Benzodiazepines or “benzos” are a highly addictive class of sedative drugs. Due to the risk of seizures and other dangerous medical complications that can occur when attempting to quit using benzodiazepines, it may be dangerous to do so alone. A professional detox program can help you withdraw safely from benzodiazepines. This article will discuss the following benzodiazepine detox information:
- Benzodiazepine addiction.
- What is detoxification?
- Benzodiazepine withdrawal symptoms.
- The detox process.
- Post-detox treatment.
The benzodiazepine class includes drugs such as Xanax, Valium, Ativan, and Klonopin. Doctors commonly prescribe benzodiazepines for the short-term management of anxiety. However, should a person use benzos for a longer-than-intended duration of time, or otherwise abuses the medication to achieve heightened calming or euphoric effects, they are likely to build tolerance. Once tolerance is built, the user must take increasing doses to experience the desired effects. Physical dependence can take hold as a result of long-term and/or heavy benzodiazepine use. Once someone is dependent on a benzo, they must continue to use the drug if they want to avoid withdrawal symptoms. Both tolerance and dependence can contribute to the development of an addiction, which is characterized by compulsive use despite negative consequences 1. Once someone is addicted to a benzodiazepine, the distressing and potentially fatal withdrawal symptoms present additional obstacles to quitting.
What is Detoxification?
A detox program can help to safely manage benzodiazepine withdrawal symptoms while the body clears itself of the drug and its last remaining toxic influence. Detox involves supervision and around-the-clock monitoring as well as the use of medications to mitigate severe withdrawal symptoms and prevent any associated medical complications. Detoxification can occur in a short-term detox program or as part of an inpatient or outpatient substance abuse treatment program. Detox services will typically include:
- An intake assessment, with interviewing and examination for acute intoxication or time of last drug use. Intake is also likely to include a thorough mental and medical health evaluation to help determine the relative severity of the addiction, and the presence of any co-occurring disorders.
- Supervised medical care, such as treatment for co-occurring physical or mental health disorders.
- Medication-assisted detox, to minimize dangers associated with benzo withdrawal.
- Creation of a treatment plan, outlining engagement in ongoing treatment after detox completion.
Detox is only the beginning of recovery from an addiction to benzodiazepines and is used as a stepping stone for longer-term addiction treatment. Detoxification eliminates the drug from a person’s system but does not address the behaviors that led to the development of an addiction. Without comprehensive addiction treatment, the risk of relapse may increase. Detox protocols don’t always require 24/7 supervision or need to be carried out on an inpatient basis. At times, a person can work through their detox period while being closely followed by a clinician in an outpatient setting. The feasibility of outpatient detox depends on many factors, including overall physical and mental health, length and severity of the addiction, and whether there is an addiction to more than one substance. As there is often a marked potential for the benzodiazepine withdrawal syndrome to be severe (if not life-threatening, in extreme cases), many wisely seek the services an inpatient detox to better guarantee adequate supervision in the event of a medical complication.
Is Detox Required?
Doctors observing patient during detox
Like that associated with acute alcohol withdrawal, the benzodiazepine withdrawal syndrome can be fatal due to the risk of seizures and other medical complications. For this reason, the process of acute benzodiazepine withdrawal will often take place either in a hospital setting or under the close supervision afforded by professional detox services. Seizures are a primary concern with regards to benzodiazepine withdrawal. The risk of experiencing pathological brain excitation, agitation, and seizures is high in individuals who have chronically taken high doses of benzodiazepines. Underscoring the importance of diligently followed safety protocols and seizure prophylaxis, seizures have even been reported in those who have taken a benzodiazepine for a relatively short period before quitting use 3. If you or someone you love suffers from an addiction to benzodiazepine, a professional detox program can provide the medical supervision necessary to withdraw safely and comfortably. Call our helpline at 11111 to speak to a treatment support specialist about detox programs.
Benzodiazepine Withdrawal Symptoms
Unpleasant withdrawal symptoms occur with the sudden discontinuation of or reduction in benzodiazepine use. Withdrawal symptoms can vary; there are many different factors that can affect the severity of benzodiazepine withdrawal syndrome, such as:
- Physical health.
