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Benzo Detox Treatment

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What Is Benzodiazepine?

Benzodiazepines also known as Benzos were discovered in the early 1960s and are still a mainstay in treating anxiety disorders. It is also used for those struggling with insomniaanxiety, spasticity due to central nervous system (CNS) pathology, muscle relaxation, and epilepsy. While not an indicated use, benzodiazepines for depression have become more common. When used therapeutically, they are effective at treating these conditions, but many people abuse them for their calming and euphoric effects [1]. 

Chronic abuse of benzos for anxiety and depression often leads to benzo addiction [2]. This is one of the most dangerous drugs to withdraw from, dependence can develop in as little as a month of use, making medically professional benzo detox treatment essential. One of the most significant risks of benzodiazepines and the reason to get into a benzo addiction treatment program is the high risk of overdose. If you take too much of these psychoactive drugs, you risk experiencing benzodiazepine cardiac side effects, which include slowing your heart rate to damaging or fatal levels.

What Is Benzodiazepine Detox?

What is detox? Detox or detoxification is a process or period in which a person abstains from or rids the body of toxic or unhealthy substances. Benzo detox can lead to severe withdrawal symptoms. However, proper care can reduce the likelihood of developing these symptoms and ensure a safe medically – assisted benzo detox treatment process. Typically, this means removing benzodiazepine from the person detoxing is performed safely and slowly. This will depend on their biology, dosage, and frequency of use. Trying the benzo detox at home would be a grave mistake, as benzo’s withdrawal symptoms can be unpredictable and dangerous to deal with without medical assistance.

More than most other psychoactive drugs, benzodiazepines are commonly encountered in both psychiatric and addiction medicine settings [3]. For example, psychiatrists regularly turn to this class of clinically valuable drugs to successfully treat various psychiatric disorders such as anxiety. Similarly, chemical dependency and drug addiction treatment settings routinely encounter benzodiazepines as a drug of abuse. However. in the drug addiction setting, benzodiazepines are most frequently used as secondary drugs of abuse and are most often found within a polysubstance use pattern.

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Benzo Detox Treatment

The presence of benzodiazepine polysubstance abuse, anxiety disorder, and substance use disorder, also known as dual diagnosis or co-occurring disorders, or a family history of addiction will significantly affect the type of benzodiazepine withdrawal a person will experience and the treatment for benzo detox. Benzodiazepine withdrawal is when the body begins to rid itself of the drug, which can lead to a state of shock. Uncomfortable withdrawal symptoms can result if a person suddenly stops using benzos or drastically reduces use. It is recommended to consult with a medical professional before beginning the benzo detox treatment process. This is not only more effective for your recovery process but also safer.

A clinical diagnosis of an anxiety disorder can be debilitating and affect a person for their entire life. It is important to realize that anxiety-related problems are not permanently cured or solved by medication like a benzodiazepine.

Benzo Detox
 Benzodiazepine withdrawal can be an intense experience, and benzo detox treatment is required.

As an alternative to benzodiazepines, there are non-addictive anxiety medications, medication-assisted treatment (MAT), specific psychotherapies, such as cognitive behavior therapyemotional freedom techniquesEMDR therapy, and holistic therapies that target anxiety and substance use disorder and help the person regain control of their life and improve their well-being.

Benzo Detox Treatment
Once an individual becomes psychologically or physically addicted to Benzodiazepines the safest way to stop using the drug is to enter a medically managed detox treatment program.

What is Polysubstance Abuse?

Polysubstance abuse is the consumption of more than one substance simultaneously. While some drug users have a preferred drug, others have several drugs they like to take. Polysubstance abuse is common, and these drug users are clinically classified as having multiple comorbid substance disorders. Benzodiazepine use by drug-abusing individuals consists of using benzodiazepines with other psychoactive drugs (I.e. Xanax and Alcohol, Xanax and Oxycodone, Klonopin, and Xanax, Valium and Alcohol, and Xanax and Tylenol).

The presence of benzodiazepine polysubstance abuse, anxiety disorder, and substance use disorder, also known as dual diagnosis or co-occurring disorders, or a family history of addiction will significantly affect the type of withdrawal a person will experience and the benzodiazepine addiction treatment course.

