All About Benzo Dependence
The following are conditions that may be treated with benzodiazepines which could lead to benzo dependence.
- Generalized Anxiety Disorder
- Panic Disorder
- Various phobias
- Obsessive-Compulsive Disorders
- Detoxification from alcohol and other drugs
- Severe muscle spasms
- Librium (chloridiazepoxide)
Though all these drugs differ in terms of duration and time of onset, they also share much in common. First, they all act upon a specific GABA receptor. The pharmacology involved is extraordinarily complex, but GABA is a neurotransmitter that inhibits the excitability of a wide array of neurons. The upshot is that benzos tend to have an immediate calming effect.
Most physicians prescribe benzodiazepine drugs for a short period of time, usually at the start of treatment. Unfortunately, patients often develop a high level of tolerance in just a few weeks. This means that they require more and more of the drug to achieve the same effect.
Signs of Benzo Dependence
This combination of sedating effects and increased tolerance combine to make the benzos highly addictive. While the effects of benzo use can duplicate symptoms of anxiety at times, there are also some other tell-tale signs of dependence:
- Impaired thinking, especially regarding abstract concepts
- Impaired judgment and decision making
- Taking more than the physician has proscribed
- Vision problems, especially blurriness
- Doctor and/or pharmacy shopping
- Obtaining benzos illegally
- A desire to stop without the ability to do so
- Preoccupation with the drug
- Taking benzos while consuming alcohol or other drugs
- Inexplicable drowsiness
Patients who have struggled with an SUD in the past are more likely to reach this stage of benzodiazepine dependence. However, this does not change the simple physiological fact that anyone who takes a benzodiazepine drug long enough will eventually become dependent.
Taken by themselves, benzodiazepines present a low risk of overdose death. Unfortunately, the withdrawal symptoms that follow a sudden stoppage of benzo intake are so frightening and uncomfortable that even those without a past SUD often begin to take them with other prescription medications or alcohol.
This is when a benzodiazepine addiction can contribute to an overdose death. Sadly, this is becoming a more common outcome for benzo dependent people. In 1999, benzos contributed to the overdose deaths of just over 1,100 Americans. Fast forward to 2019 and you will see that this number has risen to almost 10,000 when opioid drugs are also involved.
Early intervention is the key to saving these lives and ensuring that people already struggling with mental and physical health issues don’t participate in the emotional and mental decline associated with all addictions. If you or your loved one are exhibiting any of these signs, we encourage to contact us immediately.
The Anguish of Benzo Withdrawal Symptoms
Benzodiazepine withdrawal symptoms are incredibly difficult to endure and can begin very quickly after the user starts consuming a smaller amount. As we’ll explore in the next section, these symptoms can be extremely dangerous. That’s why it is critical that the long-term benzo user seek professional help before stopping abruptly.
This is especially true for those who have been combining them with alcohol, opioids, or other substances. Fortunately, benzo withdrawal symptoms begin to occur in a mild form quickly. This is the best time to intervene, as it decreases the possible danger and increases the chances for recovery.
We’ll examine the signs of benzo withdrawal in a just a bit. Before that, let’s have a look at their possible severity.
Benzodiazepine Withdrawal Syndrome
We cannot emphasize the difficulty of benzo withdrawal enough to do the subject justice. In fact, benzo withdrawal symptoms are so severe that they’ve been given a name. This name is benzodiazepine withdrawal syndrome, though it’s often shortened to BZD withdrawal.
Whatever you choose to call it, benzo withdrawal is nightmarish without professional help. In short, BZD withdrawal syndrome is the collection of symptoms and signs that begin to appear when a benzo dependent person decreases their dosage or stops altogether. Sadly, even persons who use benzodiazepines exactly as prescribed can experience benzo withdrawal syndrome.
Here is a list of what you might think of the ‘early signs’ of benzo withdrawal:
- Sleep problems
- Increased muscle tension
- Agitation or irritability
- Anxiety and/or panic attacks
- Shaking and hand tremors
- A decreased ability to concentrate
If any of these symptoms emerge when you or a loved one slows or stops their benzo intake, it is imperative to seek professional help immediately. It is never too late or too early to intervene in such a dangerous matter.
