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Edited & medically reviewed by THE BALANCE Team
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Abuse of benzodiazepines is far more prevalent than you may expect. Abusing these drugs, if remain unattended, can have a detrimental effect on your relationships, job, and emotional and physical health. Benzodiazepines are a class of drugs that includes benzodiazepines. Xanax and Valium are two well-known names. In the US, they are among the most often prescribed drugs. When consumers who don’t have a prescription get these medicines and use them for their sedative effects, it’s called abuse.

Occasionally, individuals who have prescriptions may also abuse these drugs. Taking more doses and running out of your prescription, or obsessing about when you can get another dose and feeling you can’t survive without it, could indicate problems.

A benzodiazepine may be prescribed by a doctor for the following recognized health conditions:

  • Anxiety
  • Sleeplessness
  • Withdrawal from alcohol
  • Management of seizures
  • Relaxing Skeletal muscles
  • Amnesia induction for unpleasant operations
  • Administered prior to the administration of an anesthesia (before surgery)

Benzodiazepines work on the nervous system, causing drowsiness and muscle relaxation while also reducing anxiety.

Despite the fact that over 2,000 distinct benzodiazepines have been developed, only around 15 have been approved by the FDA in the US. The duration of their effects is frequently used to classify them.

  • Triazolam and Midazolam are ultra-short-acting sedatives
  • Lorazepam and Alprazolam are two short-acting benzodiazepines
  • Long-acting benzodiazepines include clonazepam, diazepam, and chlordiazepoxide 

Benzodiazepines are widely used and abused. This abuse is partly due to the potential negative consequences they have, as well as their unrestricted availability. They can be abused for a long time or,  deliberately or mistakenly overdosed as seen more often in hospital emergency rooms. Benzodiazepine usage rarely leads to death or serious disease when used alone; nevertheless, they are usually coupled with alcohol or other medicines.

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Because they can significantly impair and even suppress the abilities that usually help a person to avoid or even want to oppose sexual violence or attack, benzodiazepines have been used as a “date rape” drug. The number of people caught and convicted of this crime has risen considerably in recent years. The substance is commonly added in liquid and powder form to alcoholic beverages or even soft drinks, and it has a bitter flavor.

Even though some people are genetically predisposed to drug addiction, there is no doubt that environmental variables play a substantial role. Low socioeconomic standing, peer influences, and unemployment are some of the more typical environmental factors.

Benzodiazepines reduce insomnia and anxiety in moderate or regular dosing. They’re generally tolerated well. People who take benzodiazepines may experience drowsiness or dizziness. With higher doses, these adverse effects can become more prominent.

Benzodiazepines in large doses can have more dangerous negative effects. The following are symptoms and signs of overdose and acute toxicity:

  • Lethargy
  • Confusion
  • Dizziness
  • Eyesight is hazy
  • Disability
  • Slurring of speech
  • Coordination issues
  • Respiratory problems
  • Coma

Alteration in appearance and personality that influence relations and work performance are nonspecific indicators of chronic usage or dependency. A sudden change in mood or a decline in school performance is both warning signs in kids. Chronic usage of benzodiazepines can cause the following symptoms, which are similar to many of the reasons why they were prescribed in the first place:

  • Anxiety
  • Sleeplessness
  • Disordered eating
  • Lightheadedness
  • Weakness

Telling your physician to scale down your benzo dose is the simplest method to avoid withdrawal. Tapering includes gradually lowering the dose over a period of several weeks and even months.

You can decrease your dose on your own, although working with a doctor is recommended. Your physician may want to change you to a different benzodiazepine before you start tapering, depending on which one you’re already on. Short-acting benzos make withdrawal more difficult by causing too many highs and lows. Diazepam, a long-acting benzodiazepine, is the most commonly used medication for dose reduction.

There is no set taper schedule that you must adhere to. Depending on your current dose and specific health circumstances, your physician will help you create a tailored tapering strategy. Some people reduce quickly, taking 2 – 3 weeks to finish. Others gradually taper over a period of months.

You may still feel some withdrawal symptoms during your tapering-off process. It’s possible that this will happen after each dose drop.

Your physician can suspend or slow down the tapering if your discomfort becomes intolerable. In reaction to symptoms of withdrawal, most clinicians do not choose to reverse the tapering and increase the dose.

To deal with these breakthrough symptoms, it’s beneficial to have a backup plan for managing anxiety. The following are some useful strategies:

  • Cognitive-behavioral therapy (CBT)
  • Mindfulness teaching
  • Workout
  • Meditation

Every Benzo user has a different Benzos withdrawal schedule. The timeline below is only intended to serve as a guide, as most people must gradually reduce their Benzodiazepine use across several weeks.