What Are Co-Occurring Disorders?

When a person is diagnosed with a mental health disorder such as anxiety and depression and substance use disorder, they are said to have co-occurring disorders. Though the disorders can exist separately from one another, when they coexist in the same person, they usually cause the symptoms of both disorders to be intensified. It is common for a person with co-occurring disorders to have more severe symptoms than a person with only one of the disorders. 

Types Of Benzodiazepines

There are many different benzodiazepines on the market.  Doctors may prescribe one over the other for various reasons.  Perhaps their clients have seen more success for one over the other, or the formulation of specific benzo is known to meet a particular client’s needs better.  Here is a list of the different types of benzodiazepines with their generic and brand names.

  • Alprazolam (Xanax, Xanax XR)
  • Clobazam (Onfi)
  • Clonazepam (Klonopin)
  • Clorazepate (Tranxene)
  • Chlordiazepoxide (Librium)
  • Diazepam (Valium, Diastat Acudial, Diastat)
  • Estazolam (Prosom – discontinued brand in the US)
  • Lorazepam (Ativan)
  • Oxazepam (Serax – discontinued brand in the US)
  • Temazepam (Restoril)
  • Triazolam (Halcion)

Side Effects Of Benzo Detox Treatment 

Benzodiazepines (benzos), such as Valium or Xanax, are central nervous system depressants that act similarly to alcohol. They cause users to feel sedated and relaxed, so doctors prescribe them for people with anxiety problems and sleep. The side effects of benzo detox are dangerous. Detox from benzos also requires medical monitoring to ensure it is done safely.

Some side effects of benzo detox include:

  • Depression
  • Insomnia
  • Anxiety
  • Tremors
  • Loss of appetite
  • Muscle spasms
  • Difficulty concentrating
  • Impaired motor functions
  • Suicidal thoughts and behavior
  • Migraines
  • Nausea
  • Vomiting
  • Dizziness
  • Hallucinations
  • Seizures
  • Restless leg syndrome
  • Rebound anxiety
  • Rebound insomnia
  • Impaired memory
  • Chest pains
  • Delirium
  • Convulsions

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Benzo Detox Treatment for Benzo Addiction

Detoxing from benzos is intense and can be dangerous without proper medical supervision. Suicidal behavior and seizures are the two most dangerous risks. Approximately a third of individuals receiving treatment for benzos withdrawal symptoms experience grand mal seizures. Quitting cold turkey increases the risk of seizures. The detox and recovery process can last several months, depending on the duration of use. Medically supervised detox includes tapering down the dosage of benzodiazepines. Reducing the dosage in increments lowers the risk of serious side effects. Medications are also effective during benzo detox.

Inpatient Benzo Detox Treatment

Inpatient benzo detox treatment is usually warranted when a person has been taking large doses of benzodiazepines for a long time, is suffering from polysubstance abuse, or experiencing co-occurring disorders. During inpatient benzo detox treatment, you’ll be closely monitored, and you may receive medications to help alleviate uncomfortable withdrawal symptoms.

Benzo Detox
 Benzodiazepines are habit-forming. Learn more about benzo detox treatment

Benzo Detox Treatment Medications 

No medication is specifically FDA-approved for the treatment of benzodiazepine dependence. However, some medications are used off-label to treat benzodiazepine withdrawal or used to manage the spectrum of symptoms that can arise during withdrawal.

Medications for Benzodiazepine Withdrawal 

Some of these medications include:

  • SSRI antidepressants may be used for anxiety. 
  • Anticonvulsants may be used for people with a history of multiple seizures. 
  • Beta-blockers may be used for physical symptoms such as tremors. 
  • Clonidine may be used to maintain normal blood pressure if the person’s blood pressure becomes too high during withdrawal.
  • Ondansetron can be given to treat nausea or vomiting during withdrawal.
  • Some medical professionals give pregabalin (Lyrica) to treat benzodiazepine withdrawal. However, this is an off-label use. Lyrica also shows promise as a treatment for alcohol dependence [1] but mixing Lyrica and alcohol is dangerous; alcohol can add to the drowsiness caused by this medication.