Over time, these withdrawal symptoms will worsen. After several years of not using, a person might start to experience a worsening of their earlier symptoms, excessive sweating, memory lapses, and severe headaches. Here is an incomplete list of what else you might experience or see as BZD withdrwal syndrome worsens:
- Nausea, vomiting, or dry heaving
- Suicidal ideation
These symptoms are a definite signal of severe benzo dependence and require immediate medical attention. Next, we’ll look at a possible ‘timeline of benzo withdrawal,’ to help those who are suffering know what to expect.
The Benzo Withdrawal Timeline
While the time that benzo withdrawal follows is different for everyone, there are some recognizable patterns. However, it is important to understand the various factors that contribute to the intensity, type, and duration of symptoms. Here are some of the most important things to consider:
- The type of benzo the person has been taking
- How long they’ve been taking the drug
- Whether they’ve followed prescription guidelines or not
- The presence or absence of co-morbid mental health conditions
- The consumption of other substances alongside the benzo
Age, weight, and varying metabolic rates of individuals also help determine the timeline of benzo withdrawal, but these are difficult to factor in with any precision.
Before we dig into a possible timeline, please remember: the benzo withdrawal process absolutely requires medical supervision. This is one of the most important takeaways you can gain by reading this post.
Generally speaking, you can divide the process of benzo withdrawal into three overlapping phases. These phases are 1) Early Withdrawal, 2) Acute Withdrawal, and 3) Post-Acute Withdrawal. We’ll discuss the respective timelines of these phases in the following sections.
Early Benzo Withdrawal
The earliest symptoms of benzo withdrawal can begin within 12-24 hours of stopping or decreasing the drug. The timing depends on how long the particular benzo stays active in the human body. Xanax, for instance, has a short half-life, while Valium is a much longer acting drug. This means that the onset of withdrawal symptoms from Xanax will begin much more quickly than those brought about by Valium use.
Here’s what to expect during the first few days of benzo withdrawal:
- A return of the symptoms for which the drug was prescribed
- Increased anxiety
- Panic attacks
- Agitation and mood swings
This is a particularly dangerous stage of BZD withdrawal syndrome and no one should attempt to endure this phase without help.
Acute Withdrawal Stage
The acute stage begins about 3-5 days after stopping or reducing the benzo and typically lasts approximately one month. This is the most difficult stage of the withdrawal process for almost every benzo user. Additionally, it is during the first few days of this stage that medical supervision is most important.
During the acute withdrawal period, long term users can expect to feel several distressing symptoms. Some of these include:
- Redoubled anxiety
- Severe panic episodes
- Worsened insomnia and disturbed sleep
- Cognitive impairments
- Psychotic episodes
Also called ‘Protracted Withdrawal,’ this phase begins approximately one month after the drug is stopped and affects every user differently. It is almost impossible to predict the symptoms a specific benzo user will experience during the post-acute phase, but here are some of the most common:
- Difficulties in Concentration
- Mood swings
These symptoms can last up to a year or longer and ongoing counseling and/or medication is often necessary to cope with them.
Can Benzo Withdrawal Symptoms Be Fatal?
We get it– this post is not a pleasant read. However, as professionals, we are obliged to warn you of the dangers of benzodiazepine addiction and withdrawal symptoms. Fortunately, our main message is one of hope. And that message of hope is predicated on the comprehensive treatment programs that Recovery by the Sea offers for benzo addiction.
After the client is safely detoxed, we make a detailed assessment of their early recovery needs and create a highly individualized care plan. Depending on their living status, duration of use, physical problems, and mental health, clients then immediately begin to participate in one of our specialized treatment modalities. Our programs include:
- Partial Hospitalization (PHP)
- Intensive Outpatient/IOP
Components of Benzo Dependence Treatment
You can find specific information on these programs in the appropriate sections on this site, but here is a sampling of what they offer:
- Medical supervision
- Attentive case management
- Individual and group therapy
- Family/relationship therapy
- CBT, EMDR, and Trauma Therapy
- Yoga and meditation sessions
- Life Skills Workshop
- Wellness Education
- Community and peer support programs
Our expert team of clinicians created, staff, and modulate these programs. At Harmony Recovery, it is our solemn mission to deliver individualized, evidence-based and compassionate care in safe environment. To conclude, we have no choice but to inform you of the dangers of benzo dependence. However, we are much happier to deliver you this message of hope. Help is available to all who suffer from this terrible affliction. You’ve shown great courage in taking this critical first step. It is our profound hope that you continue this rewarding process by contacting us today.