Timeline for Benzodiazepine Withdrawal

During the first 6-8 hours after quitting usage, the initial indicators of withdrawal, such as insomnia and anxiety, may appear. This is dependent on how long the chemical takes to leave the body. For people taking short-acting Benzos, symptoms of withdrawal normally emerge in 6-8 hours.

Days 1-4: After a few days, rebound insomnia and anxiety reach their climax. Sleeplessness and heightened anxiety are frequent at this time. Increased breathing and heart rates, perspiration, and nausea are also common at this time. During this time, patients who took longer-acting Benzodiazepines begin to experience withdrawal symptoms.

Days 10-14: Withdrawal symptoms usually last a minimum of 10-14 days, eventually disappearing completely. During this time, the withdrawal symptoms associated with longer-acting Benzos start to peak, ultimately diminishing 3-4 weeks after the cessation date.

Day 15 and beyond: Patients who are strongly reliant on benzodiazepines may have post-acute symptoms of withdrawal, sometimes known as PAWS. Months after stopping, these are sporadic bouts of severe withdrawal symptoms. PAWS can be avoided by gradually reducing Benzo use with the advice of a doctor.

You can contact your doctor if you have any queries, but if you are unsure whether somebody needs urgent medical assistance, you should immediately report to the hospital emergency department.

If you suspect you or somebody has consumed an excess dose, get medical attention right away.  It’s possible that the consequences of an overdose won’t show up immediately.

If you bring the pill bottles with you, it will help clinicians identify the quantity and type of medicines you’ve consumed.

The diagnosis is made by physical examination, medical history, and any lab tests that have been done.

The diagnosis of acute intoxications is typically straightforward because you or your relatives can inform the physician exactly what was consumed.

Chronic drug abuse is more difficult to diagnose since the person who is abusing drugs and their family sometimes try to cover up or hide what is going on.

A first evaluation is performed in the emergency department in the case of a probable hazardous drug overdose. Physicians will examine your breathing and confirm that your pulse and rhythm are regular. The rest of the examination is based on you and your concerns. Many of the indications and symptoms will be discussed with the doctor. It is easier to hide drug abuse unless you are willing to disclose that you are overusing or misusing benzodiazepines, or unless members of the family are available to assist with the medical history.

In the urgent care department, you’ll almost certainly be wired up to a monitor that measures your heart rhythm, pulse oximetry (to know the levels of oxygen is in your bloodstream), and blood pressure. An intravenous line will be put in place.  If you are breathless or have a low level of consciousness, you will be given oxygen.

Urine drug tests are sometimes carried out. Many commonly misused substances, including benzodiazepines, can be detected with these lab tests.  The urine drug tests, on the other hand, do not show a specific quantity or amount of the drug consumed. All ladies of reproductive age have their urine tested for pregnancy.

If there is a suspicion that you have taken other harmful substances, blood tests,  chest x-rays and ECGs may be taken.

Tapering off benzodiazepines is a common part of medical detoxification. Weaning down may include lowering the dosage or administering a Benzo with a lower potency. The type of drug consumed and the intensity of the addiction dictate the technique adopted.

Clonazepam and Diazepam are two benzodiazepines that are commonly used during detox. Since they are long-acting and far less strong than other benzodiazepines these medications are used to taper down. While the user lessens their dose, these medications keep symptoms of withdrawal at bay.

The removal of the drug from the addict’s body is the first stage in resolving a Benzodiazepine addiction. This is known as detoxification, and if not done correctly, it might result in hazardous adverse effects. A grand mal seizure can happen in as many as 20-30 percent of people who are going through uncontrolled withdrawal from these substances.

Even though most individuals start reducing their dose until it is safe to stop taking the pills entirely, there are drugs that can aid with symptoms of withdrawal during the detox process. Here are a few examples:

Buspirone is widely prescribed to patients with anxiety disorders who have a history of substance addiction. This medicine does not cause physical dependence and can help with symptoms of withdrawal.

The only disadvantage is that buspirone takes two to three weeks to start working. As they scale down their Benzo levels, individuals in detox may start taking buspirone.

Flumazenil is generally used to manage Benzodiazepine overdoses, however, it has shown some promise in lowering long-acting Benzodiazepine symptoms of withdrawal. Because it connects to the same reward areas in the brain as Benzos, flumazenil can counteract their effects and ease withdrawal symptoms.

It can also be utilized to detox quickly because it pushes benzodiazepines out of the organ systems. Rapid detox might exacerbate withdrawal symptoms, thus this medicine should be used with care.

Acute toxicity: The management required is usually determined by the medications consumed and how much of them were taken. Frequently, only a brief period of assessment in a hospital emergency room is required:

The physician may suggest gastric lavage if the medications were taken inside the past 1-2 hours. A big tube is inserted straight into your stomach via your nose or mouth during this treatment. Large amounts of water can then be forced down the throat in an attempt to flush the pill pieces out. This is only used if you are confirmed to have consumed other potentially life-threatening drugs.