Medications for Benzodiazepine Withdrawal and Anxiety Disorder

Certified addiction physicians and psychiatric nurses and therapists with mental health experience can help sort out substance-induced mental health symptoms from an actual mental health disorder. Medications can be prescribed to manage the mental health disorder, address the addiction, and avoid developing a new addiction. Common psychiatric medications prescribed in drug rehab centers for dual diagnosis treatment of benzodiazepine addiction and withdrawal are:

  • Klonopin (Clonazepam). Klonopin is a long-acting benzodiazepine that can help minimize symptoms of benzodiazepine withdrawal from short-acting benzo addiction. It is used to treat seizures as well as panic and anxiety.
  • Phenobarbital. Phenobarbital is from the class of drugs known as barbiturates. This particular drug is generally used to treat seizures and anxiety. It works by slowing down the activity in the brain. It is used to counteract benzodiazepine withdrawal.
  • Buspirone (Buspar) Buspirone is a medication used to reduce anxiety. It is classified as an anxiolytic because it influences the neurotransmitters in the brain, especially serotonin. It is different than benzodiazepines as it does not depress the central nervous system or cause sedation.
  • Tegretol (Carbamazepine) This drug is prescribed to help reduce anxiety symptoms. It acts upon the brain by calming activity.
  • Tofranil (Imipramine) Tofranil is among the drugs in the tricyclic antidepressant class. It is used to treat depression and anxiety due to benzodiazepine abuse.

Medications for Benzodiazepine and Alcohol Withdrawal Symptoms

In line with the possible side effects and addictive properties of benzodiazepine use, especially if it involves both benzo and alcohol use disorder, there is growing evidence suggesting that non-benzodiazepine GABAergic compounds represent promising medications in the treatment of alcohol-dependent patients.

The main objectives of the clinical management of benzodiazepine and alcohol withdrawal symptoms are to decrease the severity of symptoms, prevent more severe withdrawal clinical manifestations such as seizures and delirium tremens, and facilitate entry of the patient into a treatment program to attempt to achieve and maintain long-term abstinence from both substances.

  • Baclofen is a stereoselective gamma-aminobutyric acidB (GABAB) receptor agonist with an approved indication to control spasticity. The efficacy of baclofen could be related to the activation of GABAB receptors that might offset alcohol withdrawal symptoms (AWS)-associated with the enhanced function of NMDA mediated glutamate excitatory neurotransmission, resulting in an attenuation of alcohol withdrawal symptomatology. 
  • Carbamazepine is the oldest drug investigated in the treatment of AWS in US trials and is approved as a treatment for AWS in Germany. It is a tricyclic anticonvulsant that acts by inhibiting voltage-dependent sodium channels and activating the voltage-dependent potassium channels. The rationale for using carbamazepine in treating AWS is its potential to suppress withdrawal-induced kindling in limbic structures.
  • Gabapentin has an FDA-approved indication as an adjunctive treatment for partial seizures. This medication is structurally related to GABA, crosses the blood-brain barrier readily, and is distributed to the CNS. Gabapentin is an anti-epileptic agent that has shown preliminary evidence of efficacy for improving symptoms of cocaine addiction and alcohol withdrawal in pilot studies. However, it has been reported that some people smoke Gabapentin which can lead to addiction.
Benzo Detox
Addiction to benzodiazepines can happen to anyone.
  • Flumazenil has been categorized as a pure benzodiazepine antagonist and as a benzodiazepine partial agonist. Consequently, there is not enough clinical data to justify the possible use of flumazenil in treating AWS. Moreover, it should be considered that seizures and sedation may occur after flumazenil administration.
  • Gamma-hydroxybutyrate (GHB) is a short-chain fatty acid structurally similar to the inhibitory neurotransmitter GABA. In 2002, though highly controlled, GHB was approved by the FDA for the treatment of cataplexy in narcoleptic patients. Regarding the treatment of alcohol dependence, GHB has been approved in some European countries, while in the US GHB is a severely restricted Schedule III Controlled Substance and does not have a practical application in the treatment of alcoholic patients. Recreational use of the drug can quickly progress to GHB drug addiction and quitting the drug can be hellish and often leads to withdrawal from GHB.

