Benzodiazepines (benzos) are central nervous system depressants that can be a useful medication for treating anxiety disorders. A calming effect they produce can actually make a person want to use more of the drug. Abusing central nervous depressants can lead to increased tolerance, dependence and addiction. Benzodiazepine dependence, in many cases, warrants the need for a medical detoxification.
There’s no need to feel ashamed if you need help with an addiction benzodiazepines. There are millions of others who have been in the same boat and in turn sought professional guidance. You didn’t do anything wrong. A physical addiction happens naturally with long-term use of benzodiazepines; even if they’ve been prescribed. The next step is knowing how to safely stop using them.
List Of Benzodiazepines
There are a lot of different prescription medications; some are more potent than others and some more likely to be abused. Benzos aren’t as potent as opioids or amphetamines but they are addictive nonetheless. The following is a list of common benzodiazepines:
- Ativan (lorazepam)
- Dalmane (flurazepam)
- Diastat (diazepam)
- Doral (quazepam)
- Halcion (triazolam)
- Klonopin (clonazepam)
- Librium (chlordiazepoxide)
- Paxipam (halazepam)
- ProSom (estazolam)
- Restoril (temazepam)
- Serax (oxazepam)
- Tranxene-SD (clorazepate)
- Valium (diazepam)
- Xanax (alprazolam)
Understanding Benzodiazepine Abuse
Substance abuse is defined by the National Institute on Drug Abuse as using illegal drugs or legal drugs inappropriately.
“This includes the repeated use of drugs to produce pleasure, alleviate stress and/or alter or avoid reality.”
Central nervous system depressants are abused for the relaxing effects and thus people from all walks can potentially use them inappropriately. When someone becomes addicted to benzodiazepines, it becomes an obsessive and compulsive behavior that they start to lose control over.
So they’re simply recreating behaviors that they’ve learned through their environments—perhaps to cope with an emotional trauma but not always. The point of detoxification is to prepare for treatment programs which are used to help to “unlearn” these behaviors.
Dangers Of Abusing Benzodiazepines
Is it possible to unintentionally become hooked on a prescription medication? Yes. When you’re taking benzodiazepines, they change your brain’s chemistry by replacing your natural dopamine. Dopamine is a compound that’s responsible for the good feelings you get when you’re working out, eating a good meal or just feeling happy.
After prolonged use of benzos, it is possible to develop an addiction—better understood as a strong desire to continue taking drugs or need to increase dose size. Dependence can also lead to withdrawals when the drugs are absent. Furthermore, “dependence on alcohol or other sedatives may increase the risk of benzodiazepine dependence” (U.S. National Library of Medicine – NLM).
Benzodiazepines withdrawals can happen if your body’s fighting the physical cravings that happen while you’re detoxing. Withdrawals are unpleasant and might lead to mood swings, intense cravings and further discomfort. Not everybody’s withdrawal symptoms will be the same; they depend on how long you’ve been using the drug, how much of it you’ve used and other factors like age or overall health can also make a difference. Some of the aforementioned withdrawal symptoms are:
- Difficulty Concentrating
- Sleep Disturbance
- Trembling or Shaking
- Increased Tension
- Panic Attacks
- Abdominal or Stomach Cramps
- Dry Heaving and Nausea
- Some Weight Loss
- Hand Tremor
- Muscular Pain and Stiffness
Side-Effects And Other Concerns
Benzodiazepines might also be the cause of birth defects during the first three months of pregnancy. From the Mental Illness Research, Education, and Clinical Center (MIRECC), “too much use of a benzodiazepine during pregnancy may cause the baby to become dependent on the medicine. This may lead to withdrawal side effects after birth. Also, use of benzodiazepines during pregnancy, especially during the last weeks, may cause body temperature problems, breathing problems, difficulty in feeding, drowsiness, or muscle weakness in the newborn infant.”
They go on to advise that the side effects of withdrawals are more likely to affect elderly patients, stating that “taking benzodiazepines for trouble in sleeping may cause more daytime drowsiness in elderly patients than in younger adults. In addition, falls and related injuries are more likely to occur in elderly patients…”
Withdrawal Timeline And Length of Detoxification
Not everybody’s detox will be the same but the withdrawal patterns are going to be similar from one person to another. The physical withdrawals generally begin with flu like symptoms and as those subside, a person’s mental addiction takes over. From NLM, “the most common is a short-lived ‘rebound’ anxiety and insomnia, coming on within 1-4 days of discontinuation, depending on the half-life… The second pattern is the full-blown withdrawal syndrome, usually lasting 10-14 days; finally, a third pattern may represent the return of anxiety symptoms which then persist until some form of treatment is instituted.”
