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Benzo Withdrawal: A Guide On Symptoms, And Timeline

Last Updated: June 13, 2022

Authored by Sharon Levy, MD, MPH

Reviewed by Michael Espelin APRN

Benzodiazepine or benzo withdrawal is a period of time that follows abstinence from the drug. During this period, the patients may experience a series of unpleasant withdrawal symptoms. These problems occur as the body cannot adapt to a new equilibrium, following an abrupt stop of substance use. Long-term benzo abuse can cause dependence and poses some threats to the health, both physical and mental. 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 addicted. To make things worse, all this can happen even with prescribed use. Therefore, it is not recommended for long time use of benzodiazepines, as there is a probability of developing an addiction to these drugs.

Signs And Symptoms Of Benzo Withdrawal

Benzodiazepines are a group of drugs known for their sedative and tranquilizing properties. They are most commonly prescribed to help with anxiety, panic, seizure disorders, insomnia and muscle spasms or tension. They are incredibly popular and some of the most recognizable benzodiazepines include Klonopin (clonazepam), Restoril, Midazolam and Valium (diazepam). However, benzodiazepines are some of the most difficult drugs to quit. Many addicts are scared off of doing so, the minute unpleasant symptoms arrive. Therefore, it is important to have a strong support group and not give up.

Benzo withdrawal symptoms vary from person to person, but in general, it is fair to say that they 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 benzo one was using. Short acting benzodiazepines, such as for example Halcion, tend to produce intense symptoms more quickly but are also generally over within 7 days. Longer-acting varieties, such as Valium can have acute benzo withdrawal symptoms lasting up to a year, and it is not uncommon to have lingering effects lasting indefinitely.

Some of the benzodiazepines withdrawal signs and symptoms include:

  • Sleep problems
  • Irritability
  • Severe stress and anxiety
  • Panic attacks
  • Shaking
  • Excessive sweating
  • Problems with focus
  • Nausea
  • Loss of weight
  • Racing and palpable heartbeat
  • Headache
  • Pain in the muscles
  • Changes in perception and thinking
  • Hallucinations
  • Convulsions

In almost all cases, Benzodiazepines withdrawal does not cause any life-threatening problems to the health. Nonetheless, they can be very bothersome. Do not stop taking benzos without consulting a doctor first. Most probably, they will recommend reducing the dose gradually. This can make the benzo withdrawal symptoms more bearable.

A woman experiencing benzos withdrawal symptoms looks at some pills on the table.

Benzo Withdrawal Timeline: What To Expect?

When Benzodiazepines withdrawal signs 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 drug discontinuations signs earlier. Furthermore, the method of abuse also plays a pivotal role in determining the onset of withdrawal, as well as drug interaction, as for instance, taking benzo and alcohol together can exacerbate the discomforting benzo withdrawal process. If injected or snorted, the drug reaches the  brain virtually in no time, which in its turn poses a risk of benzodiazepine overdose. As a result, the drug discontinuation signs start very early. In the same way, taking a pill extends the drug elimination time. This is because the drug has to cross various barriers in the digestive tract before it reaches the brain.

Take a look at the information available on the benzo 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 signs 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 drug discontinuation signs 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.

The period of benzo withdrawal symptoms 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 discontinuation process. In any case, a patient should seek professional help once they experience any of the symptoms.

Benzodiazepines Withdrawal Treatment Options

Despite what it may seem, withdrawing from benzodiazepines is possible, and more importantly, the benzo withdrawal process can be done safely. Patients should never consider quitting a benzo cold turkey without consulting a medical professional. This can cause an even bigger shock to the system, and make benzo withdrawal symptoms even worse than need be.

If one is considering stopping benzo medication, whether suffering from addiction or experiencing benzodiazepine side effects, 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 benzo medication over an extended period of time, making the whole process more gradual and manageable.

If someone is suffering from an intense addiction, and has been consuming large amounts of benzodiazepines over a long period of time, the help of a 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 benzo withdrawal symptoms become too intense or present a risk to one’s health, both physical and mental. 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.

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Page Sources

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Published on: April 5th, 2017

Updated on: June 13th, 2022

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.