Benzodiazepine Withdrawal and Detox

Benzodiazepines, or “benzos” for short, are prescription CNS (central nervous system) depressants for treating anxiety and insomnia.¹ Long-term benzo use or misuse can lead to physical dependence, withdrawal, and addiction.² This is especially true if you have a previous history of substance abuse.²

According to results from the 2019 National Survey on Drug Use and Health, around 4.8 million Americans aged 12 and older reported misusing benzodiazepines in the past year.³ Fortunately, seeking benzodiazepine withdrawal treatment can help you stop misusing benzos and help you take back control of your life.

What Is Benzodiazepine Withdrawal?

Withdrawal is a set of symptoms that can happen when your body is dependent on a drug and you suddenly stop taking it or greatly reduce your dose.⁴ This can happen even if you take benzos exactly how your doctor told you. Dependence means that over time your body gets used to benzodiazepines to the point that it feels benzos are necessary for the body to function normally. As a result, you are at risk of physical withdrawal if you suddenly stop using benzos or greatly reduce your dose. Benzodiazepine withdrawal symptoms are very serious and can even be deadly.

Benzodiazepine Withdrawal Symptoms and Signs

Common signs and symptoms of benzodiazepine withdrawal include:^1,4

• Anxiety
• Trouble sleeping (insomnia).
• Depressed mood.
• Headaches.
• Concentration or focus issues.
• Hallucinations (seeing or hearing things that aren’t there).
• Nausea.
• Feeling irritable.
• Tremor (shakiness).
• Increased heart rate.
• Seizures (potentially fatal).

Rebound Symptoms of Benzo Withdrawal

You may also have rebound symptoms during withdrawal.⁴ Rebound symptoms mean the symptoms that you took the medicine for in the first place return.⁴ For example, if you took benzos to treat insomnia, you may have insomnia again. Rebound symptoms are often more intense than they were before treatment and last for a few days or weeks.⁴

The withdrawal symptoms you have and how severe they depend on certain factors, such as which benzo you took, how long you used it, and if you use other substances.

Dangers of Mixing Benzos and Other Substances

According to the DEA, benzodiazepine abuse is common in those who abuse multiple substances (called “polysubstance use”).² Mixing benzos with other substances can be hazardous to your physical and mental health and increase your risk of injury, overdose, and death.⁶ A study in the journal Substance Use & Misuse reports that nearly half of those who misused benzodiazepines also misused other substances, with rates of benzo misuse being 4 times greater in people with alcohol use disorder (AUD) when compared to the general population and 39 times greater in people with an opioid use disorder (OUD).⁵

Mixing alcohol with benzos increases the sedative effects of both substances, which can increase your risk of overdose.⁷ Chronic alcohol and benzodiazepine abuse also increases the risk of negative health effects on your heart, liver, kidney, brain, and digestive system, as well as worsening existing psychiatric conditions.⁷

Combining opioids and benzos also increases your risk of overdose. In 2019, roughly 16 in 100 opioid overdose deaths also involved benzodiazepines.⁸ And out of the 9,711 reported benzodiazepine overdose deaths in 2019, more than half involved the use of synthetic opioids other than methadone.⁹

Some benzo users may even take opioids without knowing it. Benzos bought on the street may be counterfeit (fake) and could contain the highly potent opioid fentanyl or other dangerous substances.¹⁰ In addition to these dangers, combining opioids and benzos may increase mental health distress levels and lead to poor mental functioning.⁵

How Long Does Benzodiazepine Withdrawal Last?

The benzo withdrawal timeline can vary from person to person, depending on:^11–13

• How much you take.
• How long you’ve taken it.
• If you have other physical or mental health issues.
• If you use other substances, especially other CNS depressants such as alcohol.
• If you use an extended-release or immediate-release formula.

When Do Benzodiazepine Withdrawal Symptoms Start?

Benzodiazepine withdrawal symptoms can begin as follows:¹¹

• Short-acting benzos (oxazepam, alprazolam, and temazepam): 1 to 2 days after your last dose and last 2 to 4 weeks or more.
• For long-acting benzos (diazepam and chlordiazepoxide): 2 to 7 days after your last dose and last 2 to 8 weeks or more.

Can You Die from Benzodiazepine Withdrawal?

Benzodiazepine withdrawal can be life-threatening in some cases, especially if you take high doses or use multiple substances.^6,13,14 According to a study published in Emergency Medicine News, the most common benzo withdrawal symptom is behavioral change, but seizures can happen in rare cases and may be fatal, especially if a person is left untreated.¹⁴

Other severe and possibly dangerous withdrawal symptoms include:^1,4,13

• Hallucinations.
• Psychosis (not being able to tell what is or isn’t real).
• Suicidal thoughts.
• Delirium (sudden, extreme confusion).

Benzodiazepine Detox and Treatment

It can be hard to know how to cope with benzodiazepine withdrawal, as it can be very challenging. Patients going through benzo withdrawal have described withdrawal symptoms as very stressful, similar to having the flu, and unpredictable.¹⁵ But the good news is professional medical detox can help ease these symptoms and keep you as safe and comfortable as possible while you go through the process.^12,13

For safety reasons, the Substance Abuse and Mental Health Services Administration (SAMHSA) suggests inpatient detox or some other form of 24-hour medical care for people withdrawing from benzodiazepines.¹³ A typical benzodiazepine detox process follows these 3 steps:¹³

• An assessment to help decide the right level of care for your recovery needs and to make a treatment plan.
• Stabilization, where you get medical support to help you withdraw from benzos and become medically stable.
• Getting ready for additional treatment. You care team will help you prepare for the next step of treatment, as detox is only the first step of the process. Post-detox care will help you learn the skills you’ll need to stay sober and to address the reasons you may have developed an addiction in the first place.

Benzodiazepine Detox Medications

A common benzo detox method is tapering your current benzodiazepine. This means slowly reducing the dose you take over the course of time. Tapering can last a few weeks or even months, depending on the specific benzo you take. This method is typically only effective for long-acting benzos.¹³ If you take a short-acting benzo, which can have a greater risk of withdrawal symptoms, your care team may switch you to a longer-acting benzo.^12,13 Other benzodiazepine withdrawal medicines that your care team might prescribe include:¹³

• Phenobarbital.
• Anti-seizure medicines such as carbamazepine.
• Clonidine to ease withdrawal symptoms.
• Antidepressants such as trazodone and imipramine.

Can I Quit Benzos Cold Turkey?

Before quitting benzodiazepines on your own, especially if you have been using them for a long time, talk to your doctor. They can help assess your withdrawal risks and suggest the right level of treatment that is best for your needs. They can also help create a tapering schedule to help you stay safe and comfortable during withdrawal so you’re better able to enter recovery in a medically stable state.¹³

Unpleasant withdrawal symptoms, an increased risk of immediate relapse, and the risk of dangerous withdrawal symptoms such as seizures (which need prompt medical attention) are key reasons to avoid detoxing on your own without medical advice or oversight.¹³

Finding Treatment for Benzodiazepine Withdrawal

Benzodiazepine withdrawal treatment and medical detox can help manage withdrawal while helping you stay as safe and comfortable as possible during early recovery. American Addiction Centers is a leading provider of detox and addiction treatment, with benzodiazepine detox centers across the nation. Our professional, caring staff and medical experts know how to treat benzodiazepine withdrawal and can help you get started on the path to recovery. For more information about treatment, you can either text our team or call our confidential detox hotline available 24/7 at . You can also instantly find out if your insurance covers treatment by filling out the form below:

Does your insurance cover rehab for benzos?

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