Benzodiazepine Withdrawal & Detox
Benzodiazepine withdrawal and detox should be taken extremely seriously because in some cases death can occur. While deaths are rare, there are also other “benzo” withdrawal symptoms that can be dangerous, including seizures, coma and severe psychological disturbances. Consequently, if you’re addicted to this class of drugs, the only safe option is also the most likely to achieve success: benzodiazepine detox. (Also referred to simply as ‘benzo detox’)
Benzodiazepines are a class of drugs that belong to the sedative family. These drugs produce a number of significant effects in addition to sedation, including uses as anti-anxiety medications, anti-convulsants, muscle relaxants and other clinical applications. (1) The most well-known benzodiazepines include Xanax and Valium, which are both highly addictive.
With prolonged use of drugs like Valium, tolerance develops as the body fights to negate the effects of the substance. Unfortunately, the development of an increasing tolerance means that more and more of the drug must be taken in order to achieve the same effects. Over time, this tolerance morphs into a physical dependence on the drug, whereby the body cannot function “normally” without it.
Dependence invariably leads to outright addiction if use of benzodiazepine is continued – especially when combined with increasing doses as a result of tolerance. Once addicted, there are significant health risks – including risk of seizure, coma and death – if an addicted individual were to suddenly stop using the drug.
While not everyone who becomes dependent on benzodiazepine will experience Acute Withdrawal Syndrome, about 30% will, and many of these experience associated debilitating symptoms. (2) AWS also occurs with many other substances, but in particular benzodiazepines are notorious for strong, potentially dangerous withdrawal symptoms. Consider the following disturbing passage from a National Centers for Biotechnology Information study/report about benzodiazepine withdrawal syndrome:
“Physiological dependence on benzodiazepines is accompanied by a withdrawal syndrome which is typically characterized by sleep disturbance, irritability, increased tension and anxiety, panic attacks, hand tremor, sweating, difficulty in concentration, dry wretching and nausea, some weight loss, palpitations, headache, muscular pain and stiffness and a host of perceptual changes. Instances are also reported within the high-dosage category of more serious developments such as seizures and psychotic reactions.” (3)
Perhaps even more concerning is that, like AWS caused by sudden alcohol cessation, abruptly discontinuing use of benzodiazepine can result in fatal but rare complications. In fact, in the addiction treatment industry this is a widely known concept and one that many treatment centers and detox facilities emphasize in order to offer services. However, while death from “benzos” is possible, it is highly unlikely and cannot be compared to the same risk for alcohol. In fact, a 2009 study indicates that only 2 cases of death from AWS related to benzodiazepines have been recorded in medical literature. (4)
Nevertheless, the symptoms of benzodiazepine withdrawal are severe enough to cause extreme difficulties in remaining abstinent from the drug, which often requires professional medical detox and other types of treatment in order for a dependent or addicted person to achieve success in abstinence.
For many people, professional medical drug detox is necessary in order to get clean and stay clean from benzos. Detox for benzodiazepine allows an addicted individual a safe, medically monitored environment in which they can be treated for their AWS symptoms. There are 3 primary reasons why attending a drug detox program for benzos is so critical for many attempting to get clean:
1.) Warehousing Effect
By removing an addict from an environment where drugs are easily obtainable, people in the early stages of recovery stand a much better chance of success because chemical substances are not readily available to them in the treatment setting.
2.) Treatment of Symptoms
Generally, the symptoms of withdrawal are what cause an addict to return to drug use in order to seek relief. By treating these symptoms medically or therapeutically, there are fewer motivators for an addict to return to illicit drug use.
3.) Therapy & Progressive Treatment
A detox program for benzodiazepine often provides different types of therapies in order to educate and empower a person to continue to stay clean on their own after treatment. However, drug detox generally only lasts from 5-14 days, after which time additional long term treatment is often needed. Detox centers are able to continue the treatment process by offering extended therapies and in some cases a direct transition to a longer-term care facility; most notably an inpatient drug treatment program. In fact, nearly all long term drug treatment centers require that detox is completed prior to admission for long term care.
Of all substances that a person can become addicted to, benzodiazepine and alcohol are perhaps the most dangerous and are the two substances that require strict medical drug detox in order to assure the patient’s safety. This is because while rare, the risk of serious complications and death can occur with these two substances, and the withdrawal symptoms make independent, “cold-turkey” success extremely unlikely.
(1) Ashton, Heather The diagnosis and management of benzodiazepine dependence Benzo.org.UK Accessed 05/12/2013 http://www.benzo.org.uk/amisc/ashdiag.pdf
(2) Lader, Malcom Effectiveness of Benzodiazepine: Do They Work or Not? Institute of Psychiatry, King’s College London Expert Rev. Neurother. 8(8), 1189-1191 (2008) http://www.expert-reviews.com/doi/pdf/10.1586/1473722.214.171.1249
(3) Pétursson H. The benzodiazepine withdrawal syndrome. Addiction. 1994 Nov;89(11):1455-9. PMID: 7841856 [PubMed - indexed for MEDLINE] Department of Psychiatry, Borgarspítalinn/University of Iceland, Reykjavik. http://www.ncbi.nlm.nih.gov/pubmed/7841856
(4) Lann MA, Molina DK. A fatal case of benzodiazepine withdrawal. Department of Pathology, University of Colorado Denver Am J Forensic Med Pathol. 2009 Jun;30(2):177-9. doi: 10.1097/PAF.0b013e3181875aa0. http://www.ncbi.nlm.nih.gov/pubmed/19465812