The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the standard tool for clinical professionals and researchers for the classification of mental health and substance use disorders. The DSM-5 includes Benzodiazepines in its “Sedative, Hypnotic, or Anxiolytic” category and outlines the dangers of use, abuse, and dependence upon these and other substances in the same class. Review some of the following to see if they apply to you, or someone you love:
Table of Contents
- Has the medication been taken in larger amounts, or over longer periods of time than intended?
- Have attempts to stop on your own have been unsuccessful?
- Are there cravings or strong urges to use?
- Is there continued use despite negative social, financial, emotional or physical consequences?
There has been an increasing amount of prescriptions written for benzodiazepines. Data from the U.S. Centers for Disease Control and Prevention (CDC) reports in 2016 reveal Xanax, a popular benzo, was consistently in the top 10 substances involved in overdose deaths. Unfortunately, the numbers also show how few people actually get the help they need. Overall around less than 10% of the people needing treatment are able to benefit from quality detox followed by a long-term treatment program to address their substance use, as well as the underlying factors.
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What Are Benzodiazepines?
Benzodiazepine is a class of drugs that act as a depressant. Most of the popular benzo’s were initially developed for use in the United States in the 1980s for the treatment of anxiety and sleep disorders. They were developed to address these issues without the harmful side effects of the traditional barbiturates of the time. Some other commonly prescribed benzodiazepines include diazepam (Valium) and clonazepam (Klonopin).
The central nervous system (CNS) consists of the brain and the spinal cord. It is constantly communicating with cells and organs to ensure the body is functioning properly.
The brain and the body are constantly seeking harmony in order to function well. The medical term is homeostasis, and it means that when anything disrupts the CNS, efforts must be made to return to a certain level of stability. For example, when the body becomes hot from exercise or being outside in the sun, we sweat in an effort to cool off or reach the previous level of homeostasis.
Over time, benzodiazepine use will interfere with the CNS’ ability to return to a balanced state.
How Benzodiazepines Affect the Brain
Everything we do affects our central nervous system. The foods we eat, how much sleep we get, the quality of the air and water we ingest, even things like stress and unseen toxins in cleaning products will have some kind of an effect.
Benzodiazepines act as a central nervous system depressant, similar to alcohol. It acts as a sedative and is typically prescribed to control anxiety symptoms or help promote sleep. Benzodiazepine use will increase the efficacy of the neurotransmitter GABA, which acts as an inhibitor throughout the CNS to prevent over-excitation or anxiety. The problem develops when the brain stops making GABA once the benzos have been introduced. The brain “understands” that all is well and decides it doesn’t need to produce more of the inhibitory GABA, which leads to someone needing more and more of the drug to maintain the anti-anxiety effects.
Additionally, benzodiazepines have a relatively short half-life, which means it is processed by your body fairly quickly and slight withdrawal symptoms can occur between doses. This has contributed to the likelihood of it becoming a substance that is abused.
Whether the Benzodiazepines are snorted, injected, or taken orally, the following are some signs or symptoms to be aware of:
- Impairment in judgment, memory, or cognition
- Inappropriate sexual or aggressive behavior
- Slurred speech
- Movements become uncoordinated
- Unsteady gait
- Rapid, involuntary movement of the eyes
- Stupor or coma
What You Can Expect From Benzodiazepine Withdrawal
A Timeline of Withdrawal Symptoms
Benzodiazepine withdrawal is dangerous and should not be undergone alone, particularly when other substances are involved like opioids or alcohol. Because opioids and alcohol have similar depressant effects on the CNS, the inclusion of benzos can lead to a potentially fatal withdrawal.
The extent and severity of the withdrawal symptoms will depend on the type, frequency and amount of benzodiazepines used by the individual. Typically the experience of withdrawal involves the opposite of the effect the drug produced. For example, because we know benzodiazepines act to increase the effectiveness of the inhibitory transmitters, during withdrawal those transmitters are not regulated, and an extreme excitatory reaction will occur and potentially lead to seizure activity.
Withdrawal symptoms can be acute or chronic. Acute withdrawal symptoms usually begin within a few hours to a few days after the last use and can include:
- Nausea or vomiting
- Psychomotor agitation
- Hand tremors
- Increase in heart rate, sweating, etc.
