Benzodiazepine Abuse, Side Effects, Detox, & Treatment
What are Benzos?
Benzos are central nervous system (CNS) depressants that induce feelings of calm and sedation.1 They are only available by prescription; however, these drugs have a high abuse potential and some people may acquire them illegally by buying them on the street or purchasing them for others who have a prescription. Others may visit multiple doctors to seek out more of the drug than their primary physician will provide.2
What Drugs are Considered Benzos?
Commonly prescribed benzos include:1
- Alprazolam (Xanax).
- Diazepam (Valium).
- Lorazepam (Ativan).
- Clonazepam (Klonopin).
- Chlordiazepoxide (Librium).
Why are Benzos Prescribed?
Benzos are most often prescribed to treat anxiety disorders.1 They may be used for the treatment of generalized anxiety, social anxiety, and panic disorder.3 They may also be prescribed to help with muscle spasms and seizures.2,3 Benzos are recommended for short-term, intermittent, “as-needed use. When used regularly beyond 2-4 weeks, even at therapeutic dosages, dependency may develop and people may experience withdrawal symptoms, which can increase the risk of addiction.3
Benzos are sometimes prescribed for Orange County alcohol rehab treatment in a medical detox setting.4 They can help reduce the risk of severe alcohol withdrawal symptoms, like delirium tremens and seizures.4
Misuse can occur even among those who have a prescription from their doctor.5 Misuse of prescription benzodiazepines can take several forms:2,5
- Taking someone else’s prescription.
- Taking more than what was prescribed.
- Taking them in ways other than prescribed (snorting or injecting, for example).
- Taking benzos with the intent of “getting high.”
- Taking benzodiazepines in combination with alcohol or other drugs.
What are the Signs of Benzo Addiction?
Drug addiction develops when a person continues to use a substance compulsively despite it causing significant problems in their life.5 People who continue to use a substance despite its negative consequences may be diagnosed with a substance use disorder, the clinical term for addiction. 6 When that substance is benzos, a person who meets criteria for an SUD is said to have a sedative, hypnotic, or anxiolytic use disorder, if they meet two or more of the below criteria within a 12-month period: 6
- Consuming more benzos or taking benzos for a longer period of time than intended.
- Trying to cut down on benzos but being unable to do so.
- Neglecting responsibilities in different areas, like home and work, because of benzo use.
- Cravings or urges to use benzos.
- Spending significant time getting, using, or recovering from benzos.
- Taking benzos in risky situations, like while driving.
- Continuing to take benzos even though it has negative effects on one’s physical and mental health.
- No longer participating in recreational and social activities because of benzo use.
- Continuing to take benzos even though it has negative effects on one’s relationships.
- Needing to take more benzos over time to achieve the desired effects (tolerance).
- Experiencing withdrawal symptoms when not taking benzos or taking benzos to avoid withdrawal (dependence).
The last two criteria are not considered to be met for individuals taking benzos under medical supervision.
What to Do If You Suspect Someone is Abusing Benzodiazepines
Recognizing that a loved one has a problem with benzos can be difficult, especially if they have a prescription. A person who is “high” on benzos may seem drowsy, slur their words, appear dizzy, or seem overly sedated.5 While some of these side effects are common in the first few days of use, the prolonged presence of such symptoms might indicate your loved one is using too much or that they are using benzos with other drugs like alcohol or opioids. 5,18 Visting multiple doctors for prescriptions may also indicate problematic use.2
When a person is misusing substances, loved ones may notice changes in their personality, mood, and behavior. Their relationships may be negatively affected, and they may prioritize the use of benzos before other areas of their life, like family, friends, work, school, and commitments at home. 6
If you suspect that someone you care about is misusing benzos, you can offer to assist them in getting help.7 Consider talking to them in a time and place that is private and free of distractions. Express your concerns directly and acknowledge their feelings. Offer to help them get treatment or, if they resist, attempt to get them to see a doctor. Remember that people with substance use disorders may be conflicted about quitting. Be patient and let them know you are here to help when they are ready.7
What are the Effects of Benzodiazepine Abuse?
People who start taking benzos usually feel sleepy and uncoordinated for the first few days until the body adjusts to these side effects. Other effects may include: 5
- Slurred speech.
- Poor concentration.
- Dry mouth.
- Problems with movement and memory.
- Lowered blood pressure.
- Slowed breathing.
