Benzodiazepine medications are some of the most prescribed drugs in the United States. ABC News published that in 2007, more than 82 million prescriptions were written for these tranquilizers. Benzodiazepines are commonly used to manage anxiety, sleep issues, and sometimes to treat convulsions or seizures. Benzodiazepines, commonly referred to as “benzos,” may also be used during medically assisted detox for alcohol or opioid drug dependency.
The Centers for Disease Control and Prevention (CDC) reported that in 2012, for every 100 people in America, there were 37.6 benzodiazepine prescriptions.
- Xanax (alprazolam)
- Valium (diazepam)
- Ativan (lorazepam)
- Klonopin (clonazepam)
These drugs are usually intended to be taken short-term, as they can lead to tolerance and dependence when taken regularly for longer periods of time. Even when taken as directed, benzodiazepine medications may cause withdrawal symptoms and physical dependence when stopped suddenly. For example, according to Psychiatric Times, of those taking diazepam medications for eight months or more, 43 percent experienced withdrawal symptoms when they stopped taking the drug.
Benzos are also regularly diverted and abused, as the National Survey on Drug Use and Health (NSDUH) in 2013 found that approximately 0.6 percent of the American population over the age of 12 had abused tranquilizers in the month prior to the survey. Chronic benzodiazepine use or abuse can lead to addiction and may require specialized treatment in order to recover. The start of many treatment programs is usually detoxification, or detox, which is the purging of the drug, or drugs, from the system. Detox from a benzodiazepine medication should be closely monitored and supervised by medical professionals to ensure safety.
The initial goal of a detox protocol is generally physical stabilization. Benzos are central nervous system depressants that work by slowing down brain activity and suppressing certain regions of the brain that are responsible for stress and anxiety. Benzodiazepine drugs stimulate the production of gamma-aminobutyric acid, or GABA, which is an inhibitory neurotransmitter. This particular neurotransmitter is one of the brain’s chemical messengers that promote relaxation by telling neurons to slow down or stop firing. GABA is considered a natural tranquilizer, or hypnotic, and benzodiazepines increase its effectiveness. Suppressing the central nervous system also slows down respiration, heart rate, body temperature, and blood pressure.
Over time, a tolerance to benzos can occur requiring the person to take higher doses in order to produce the same effects. After taking a benzodiazepine regularly for even a few weeks, the brain may become dependent on the chemical interaction in order to continue to function in what it now considers a “normal” manner. This is considered physical dependence. It is often followed by addiction, which is characterized by compulsive drug-seeking behavior and tolerance as well as physical and psychological dependence.
You should never attempt to stop taking a benzodiazepine suddenly on your own as this can lead to a rebound effect as your brain attempts to restore a natural balance. Instead, most medical professionals agree that the most successful way to avoid negative side effects and withdrawal symptoms is to slowly taper off the drug in a controlled manner under medical supervision. The duration of the weaning, or tapering schedule, will depend on the length of time you took benzos, the amount you took, the method in which you took it, your level of dependency, and some genetic or personal physiology factors. Withdrawal symptoms may also vary in severity and duration.
- Muscle weakness or tension
- Increased heart rate
- Muscle aches
- Blurred vision
- Trouble concentrating
- Memory issues
More serious side effects may also occur including hallucinations, depersonalization, delirium, seizures, numbness or tingling, altered sensory perceptions, or psychosis. Benzodiazepines are often abused with other drugs or alcohol as well, which is called poly-drug abuse; this can increase potential side effects and may influence the detox protocol. Reports published by the Center for Research on Substance Abuse and Health Disparities at Nova Southeastern University indicate that as many as 90% of benzodiazepine-related fatalities studied in South Florida involved at least one other drug, for instance. It is important to be upfront with your medical team during recovery about what substances you may have taken in order for detox to be successful.
Benzodiazepine withdrawal is rarely life-threatening, but without assistance managing symptoms, it can be very uncomfortable. By slowly lowering the dosage, called tapering, or by switching from a short-acting benzodiazepine like alprazolam to a longer-acting one with a longer half-life such as diazepam, withdrawal symptoms and drug cravings may also be successfully managed during detox. Beta-blockers and antidepressant medications may be used to manage more severe side effects of benzodiazepine withdrawal during medically assisted detox as well.
Benzodiazepine detox is commonly recommended as a residential treatment in a specialized facility, although in some cases, an at-home detox may be successfully completed. Withdrawal symptoms may peak within a few days and can continue for weeks or even months so proper support and medical care really are essential.
Benzodiazepine withdrawal syndrome has both physical and emotional components. While the initial goal is regaining physical balance, the psychological factors must be taken into consideration as well. Often, benzodiazepines are prescribed to treat symptoms of mental illness, and these medications may even be abused in an attempt to self-medicate or provide temporary relief. Benzos also interfere with the brain’s natural reward circuitry, encouraging users to continue taking them in order to produce pleasant or euphoric results.
One-half of those suffering from a severe mental illness and one-third of those suffering from any mental illness abuse substances, according to the National Alliance on Mental Illness (NAMI). Conversely, NAMI also reports that one-half of all drug abusers suffer from mental illness. When two disorders occur in the same person at the same time, the disorders are considered co-occurring, and specialized integrated treatment produces the most successful results. Both disorders are treated simultaneously with evidence-based treatment models that incorporate personal preferences, clinical experience, and scientific research.
Since benzodiazepines are often prescribed for their calming effects, psychotherapies that focus on reducing stress and anxiety, and that provide healthy coping mechanisms and new life skills, are highly regarded. Behavioral therapies can work to discover potential emotional or environmental triggers that may increase the likelihood of a relapse, and they can retrain negative behavior patterns and thoughts into more positive ones, improving self-esteem and increasing self-worth. Peer support groups can provide a safe haven for shared circumstances, creating a positive social network. Educating yourself and your family on what to expect during detox and recovery can help everyone to understand the process and limit the surprises faced, making the process smoother and easier to navigate.
A serene and peaceful environment away from daily stressors may be most desirable during a more comprehensive residential detox. Black Bear Lodge fosters the mind, body, and spirit in a picturesque forested landscape, providing a place to heal in privacy.
Detox is overseen by consulting physicians, and addiction treatment professionals are on hand to offer care and support. If you’d like to learn more, contact us today at 706-914-2327.