Benzodiazepine Overdose

The most significant risk of using benzodiazepines is potentially overdosing.  With a propensity for developing a tolerance, the longer someone takes benzodiazepines, the greater dosage they will likely need to take to achieve the desired effect, and the greater the risk of overdosing.  As a sedative, benzos cause breathing to slow. In turn, less oxygen is passed through the lungs to the brain and the rest of the body. When a dose too great is taken, breathing slows to the point of being potentially fatal.

Mixing Benzos & Other Sedatives

The risk of overdosing on benzodiazepines increases significantly when taken with certain other substances.  Specifically, mixing benzos with other forms of sedatives can be deadly. In addition, substances such as alcohol and opioids also slow the breathing of a user.  However, when these substances are taken together, the dosage required of each importance to reach lethal levels is significantly lowered.

Benzo Detox Treatment & Withdrawal

As mentioned above, benzodiazepine detox can lead to severe withdrawal symptoms.  However, proper care can reduce the likelihood of developing these symptoms and ensure a safe detox.  Typically, this means that the individual detoxing will be weaned off of the substance gradually, depending on their biology, dosage, and frequency of use, the time it takes to tapper off will vary.

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Benzo Withdrawal

The withdrawal symptoms of benzodiazepines are physically and emotionally painful and can even be life-threatening if the user stops “cold turkey.”  Those with a history of taking higher doses or taking the substance for a prolonged time have the worst withdrawal symptoms. Benzodiazepine withdrawal symptoms are highly variable and often come and go.  They may vary in severity and frequency throughout all phases of the withdrawal process.

Benzo Withdrawal Symptoms List

The most common benzo withdrawal symptoms, often called “rebound” symptoms, usually manifest within 1-4 days of discontinuing use, depending on the benzo used, the amount of use, and the frequency.  These symptoms typically last up to ten days and include:

  • Sleep Disturbances
  • Increased Tension
  • Anxiety
  • Panic Attacks
  • Seizures
  • Difficulty Concentrating
  • Excessive Sweating
  • Heart Palpitations
  • Headache
  • Muscular Stiffness or Discomfort
  • Mild to moderate changes in perception
  • Cravings
  • Hand Tremors

Rebound Symptoms

In addition to withdrawal symptoms, benzo detox most commonly brings rebound symptoms.  Rebound symptoms are the return of symptoms that may have been present at the start of taking the medication, and the symptoms may be heightened for a few days.  This may include insomnia, anxiety, and stress.  However, as the body regulates through detox, these symptoms will likely subside or reduce.

Duration of Withdrawal

The half-life (time spent in the body after consumption) of a benzodiazepine varies by brand.  Withdrawal symptoms from shorter-acting benzos begin sooner than those from longer-acting ones because it takes a shorter time for the drug to leave the user’s system.

The first signs of withdrawal usually start within 6 to 8 hours for shorter-acting benzos and 24 to 48 hours for longer-acting benzos. Short-acting benzos are notable because of the intense and severe withdrawal symptoms people experience when they quit taking them. Long-acting benzos cause less intense withdrawal symptoms, and it takes longer for symptoms to start.

Taking benzos more frequently, in higher doses, in more potent forms, and for a prolonged time, all increase the duration of withdrawal.  In cases of mild addictions, it may take as little as seven days to overcome withdrawal symptoms.  Other issues can take up to three months as the user is slowly weaned off the drug to prevent life-threatening withdrawal symptoms.

Benzo Detox
Withdrawal & Detox from Benzodiazepine Addiction.

Benzo Detox Treatment Timeline

Like detoxing from other prescription drugs, benzo withdrawal timelines can differ from case to case.  For someone using short-acting benzos, withdrawal symptoms may begin to present themselves in as little as 6 to 8 hours.  However, if a longer-acting benzodiazepine was used, it could be 24 to 48 hours before symptoms are observed. Withdrawal symptoms typically last about four days. Rebound symptoms may last about 2-3 days from when they begin.