Can You Overdose on Benzos?
An overdose can happen when a person consumes more of a drug than their body can handle. Benzo overdose by itself is rare, but it can occur.8 Benzos slow breathing and more often produce life-threatening overdose when taken with other drugs that also depress respiration, such as alcohol, opioids, or other sedatives.15
Can Benzos Damage your Brain?
There is conflicting information about whether long-term benzo use can damage the brain.9 Evidence suggests that long-term benzo use may cause persisting cognitive problems such as impairments in a person’s verbal learning, processing speed, and visuospatial abilities.15
Experiencing a drug overdose, whether on benzos alone or if benzos contributed to overdose, can lead to long-term brain damage.5 During an overdose, breathing slows or stops, which may lead to inadequate amounts of oxygen reaching the brain. Depending on the severity of the overdose, if the person survives they could suffer permanent brain damage.5
Benzodiazepine Withdrawal & Detox
Taking benzos daily for as little as 2-4 weeks, even if used as prescribed, can lead to dependence.5 The timeline and severity of dependence is based on the type of benzo, the drug’s dosage, duration of therapy and potency.19 The body becomes accustomed to the medication’s presence and an individual may experience withdrawal symptoms when they stop taking it or when the dose is cut back significantly. Benzo withdrawal symptoms can range from mild to moderate and, in some cases, severe and life-threatening.4,5
- Symptoms of benzo withdrawal include:4,5
- Hand tremor.
- Increased heart rate and blood pressure.
How Long does Benzo Withdrawal Last?
Benzo withdrawal symptoms typically last 1 to 5 weeks.11 The type of benzo a person is withdrawing from can also impact when withdrawal symptoms begin and how long withdrawal persists. Benzos with a short half-life, such as Xanax and Ativan, may cause symptoms within hours of the last dose and cause the most severe withdrawal symptoms within 2 days. Withdrawal from benzos with a longer half-life, like Valium, might be delayed for up to a week and peak in severity during the second week .6
While acute withdrawal symptoms, like elevated heart rate and blood pressure, seizures, and delirium, may resolve within a few days to weeks, less intense symptoms like anxiety and insomnia can continue for months, particularly in those who were prescribed benzos as a treatment for anxiety.6 Treatment can help address both short- and long-term benzodiazepine withdrawal symptoms.
How to Detox from Benzos Safely
Because benzo withdrawal can be highly variable, a supervised medical detox may be needed to limit the risks of withdrawal complications, like seizures. During medical detoxification programs, medical professionals assess, monitor, and treat withdrawal symptoms. Once detox is complete, a person can transition to addiction treatment. Continuing with treatment is important because it addresses the underlying reasons for addiction and helps a person develop healthy coping skills and learn strategies to prevent relapse in the future.5
How do You Treat Benzo Addiction?
After detox is complete, treatment for benzo addiction can continue in an inpatient facility, residential rehab, or on an outpatient basis. Treatment provides support and teaches skills for coping with triggers, dealing with negative feelings, and reducing cravings. 5 Therapies for addiction treatment may include cognitive-behavioral therapy (CBT), as well as other therapy types that may be provided in individual or group sessions.5
How Long Is Benzo Addiction Treatment?
The length of benzodiazepine addiction treatment can vary depending on the severity of your addiction, your personal preferences, and recommendations made by your treatment providers. Many people need at least 90 days in treatment to experience a significant reduction in or to completely stop their substance use.14 Those who can’t commit to that much time initially may complete a shorter course of treatment (such as a 30 or 60-day rehab program) and then transition to some form of aftercare or continuing care (such as outpatient therapy, individual counseling or therapy, a move into a sober living facility, or involvement in regular mutual help meetings).
Does Insurance Cover Benzo Addiction Treatment?
Yes, health insurance often will cover treatment for addiction. Recent federal laws, including the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (MHPAEA), require that health insurance companies provide adequate coverage for substance use and mental health treatment. 16,17
Depending on your specific insurance plan, treatment may be covered at no cost to you, or you may be required to pay a copay or meet a deductible. You can always contact your health insurance company directly and ask about your eligibility and benefits for substance use treatment. You can also complete our secure and HIPAA-compliant insurance benefits verification form. Shortly after providing your insurance information, you will receive an email with more information about your benefits.
With the help of treatment, those struggling with a benzo addiction can gain the tools needed to find recovery.