For those who arrive at the urgent care within four hours of taking medicines, a single dosage of activated charcoal is indicated. This prevents the drug from being absorbed. It’s a black powder that you consume after mixing it with water. Vomiting, nausea, and stomach cramping are all possible side effects.

Flumazenil is a benzodiazepine antidote that works to mitigate the benzodiazepine’s harmful effects. The hypnotic effect of benzodiazepines is reversed. It is, however, normally kept for acute cases because it can trigger seizures and withdrawal in chronic benzodiazepine consumers, and because of its brief duration of action, it may need further injections with close monitoring.

Chronic abuse may usually be treated at home with the assistance of your doctor or at specialized drug rehabilitation programs. To avoid withdrawal and seizures, the first step is to gradually reduce the use of benzodiazepines. This is frequently easier than the lengthy rehabilitation phase in which the individual tries to remain drug-free. Aside from medical attention, someone consuming these drugs frequently requires social support as well as assistance in locating housing and jobs. Participation of friends and family can be quite beneficial during this trying time.

Though treatment methods and program design vary greatly, there are a few fundamental treatment options that are commonly utilized by patients wishing to overcome benzodiazepine addiction. Here are a few of them:

A hospital: High-risk individuals should detox in a completely operational hospital setting where medical issues can be closely monitored. The ICU may be the safest place for people with pre-existing illnesses or background of withdrawal problems.

Inpatient detox centers are specialist detox and withdrawal facilities with substantial addiction treatment experience. Patients are housed in the facility for the duration of their therapy and are closely monitored by medical personnel. Typically, these programs follow medically supervised detox regimens in upscale residential treatment centers.

Inpatient addiction treatment: These are longer-term programs than detox, usually lasting 1 month to 3 months. They include medical assistance and rigorous counseling, but many also include an organized and monitored detox period at the start of a lengthy treatment program. Interpersonal therapy, support networks, group therapy, and family therapy are available as treatment develops beyond the detox stage.

Outpatient detox programs are specialized addiction treatment programs that provide greater flexibility in treatment regimens than inpatient facilities. You may need to come in daily or weekly for treatment support, depending on your needs. These programs can monitor your health and give methadone maintenance for opioid addiction while you taper off benzos.

Intensive outpatient programs (IOPs): These are thorough addiction recovery programs that are similar to inpatient programs, but they permit you to go home at night. Individuals participate in counseling and addiction treatment for a set number of sessions per day or week. Interpersonal therapy, support networks, group therapy, and family counseling are all available.

Doctor’s office: If your doctor has a low clinical suspicion that you’ll have a difficult withdrawal, he or she may prescribe a tapering timetable and monitor your progress with regular check-ins at the doctor’s office. Any continuous outpatient addiction counseling or therapy might actually occur in an office environment for those who seek less intensive assistance.

Each program has its own set of advantages and disadvantages. Your decision will be influenced by a number of factors, including your personal preferences and your capacity to take time off from work, education, or family obligations.

Other considerations to think about when selecting a rehab and recovery program are:

Are you looking for a treatment facility that is close to home or one that is further away? While some people desire to stay close to a supportive family setting while recovering from addiction, others wish to get away from the daily stressors that contributed to their addictive habits.

Do you want to be in a program with solely females, males, soldiers, LGBTQ+ persons, or teenagers as patients? These particular demographics are served by a variety of addiction services.

5-star resort-style rooms, saunas, swimming pools, massage, and yoga are among the posh amenities offered by certain premium luxury inpatient treatment programs. As part of their rehabilitation, Luxury Rehab centers may emphasize outdoor adventures or artistic expression.

Is addiction treatment covered by your insurance? Many insurance companies will pay the cost up to a specific level, although there may be limitations depending on the plan.

Payment and cost: Addiction treatment can be costly. Think about how much you’re willing to pay, how much your healthcare insurance would cover, and, if necessary, look into programs that give financing options or other flexible plans.

Drug addicts sometimes deny their dependence or abuse problem by rationalizing their drug usage or blaming it on work or family pressures. The most crucial thing a person can do at home is acknowledged that there is a problem and seek assistance.

Recognizing the symptoms and signs of abuse is easier when you are aware of them.

A further step is to seek assistance for the individual. This can be done through your physician or by calling one of the many drug misuse support lines available in your area.

Don’t put it off. Help is available right now. We are available to assist you or a loved one who is battling substance abuse.



The Balance RehabClinic is a leading provider of luxury addiction and mental health treatment for affluent individuals and their families, offering a blend of innovative science and holistic methods with unparalleled individualised care.


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Benzodiazepine Insights

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