will treat the withdrawal symptoms affecting the central nervous system such as anxiety, insomnia, and restlessness.
Herbal supplements, vitamins, and minerals may be useful to the patient with benzodiazepine addiction to help him or her, restore physical balance. Moreover, they may lessen the symptoms during the withdrawal process like drug cravings.
Withdrawal from benzodiazepines may start after the user’s last dose. Usually, it happens within about eight hours. The user may experience the withdrawal symptoms for months or even years. Of course, it depends on his or her addiction to this drug. With a personal detoxification treatment program, the patient with an addiction to benzodiazepines may successfully surpass this journey. As a result, the doctors will clinically declare him or her drug free.

Benzodiazepines Treatment Process

The treatment for benzodiazepine addiction will normally follow the this step-by-step process:

Step #1 – Medical assessment

Doctors require anyone with the misuse, overdose or severe addiction to benzodiazepines to undergo a medical assessment. It is to clearly identify their level of drug addiction. This procedure is vital because it will guide the rehabilitation team to determine the right treatment care program. As a result, it will help the patient achieve full recovery.

Step #2 – Detoxification

Once they diagnose the patient with a high level of drug addiction, doctors will recommend a medical procedure called “detoxification”. This is where a team of medical professionals will perform various procedures. This way, they can remove and filter all the remaining drug components of benzodiazepines from the system.

Step #3 – Residential treatment

This is one of the highly recommended addiction treatment programs after the benzodiazepines detoxification process. Here, they require the patients to undergo a 12-step program. The staff will teach the patient different skills to help them cope with the trigger factors causing addiction. Consequently, it may bring back normality in their lives. They happen in a well-maintained rehab treatment facility and are under the supervision of experts in drugs and substance abuse.

Step #4 – Aftercare treatment

Going back to the real world after the rehabilitation treatment program can be quite overwhelming. That’s why they recommend an aftercare treatment plan for the patient. This is to ensure a smooth transition from his or her recovery to regaining a new life free from drugs. Aftercare treatment program may involve attendance of private counseling, group therapy sessions and other activities designed to prevent a relapse.

Preventing Benzodiazepines Relapse

Relapse is bound to happen even after how successful the detox and rehabilitation process has been. For example, ex-patients shouldn’t go to the places where they got the introduction to drugs or substance abuse. It’s because of the higher possibility of giving in to the cravings. This is especially for patients who underwent rehabilitation who wants to prevent a benzodiazepine relapse from arising. A person returning to his or her community must have a proactive mindset of the removal of this addiction problem. This is on top of the strong support from the family member and the aftercare plan.
In conclusion, detox is just the first step to help a person with benzodiazepine addiction get treatment. They will also need other series of rehabilitation treatment programs. These will help the person with addiction problem prepare his or her journey to a sober life.

Page Sources

  1. Alexander B., Perry P. J. Detoxification from benzodiazepines: schedules and strategies. Journal of Substance Abuse Treatment. 1991; 8(1-2):9-17.
  2. Diaper A. M., Law F. D., Melichar J. K. Pharmacological strategies for detoxification. British Journal of Clinical Pharmacology. 2014; 77(2): 302–314.

Published on: March 22nd, 2017

Updated on: June 10th, 2020

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.


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