Benzodiazepine DetoxBenzodiazepine dependence affects millions of people per year, with a reported 11% of Americans taking benzos each year and 2% of the adult population reporting that they have been prescribed benzodiazepines for 5-10 years. Benzodiazepines are prescribed to treat a number of disorders, but because they are widely prescribed, they also carry a high risk of addiction. Many users become addicted unintentionally simply because they were prescribed a benzo medication by their doctors.
Despite the prevalence of benzodiazepine dependence, it is a silent epidemic that often is not addressed by medical professionals, leaving millions of users and their loved ones to suffer the consequences. If you or a loved one suffers from benzodiazepine dependence and you want to learn about how to get clean from benzos, contact us today, and we’ll help you get on the road to recovery.
What Are Benzodiazepines?Benzodiazepines are prescribed medications that, when taken as needed, can help to treat anxiety, insomnia, and panic attacks. Since they were first created in the 1950s, benzodiazepines have been widely prescribed. The four most common benzodiazepines are lorazepam (Ativan), clonazepam (Klonopin), diazepam (Valium), and alprazolam (Xanax).
What Are The Clinical Uses of Benzodiazepines?Doctors prescribe benzodiazepines to treat a number of disorders, including anxiety disorders, anxiety due to other psychiatric disorders, insomnia, convulsive disorders, and spastic and /or involuntary muscular disorders. In addition, benzodiazepines are occasionally prescribed in conjunction with other medical treatments, such as detoxification from alcohol or other substances, or for sedative purposes for surgery, dentistry, or chemotherapy. When used for short durations or only as needed, benzodiazepines can be highly effective, but it is when they are used for longer durations that patients are put at risk of dependence.
How Do Benzodiazepines Work?Benzodiazepines work by enhancing the g-aminobutyric acid (GABA) receptors to the neurotransmitter GABA, which is the most prominent and important neurotransmitter in the central nervous system. GABA regulates the excitability of neuronal activity, so that an increase in the activation of GABA induces calming and sedative effects.
What Are The Long-Term Effects of Benzodiazepines?While benzodiazepines can be effective as short-term (2-4 weeks) medications, the effect of their long-term usage is alteration and desensitization of the GABA receptors. The desensitization of the GABA receptors decreases the inhibitory effect of the GABA neurotransmitters, making it more difficult for the central nervous system to regulate neuronal activity. In other words, long-term use of benzodiazepines makes it more difficult to control feelings of anxiety or to experience truly restful sleep.
What is Benzodiazepine Dependence?The effects due to long-term usage contribute to benzodiazepine dependence as patients find that in order to regulate and control their anxiety, insomnia, or muscular or convulsive disorders, it becomes necessary to use benzodiazepines. Benzodiazepine dependence is diagnosed through assessment of the patient’s tolerance to the drug, escalation of dosage levels, difficulty in stopping benzodiazepine usage despite an awareness of the adverse effects, and the occurrence of withdrawal symptoms due to discontinuation or dosage reduction.
Symptoms of Benzodiazepine WithdrawalThe symptoms of benzodiazepine withdrawal vary and depend on the patient’s level of dependence, duration of usage, dosage levels, and method of detoxification. The general symptoms of benzodiazepine withdrawal can include:
- Anxiety (acute or general)
- Blurred or double vision
- Excitability and restlessness
- Heart palpitations
- Insomnia or sleep disturbance
- Body aches, muscle pains, stiffness or twitches
- Poor memory and difficulty with concentration
- Sensory hypersensitivity
- Skin tingling or numbness
- Sweating/ night sweats
- Irritability, rage, obsessiveness, emotional outbursts, and other behavioral symptoms
Length of Withdrawal from BenzodiazepinesThe length of withdrawal also depends on the user’s level of dependence, whether the user is taking short-acting or long-acting benzos, and the method of detoxification. The withdrawal phase for benzodiazepines can be broken down into two phases: the acute phase and the post-acute withdrawal syndrome (PAWS) phase. The acute phase describes the period of time when withdrawal symptoms are experienced most intensely. The PAWS phase describes the period when the user experiences milder but longer-term withdrawal symptoms (such as increases in anxiety and insomnia).
Short-acting benzos—such as Ativan, Halcion, and Xanax—have intense withdrawal symptoms, and the withdrawal symptoms can start to manifest within 6-8 hours of quitting. The acute phase for short-acting benzos is generally around 7 days. Long-acting benzos—among them Klonopin, Librium, and Valium—have milder withdrawal symptoms that start within 24-48 hours of quitting. The acute phase for long-acting benzos can last as long as 90 days.
The PAWS phase varies according to the user’s level of dependence and in some cases can last as long as two years. However, with the help of an addiction treatment specialist, such symptoms can be managed effectively or even prevented.
The Benzo Detox ProcessThere are a few options available for benzodiazepine detox, and users should consult with an addiction specialist to determine the best method of detox. Tapering down is a method of benzo detox that involves gradually decreasing dosages of benzodiazepine intake until intake is zero.
There are also medicines that can be administered for detox, such as Buspirone and Flumazenil. Buspirone works well for users with a history of substance abuse because it does not carry the risk of physical dependence. Buspirone is helpful for those with generalized anxiety because it relieves the emotional effects of benzo withdrawal. Flumazenil works similarly to benzodiazepines because it attaches to the same receptors, and it is mostly used to treat benzodiazepine overdoses or for to facilitate rapid detox. Flumazenil can be effective in relieving the withdrawal symptoms of long-acting benzos. Whatever the detox method chosen, for a safe detox, it is recommended that professional treatment services are involved on a consistent basis to guide the user’s recovery.