Benzodiazepine Detox and Withdrawal: Symptoms, Timeline, and Treatment

Benzodiazepines (benzos) are central nervous system (CNS) depressants that are often prescribed for anxiety and panic disorders, sleep issues, and seizures.¹ Benzos are generally indicated for short-term use, but some people misuse them to enhance the euphoric effects of other drugs; reduce the unwanted effects of drugs, such as insomnia due to stimulant use; and alleviate withdrawal from other drugs.

Regular use—even when taken as prescribed by a doctor—can lead to the development of physiological dependence, which means that a person can experience withdrawal symptoms when they stop or reduce their use.^{2, 10}

Benzodiazepine detox and withdrawal can be an important part of the recovery process, particularly to help a person safely stop using benzodiazepines. This article will give an overview of benzodiazepine withdrawal, its associated symptoms, its timeline, and how it is managed.

What Is Benzodiazepine Withdrawal?

Withdrawal from any substance, including benzodiazepines, occurs when a person stops using the substance after using it for an extended amount of time.^{2, 5} The severity and duration of withdrawal symptoms depends on:³

• The quantity/dosage
• Duration of use
• Type of benzo used
• Presence of polysubstance use
• Presence of co-occurring disorders
• Physical characteristics

A person using benzodiazepines regularly over a period of time may develop dependence, resulting in withdrawal symptoms when stopped, even if they take the medication as directed by a doctor.⁴

Dependence is the body’s physiological adaptation to a substance like benzodiazepines. A person’s body becomes so used to benzos being present in their system that if they cut back or quit, withdrawal symptoms can occur.^{2, 5}

Benzodiazepine Withdrawal Symptoms

Benzodiazepine withdrawal syndrome is like withdrawal from other CNS depressants, such as alcohol and barbiturates.^{3, 5} Potential symptoms include:²

• Increased heart rate and blood pressure
• Tremors
• Insomnia
• Nausea or vomiting
• Hallucinations
• Psychomotor agitation
• Anxiety
• Grand mal seizures

Severe withdrawal symptoms may include seizures, psychosis, or delirium and can be life-threatening, which is why medical supervision is recommended during benzo withdrawal.⁵ Severe withdrawal is more likely the longer a substance has been taken and the higher the dosages taken. The five most prescribed benzodiazepines are:¹²

• Xanax (alprazolam)
• Valium (diazepam)
• Ativan (lorazepam)
• Klonopin (clonazepam)
• Restoril (temazepam)

How Long Do Benzodiazepine Withdrawal Symptoms Last?

Benzodiazepine withdrawal symptoms vary depending on the type of benzo and its chemical makeup. For example, withdrawal from shorter-acting benzodiazepines may begin within a few hours after a person’s last dose with symptoms peaking around the second day and resolving by the fourth or fifth day after the last use.²

Benzodiazepines are available in different formulations. Some have long half-lives (long-acting), and others have short half-lives (short-acting). The length of a drug’s half-life determines how quickly it is cleared from the body.³

Withdrawal symptoms from longer-acting benzodiazepines may not appear for more than 1 week after cessation, peak during the second week, and resolve during the third or fourth week.²

Benzo withdrawal symptoms, particularly anxiety and insomnia, may persist for well beyond the timeframes listed above, sometimes for several weeks or months, and may additionally complicate recovery efforts.^{6, 7}

Benzo Detoxification and Withdrawal Management

Detoxing from benzodiazepines is the natural or assisted process of clearing the drug(s) from your body.⁵ Going through the detox process is typically the first step in the treatment process.⁸

Detox alone is rarely sufficient in supporting long-term abstinence. Continuing treatment in an outpatient or inpatient drug rehab program can help support recovery by modifying a person’s thinking, expectations, and behaviors while improving ways to cope with life’s stressors without using benzos or other substances.⁸

Due to the potential for dangerous withdrawal symptoms, medical supervision is recommended for benzo detox.⁵ Supervision may take place in an inpatient treatment center, or people with milder cases may safely undergo detox while in outpatient care. ⁹

During benzodiazepine detox, treatment professionals will help manage withdrawal through different interventions that may include:⁵

• Treatment for co-occurring mental health disorders. Anxiety is a common co-occurring condition in people taking benzos.
• Tapering benzodiazepine dose.
• Switching to a different benzo medication.
• Phenobarbital substitution.
• Use of anticonvulsant medications to help prevent seizures during detox and withdrawal.

Benzo Addiction Treatment Near Me

If you or a loved one is ready for benzodiazepine detox and withdrawal, or treatment for benzodiazepine addiction, reaching out to your doctor or a treatment facility can be an important step in getting the help you need. Each person’s unique needs require an individualized plan, which can provide the specific help you need for recovery.