Benzodiazepines can be commonly found in the medicine cabinets of tens of millions of Americans. Although this class of drug is commonly used to treat anxiety and depression, it is also widely abused. Even when taken as prescribed, consistent benzodiazepine use over a period of time can result in chemical benzo dependence. If the use of benzodiazepines is stopped abruptly the onset of withdrawal symptoms will quickly follow.

Unlike many other types of drugs, if done incorrectly, detoxing from benzodiazepines can be dangerous, and in some cases fatal. Due to this fact, navigating benzodiazepines treatment is not recommended for anyone to do without medical supervision. With that said, it is useful to go into a benzo detox with as much information as possible. Having a firm idea of benzo detox and what to expect can help you prepare for what lies ahead and alleviate any anxiety associated with the unknown.

Most people are only vaguely aware of what a benzo detox entails, including people who are prescribed benzodiazepines on a regular basis will experience the side effects of benzo abuse. The fact is that although benzos have been a popular drug of substance abuse for decades, depictions of benzo withdrawal symptoms haven’t trickled down into popular media in the same way that alcohol or opiate withdrawal has.

In order to clear up any confusion, we’ll outline a benzo detox timeline, and go over some of the symptoms that you might expect to experience. We will also spend some time talking about what benzodiazepines are, and how you might know if someone is abusing benzos. Given the fact that benzodiazepines are very commonly prescribed, it can sometimes be difficult to assess where the line between benzo use and abuse lies. This information should prove as a useful guidepost for understanding when getting treatment for benzo abuse is recommended.

What are Benzodiazepines?

Benzodiazepines are a class of drugs that was first introduced in the 1950s. Commonly referred to as benzos, benzodiazepines are actually a broad class of drugs that are used to treat a variety of different conditions. Benzos work by strengthening the function of gamma-aminobutyric acid (GABA), which is an important neurotransmitter. Higher levels of GABA sedate and relax the muscles. Here are some more key facts about benzos that you should be aware of:

    • Half-life – The half-life of benzos, or rather how quickly your body can break down the drug, is one of the primary traits that determine which type of benzos are prescribed for certain conditions. Benzodiazepines with a long half-life start working more slowly but last longer, and are generally used to treat ongoing conditions like anxiety. Benzos with a short half-life go to work faster and have a more powerful effect, and are typically prescribed to be used as needed for insomnia or panic attacks.
    • Trade Names – Benzos are seen under many different trade names. One of the earliest benzodiazepines was chlordiazepoxide which was marketed under the trade name Librium. Eventually, the use of this was eclipsed by new benzo; diazepam which was marketed under the trade name Valium. Other commonly seen benzodiazepines include Klonopin, Ativan, and Xanax. Xanax, the trade name for alprazolam, is a short-acting benzodiazepine that is the most prescribed drug in its class today.

 

  • Short Prescription Window – The use of benzodiazepines to manage medical conditions such as anxiety, panic attacks, or insomnia is intended to only occur for a short period of time. Benzos like Xanax are usually prescribed on an as-needed basis for anywhere from 2-4 weeks. Outside of this window, users run the risk of developing chemical dependence.
  • Abuse Potential – All benzodiazepines have a high potential for abuse. Those with a shorter half-life and faster onset of effects have the highest rate of abuse. Currently, the most abused benzodiazepine in the United States is Xanax, for which tens of millions of prescriptions exist.
  • Effect – The success of benzodiazepines in treating anxiety and panic disorders has been well documented, and the reason for this is due to their powerful effect on the central nervous system. All benzos have a sedative effect to some degree, with faster acting benzodiazepines having a more powerful effect over a shorter period of time. Users who take benzodiazepines will feel more relaxed, lethargic, and tired.

 

Detox Timeline

Now that we’ve outlined what benzodiazepines are, we’ll seek to answer the question “how long does a benzo detox take?” An important consideration for how long it takes to detox off of benzos is exactly what type of benzodiazepine an individual has been taking. Abuse of benzodiazepines with a long half-life may result in a longer withdrawal timeline, while abuse of fast-acting benzodiazepines will generally have a shorter withdrawal timeline. Keep in mind, however, that the withdrawal symptoms can be just as debilitating now matter what type of benzodiazepine one is withdrawing from.

First Day

The first onset of withdrawal symptoms can begin anywhere from 6-12 hours after the last dose for benzos with a short half-life and up to 24 hours after the last dose for benzos with a long half-life. Common symptoms during the early onset of withdrawal include difficulty sleeping and anxiety. Since many people use benzodiazepines to treat anxiety, the anxiety felt during this period can be more intense. This is known as rebound anxiety, which can be debilitating for some individuals.

First Week

After the first day, most individuals begin to experience a wide range of flu-like symptoms that increase in intensity through the next 72 hours. Most people generally begin to feel that their symptoms decrease in intensity after the fourth day, although it is not unusual for some heavy benzo users to continue to experience physical withdrawal symptoms throughout the first week.

Second Week

Most people going through benzo detox feel much better by the end of the second week. By this point, nearly all of the physical withdrawal symptoms have subsided, while those that persist are usually mild when compared to the first couple of days after cessation. Individuals may continue to have issues sleeping, or suffer from bouts of anxiety. A desire to use benzos again can persist beyond the two week period as well.

Benzo Withdrawal Symptoms

We’ve already outlined some of the withdrawal symptoms you might experience with benzos, but here we’ll provide a more comprehensive list. We’ll break these down into physical and non-physical withdrawal symptoms to make them easier to digest. One thing to note is that while many of the withdrawal symptoms are considered “flu-like” and are typically only dangerous due to loss of fluids, withdrawal from benzos can have serious side-effects. These include intense panic attacks, anxiety, and even seizures, which can be life-threatening.