First 6-8 hours

The first signs of withdrawal, typically anxiety and insomnia, may emerge within several hours after stopping use.  This depends on how long it takes for the substance to leave the system. Withdrawal symptoms usually appear in 6-8 hours for those taking short-acting benzos.

Days 1-4

Rebound anxiety and insomnia peak after a couple of days.  During this time, intense discomfort from insomnia and increased pressure on joints.  Other symptoms that peak during this time are increased heart and breathing rate, sweating, and nausea. In addition, people who use longer-acting benzodiazepines start feeling the first signs of withdrawal during this time.

Days 10-14

The withdrawal symptoms typically continue for at least 10-14 days before fading away completely.  The withdrawal symptoms of longer-acting benzos begin to peak, eventually fading within 3-4 weeks from the quit date.

Days 15+

People heavily dependent on benzodiazepines may experience Post-Acute Withdrawal symptoms, also known as PAWS. These are random periods of sharp withdrawal symptoms months after quitting. Tapering down benzo use with the help of a doctor can prevent PAWS.

Post-Acute Withdrawal Symptoms (PAWS)

Post-acute withdrawal symptoms often continue to occur for six months or longer after ceasing Benzodiazepine use. Symptoms of PAWS include:

  • Poor concentration
  • Loss of sex drive
  • Depression
  • Persistent anxiety
  • Chronic insomnia
  • Difficulty performing complex tasks

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Benzo Detox Treatment Near Me

There is a strong link between mental health and substance abuse. Individuals who struggle with mood disorders like depression and anxiety are more susceptible to developing an addiction to drugs or alcohol, often to self-medicate symptoms of their underlying mental health condition. These co-occurring disorders can make each other worse without proper benzo detox treatment.

To determine the most effective ways to treat benzos addiction, such as Ativan Addiction, Xanax Addiction, alcohol, and anxiety meds addiction, it’s crucial to accurately assess all the symptoms. When the symptoms have been evaluated by a mental health professional, it may be determined that another form of mental condition is present and needs a particular type of treatment. Very often, some combination of psychotherapy, medication, and/or lifestyle changes are effective for coping with functional.

Medically-Assisted Detox

Detox is often considered the first stage of treatment. It will help you navigate the complicated withdrawal process, but it doesn’t address patterns of thought and behavior that contribute to drug abuse. Various benzo detox treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient benzo detox treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of withdrawals.

Psychotherapy for Depression and Anxiety

Several different modalities of psychotherapy have been used in the treatment of anxiety and depression, including:

  • Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves making changes in both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
  • Dialectical Behavioral Therapy – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
  • Person-Centered Therapy – is a strategy that allows and encourages clients to understand and resolve their concerns in a safe, supportive environment.
  • Solution Focused Therapy – is an approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.

Dual Diagnosis Treatment

Substance abuse and mental health disorders often co-occur. In many cases, traumatic experiences can result in a mental health disorder and substance abuse. Dual diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. This strategy treats both the substance abuse problem and the mental disorder simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend largely on the treatment for both disorders done by the same team or provider.

Medication-Assisted Treatments

Medication-Assisted Treatments (MAT) for substance use and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

Someone with a Xanax addiction may take up to 20 or 30 pills per day. If the user stops the Xanax dosages, they may experience withdrawal effects such as anxiety, restlessness, insomnia, and tremors. The development of tolerance and withdrawal are indications of addiction. Contact one of our helpful benzo detox treatment specialists today if you or a loved one are struggling with long-term Xanax and alcohol addiction and a co-occurring mental health condition such as anxiety and depression. We Level Up can provide information on dual diagnosis and detox programs that may fit your specific needs.

Benzo Detox
Comprehensive benzo detox treatment and therapy can help people address the root causes of benzodiazepine addiction and develop the skills necessary for lifelong sobriety.

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Sources:

[1] NCBI – https://www.ncbi.nlm.nih.gov/books/NBK470159/

[2] NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8629021/

[3] NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/