- Grand mal seizures
- Temporary visual, tactile, or auditory hallucinations
In extreme cases, chronic withdrawal symptoms can last longer than 14 days after the last use. When medically managed, most withdrawal symptoms are alleviated within seven to 10 days. However, it is important to note that treatment following a medically managed detox will result in a better success rate. Safely removing the benzos from the brain and body is only the first step. There are other psychological, emotional and behavioral issues to address that will set you up for continued sobriety.
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It is critical to get the help you need to successfully manage withdrawal symptoms and begin a life without the use of benzodiazepines. Long-term use can negatively affect memory, mood, concentration, as well as the ability to sleep.
What Are the Benzodiazepine Withdrawal Treatment Steps?
The withdrawal from benzodiazepines is dangerous. Individuals may suffer severe seizure activity, and it can be potentially fatal if opioids or alcohol are involved, so it is critical to seek appropriate treatment. When seeking treatment, it’s important to understand the difference between the various levels of care so you can get the most out of your treatment experience.
Medical detoxification, or simply detox, is a medically managed detoxification from benzodiazepines. Following a thorough history and physical examination, the medical staff will determine the best medication protocol to manage your withdrawal symptoms safely. A detox from benzos can take up to 10 days or more, depending on the severity and extent of drug use and is up to the discretion of the medical providers. Medical complications, using more than one substance, or a history of mental health diagnoses are all examples of when detox may take longer than usual. Treatment centers will require you to successfully complete detox in order to safely and fully participate in their programs.
Detox can take place in a hospital setting if you have severe or unmanageable medical complications, or it can take place in a standalone detox facility. These standalone, privately run facilities must be staffed 24 hours a day with medical personnel, as well as support staff, to monitor your symptoms and ensure the safest, most comfortable experience possible. Specially trained staff will know how to observe your progress throughout the detox process and will be able to respond to any potentially life-threatening situations.
Residential treatment typically follows a successful detox and involves living on site and participating in a variety of therapy. Individual sessions with a trained therapist, as well as group and family therapy sessions, are some of what is required at each residential facility. It’s during this time you will be examining patterns of thoughts, emotions, and behaviors that may have contributed to your substance use. Residential treatment length of stay will vary depending on your needs, but can typically last from 30 – 90 days following the detox.
Outpatient treatment is intended for those individuals who are in a more stable position medically, physically, and emotionally. After the support from detox and residential care, the activities of daily living on your own are more manageable and you will remain involved with outpatient treatment to continue your journey of recovery. You will continue to participate in therapy on a less frequent basis and maintain connections with your support system and therapist. This is an important part of your recovery, as it will allow you to transition to the next phase of your life with the support that played such a beneficial role.
In a recovery treatment program, you will be able to address the physical, psychological, medical, and social aspects of the benzodiazepine addiction, learning through various therapeutic tools how to manage your addictive behaviors effectively and maintain long-term sobriety. This is done through a customized treatment plan, which you will customize with your therapist, and may include some of the following common treatment modalities:
If You’re Suffering from Benzodiazepine Addiction, We Can Help
If you or a loved one is struggling with benzodiazepine abuse or addiction, it is important that you treat it with the seriousness it requires and get help before it is too late.
At California Highlands Addiction Treatment, we offer quality detox as well as residential treatment and can provide the resources, support, and specialized treatment needed to get you or your loved one back on your feet and on the path to lasting sobriety.
Call 855-808-5454 now for a free and confidential consultation with one of our specialists, who are available around the clock to help you navigate your treatment options, verify insurance, and answer any questions you might have. Call now or contact us online for more information.
Hedegaard, M.D., M.S.P.H, H., Bastian, B.S, B. A., Trinidad, M.P.H., M.S, J. P., Spencer, M.P.H., M., & Warner, Ph.D., M. (2018). Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2011–2016. National Vital Statistics Reports, 67(9), 1-13. from https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_09-508.pdf
National Institute on Drug Abuse. (2018, March 15). Benzodiazepines and Opioids. from https://www.drugabuse.gov/drugs-abuse/opioids/benzodiazepines-opioids#Reference
What is Homeostasis? (n.d.). from https://www.scientificamerican.com/article/what-is-homeostasis/