Physical Withdrawal Symptoms

  • Stiffness in the muscles
  • Tachycardia (increased heart rate)
  • Seizures
  • Trembling
  • Chills
  • Diarrhea
  • Vomiting
  • Nausea
  • Insomnia
  • Ataxia (difficulty controlling motor functions and movement)
  • Paresthesia (commonly described as a burning or tingling of the skin)
  • Increased sensitivity to light, sound, smell, or touch.

Non-Physical Withdrawal Symptoms

  • Insomnia
  • Anxiety
  • Depression
  • Difficulty Concentrating
  • Hallucinations
  • Visual disturbances
  • Panic attacks
  • Agoraphobia (fear of places that might cause panic)

Signs of Benzo Abuse

It is always difficult to truly know if someone is abusing drugs without direct observation of the fact. Still, there are some things you can keep an eye out for that may indicate someone close to you is abusing benzodiazepines. First among these are signs that an individual is sedated. Remember, the primary effect of benzos is to suppress the central nervous system. Individuals who are abusing benzodiazepines may exhibit signs that they are sedated. Common among these are difficulty staying awake, slurring of speech, or confusion.

Keep an eye out for the withdrawal symptoms we’ve outlined above. If an individual has been abusing a benzodiazepine with a short half-life, like Xanax, they’ll start to have withdrawal symptoms within 6 to 12 hours of their last dose. These withdrawal symptoms will closely resemble the common flu. If the symptoms suddenly resolve and the user appears placid and content, chances are they took more drugs to stave off withdrawal symptoms.

Like other drugs, abuse of benzodiazepines results in a number of negative outcomes in the life of the user. Over time, many people who are struggling with benzodiazepine addiction suffer from financial insecurity. If a loved one is struggling financially with no apparent reason, this, taken in the context of other behavioral signs, can be an indication of benzodiazepine abuse. Another sign of substance abuse is if an individual becomes withdrawn from those around them. Whether it is a coworker, family member, or friend, an individual withdrawing from those around them is an indicator that their drug use may have become their primary focus.

Lastly, always keep an eye out for drug-seeking behavior. Although many people are prescribed benzodiazepines, many more simply abuse them. Benzos that are commonly sold on the street such as Xanax have a high rate of abuse yet are relatively cheap. You may notice the individual you suspect of abusing benzos acting differently than normal. If they are seeking drugs, they may appear impatient or agitated.

When Should You Seek Treatment?

Whether you yourself are struggling with benzodiazepines or someone you know is struggling with them, it is important to understand when you should seek help. Treatment programs can be used to successfully help people come off of benzos, but they must know when to seek out treatment in the first place.

There are no easy answers to when someone should seek out treatment. Each person is unique and will have a unique relationship with benzodiazepines. For some people, benzodiazepines were prescribed to them to treat a specific condition, such as anxiety. For these individuals, they may find that they are using benzos prescribed for use “as-needed” every day, and this may be a clear sign that they should consider transitioning off of them.

Other people simply began to abuse benzodiazepines and developed a chemical dependence and eventually an addiction to them. For these individuals, it can be extremely tough to quit using benzos. Unlike some other types of substances, it is both difficult and dangerous to quit using benzos all at once, or “cold-turkey”. Despite this fact, many people try. The onset of severe withdrawal symptoms can sometimes push users to relapse and begin taking benzodiazepines again.

Regardless of what your situation is like, there are some key thresholds at which you should consider getting treatment for benzodiazepines. If you have been prescribed benzodiazepines to treat a specific condition but find you are using them outside of the prescribed dosage or more frequently than intended, it is probably time to consider getting treatment. If you have never been prescribed benzos but find that you can’t stop taking them or are suffering from your abuse of benzodiazepines, treatment should be a top priority.

Final Thoughts

Benzodiazepines have a dual life in the United States. On the one hand, they are considered a safe and effective treatment for panic disorder and anxiety and are widely used to treat these conditions. On the other hand, they have a high potential for abuse. This potential for abuse has been widely recognized since shortly after their introduction.

One thing that is certain about benzodiazepines is that suddenly stopping them can be extremely dangerous. Quitting benzos should only be done under medical supervision in order to avoid the possibility of severe health complications from withdrawal. Even individuals who have been taking benzodiazepines as prescribed should consult with their doctor prior to quitting their use.

Once an individual has decided to quit benzodiazepines, they will begin to experience withdrawal symptoms within a short period of time. These symptoms are often flu-like, along with increased feelings of anxiety and restlessness. Withdrawal symptoms will peak in intensity within the first four days after you have quit using benzos. After that point, they will usually decrease in intensity over the course of the subsequent two weeks.

If you or someone you know is struggling with a drug addiction involving benzodiazepines, please contact Apex Recovery today to find out how an inpatient treatment program can help them get off benzos safely and effectively.

Sources:

  1. Samonte, Pamela Rose V., and Rhea U. Vallente PhD. 2018. “Benzodiazepine.” Salem Press Encyclopedia of Health.
  2. Reyes, Carolina F., and Armando L. Soto. Benzodiazepine : Abuse & Therapeutic Uses, Pharmacology & Health Effects. Pharmacology-Research, Safety Testing, and Regulation Series. Hauppauge, N.Y.: Nova Science Publishers, Inc, 2012.
  3. https://www.aafp.org/afp/2000/0401/p2121.html
  4. https://www.aafp.org/fpm/2008/0400/pa3.html