- Co-occurring mental health disorders.
- Length of the addiction.
- Dose of benzodiazepine taken.
- Addiction to other substances.
The following is a list of potential benzodiazepine withdrawal symptoms 4:
- Excessive sweating.
- Rapid pulse.
- Hand tremors.
- Hallucinations (auditory, visual, or tactile).
- Psychomotor agitation, or repetitive, purposeless movements.
If someone experiences a seizure or hallucinations, call 911 right away and do not leave the person alone. Wait until emergency medical personnel arrive.
The Detox Process
When considering professional detox, you may be unaware of what to expect. The detox process occurs in a safe, medically supervised environment in which a person can withdraw from benzodiazepines. Many detox programs incorporate the following three components 2:
- Evaluation: During evaluation you will undergo a series of tests to determine the level of benzodiazepines present in your body and your overall physical and mental health. These assessments will be used to determine the best level of care for your individual needs and addiction.
- Stabilization: In stabilization, you will be provided with a safe and comfortable environment in which to withdraw from benzodiazepines. In some cases, medications may be administered to alleviate withdrawal symptoms. In this phase, you will also receive the necessary social and emotional support to help facilitate the next stage.
- Fostering: Fostering entry into treatment uses detox to set the stage for the transition into an addiction treatment program. In this phase, the patient comes to understand that ongoing counseling is necessary for a successful recovery from addiction to occur.
Follow up after Benzo detox
While detox is an important first step in the recovery process, it is not sufficient to merely clear the body of benzodiazepines. An ongoing treatment program can help you to obtain and maintain sobriety down the road by addressing the underlying factors influencing your benzo addiction and providing you with a series of skills necessary to foster long-term recovery. Without formal addiction treatment, your risk of relapse may increase when faced with stressors and emotional triggers. There are many different types of treatment programs available. What you decide largely depends on your individual needs and beliefs. Recovery options include:
- Inpatient Treatment: This type of treatment requires that you live at the facility for the duration of the treatment program. Treatment lengths range from 30 to 90 days, while some may accommodate longer stays if needed. Inpatient programs can vary in philosophy and services, but they often offer individual therapy, group counseling, relapse prevention classes, and aftercare planning.
- Outpatient Treatment: Outpatient treatment, which provides you with the freedom to live at home while recovering from a benzodiazepine addiction, can range from a few hours a week to several hours a day depending on the needs of the person in recovery. Some people transition into an outpatient program following detoxification, while others attend outpatient treatment after being in an inpatient program first.
- 12-Step Programs: 12-step programs, such as Narcotics Anonymous (NA), provide members with support and encouragement from peers while recovering from a benzo addiction. The support of others who have achieved recovery from addiction is vital to the recovery process.
- Luxury Programs: These upscale, inpatient treatment programs tend to be quite expensive, but for those who can afford it, the programs provide an environment like a vacation resort, with gourmet meals, private rooms, massage therapy, swimming pools, exercise facilities, spa treatments, and golf.
- Executive Programs: Executive programs are similar to luxury programs in that they tend to offer upscale amenities, but with additional focus on catering to working professionals who wish to continue working while in recovery.
Regardless of which treatment program you choose, participating in follow-up treatment after detox is critical to address the ongoing needs of the recovering person. Learning coping skills, avoiding trigger situations, and developing sober social skills are all valuable aspects of recovering from a benzodiazepine addiction. If you or a loved one has an addiction to benzodiazepines, help is available whenever you are ready to begin on the road to recovery. You can contact one of our dedicated and knowledgeable staff members today at 11111 . They can help guide you through detox and treatment options.
- Center for Substance Abuse Research. Benzodiazepines.
- Center for Substance Abuse Treatment. (2006). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No.45.
- Hu, X. (2011). Benzodiazepine withdrawal seizures and management. The Journal of the Oklahoma State Medical Association, 104(2), 62-65.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.