What Exactly Is A Detoxification?
Detoxification is the body’s way of removing unwanted chemicals. Medical detoxification is a systematic process of overcoming a physical addiction to drugs like benzodiazepines and may be required for the safety of a patient. Detoxification is how you would prepare yourself for inpatient treatment that treats the mental addiction of alcohol, opioids and benzodiazepines.
Detoxification is also a dependable way to combat the seizures that can happen during withdrawals. These seizures can cause progressive mental dysfunction and irreversible brain damage. During detox it’s helpful to get enough sleep, maintain a healthy diet, substantial fluid intake and stay away from any other substances such as alcohol which can lead to further unwanted symptoms. It is not our intention to frighten you but merely to inform you of the severity of the issue and the potential danger that comes with certain drugs.
With all of the room for side-effects and potentially even further drug use, a detoxification will work best if it follows specific guidelines. From a medical standpoint, tapering off of benzodiazepines over a four week process works best—especially if you have been taking high doses of the drug. “High-dose withdrawal includes patients who have been ingesting doses of benzodiazepines greater than the equivalent of diazepam 40 mg/d for longer than eight months. It is recommended that the patients be tolerance tested with diazepam and, if tolerant, tapered off medication as inpatients at a rate of ten percent per day” (NLM).
Even when used to treat alcohol withdrawals, benzodiazepines have been known to cause dependence issues in patients. How does one treat CNS withdrawals? Don’t give up hope, medicines like Xanax, Valium and Klonopin can be tapered off of or switched to a less potent dose to help wean off of the physical addiction they cause. Doctors from the Institute for Research, Education and Training in Addictions came up with these guidelines for medication-assisted treatment:
- Physicians should not abruptly cease high-dose benzodiazepines due to the risk of seizures.
- Tapering of benzodiazepines in outpatient settings may be attempted in patients without complications of overdose, seizures, or co-morbid medical or psychiatric disorders.
- Some people may be able to accomplish a self-taper from benzodiazepine and this should be offered as an option. Frequent monitoring and contingency management models may be considered in this case.
- If applicable, the MAT clinician should contact the prescribing physician requesting that the individual be weaned with instructions and information about the mutually-decided upon goals and timeline of the taper. The prescribing physician should be willing to taper the patient.
- Detoxification in inpatient settings is indicated for pregnant patients.
- Detoxification in the inpatient setting is preferable in patients with overdose, seizures, comorbid medical or psychiatric disorders, as well as patients on high doses of
benzodiazepines over a long period of time.
- Detoxification in inpatient settings may be necessary for patients who have had unsuccessful attempts to taper in outpatient settings.
- Depending on capacity, it may be more appropriate for clinical settings to choose not to induct a person in MAT until benzodiazepine use has ceased and not manage a patient’s taper from benzodiazepines during MAT induction. This person may be more appropriate for inpatient detoxification.
- It may be appropriate for a clinician to taper benzodiazepines in an outpatient setting if there are no available inpatient facilities.
A benzodiazepine detoxification is a treatment for the physical addiction that is so often attributed to this drug. It’s also an opportunity for you to prepare yourself for the behavioral treatment used to treat the mental addiction.
After detoxification you will enter an inpatient rehab center that offers the following types of treatment:
- Dialectical Behavior Therapy
- Cognitive Behavioral Therapy
- Mindfulness and Stress Management
- Motivational Interviewing
- Family and Peer Support
- Recreational, Art and Adventure Therapy
- Aftercare Support
Is It Safe To Detox At Home?
Withdrawals from benzodiazepines can be life-threatening. Withdrawing from benzodiazepines can lead to brain damaging seizures. Because these withdrawals can be so intense during the first few weeks, it can be impervious to seek the aid of medical professionals during this time.
Find Detoxification And A Holistic Treatment At Vertava Health of Texas
At Vertava Health of Texas, our holistic treatment programs can help you rejuvenate your mind and free yourself from the power of addiction. Contact us today to speak with a caring addiction specialist to learn more about treatment.
- Institute for Research, Education and Training in Addictions — Management of Benzodiazepines in Medication Assisted Treatment
- Mental Illness Research, Education, and Clinical Center — Benzodiazepines
- National Institute on Drug Abuse — The Science of Drug Abuse and Addiction
- U.S. National Library of Medicine — The Benzodiazepine Withdrawal Syndrome
- U.S. National Library of Medicine — Detoxification from Benzodiazepines: Schedules and Strategies