Benzodiazepine withdrawal may seem daunting, but there are many ways to make it more tolerable. This overview covers benzo withdrawal, detox and addiction treatment.

Benzodiazepines are habit-forming prescription drugs used to treat several stress-related conditions, such as anxiety disorders, insomnia, epilepsy and even alcohol withdrawal. There are many different formulations of benzodiazepines, along with many different brand names. Often nicknamed “benzos,” these drugs can become highly addictive if they aren’t used properly.

Article at a Glance:  

Benzodiazepines are used to treat anxiety, epilepsy, insomnia, and alcohol withdrawal.  

Physical symptoms of benzodiazepine withdrawal are slurred speech, impaired vision, vomiting, and flu-like symptoms.  

Psychological symptoms are irritability, insomnia, anxiety, depression, and memory loss.  

Benzodiazepine withdrawal symptoms start within one to six hours, and the drug can stay in the body up to 28 days.  

The best way to detox from a benzodiazepine is under medical supervision and in the care of addiction specialists. 

Benzodiazepine withdrawal and detox infographic

What Is Benzodiazepine Withdrawal?

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. This reaction is due to how the drug acts on neurotransmitters.

Benzodiazepines impact the brain’s gamma-aminobutyric acid (GABA) receptors in particular. However, these receptors are not meant to respond to artificial GABA stimulants like benzos, so the brain may “believe” that it no longer needs to produce its own natural GABA. When a person stops taking benzos, their body is suddenly without this necessary acid that it became accustomed to.

Signs and Symptoms of Benzodiazepine Withdrawal

Since benzodiazepines impact the mind and body, the drug’s withdrawal symptoms do as well. The severity of these symptoms depends on the duration of a person’s drug use, their dosage amounts, and the method of ingestion. Their levels of physical dependency and psychological addiction also come into play when determining the severity of withdrawal symptoms.

Symptoms may include:
  • Irritability
  • Psychosis
  • Anxiety
  • Memory loss
  • Confusion
  • Depression
  • Slurred speech
  • Impaired vision
  • Difficulty sleeping
  • Flu-like symptoms (sweating, full-body aches, headaches)
  • Diarrhea
  • Nausea and vomiting
  • Seizures
  • Intense abdominal pain
  • Tremors
  • Dizziness
  • Numbness
  • Heart palpitations
  • Muscle pain
  • Vertigo
  • Benzo belly

Benzodiazepine Withdrawal Timeline

Everyone has a different reaction during benzodiazepine detoxification. Some people may only go through detox for a few weeks, while others may have to go through the process for a few months. Everyone progresses at their own pace, and the process should not be rushed. In general, however, the benzodiazepine withdrawal timeline will occur as follows:

Days 1 – 3:

During this time, the body and brain fight to get rid of the benzodiazepines. Some people can feel the onset of withdrawal symptoms in as little as six hours without the drug. At this point, a person may experience difficulty sleeping, nausea, vomiting, or dry heaving.

Days 4 – 7:

The symptoms a person experiences may begin to lessen. Cravings may persist, but the worst part has passed. Some people may still feel an intensified feeling of exhaustion, but the most intense withdrawal symptoms are typically over by now.

Days 8 – 14:

By this time, some people may start to feel psychological symptoms like anxiety and irritability on top of their remaining physical symptoms. People may begin to experience insomnia or unpleasant dreams when they are able to fall asleep.

Days 15 – 28:

The symptoms that occurred during the second week of benzo detoxification may still come and go at this point, but the drug should be completely out of the body.

Duration of Withdrawal

The timeline of Benzo withdrawal lasts variable amounts of time and is dependent on several factors. These factors include:

  • Dosage: Higher dosages are associated with longer detox periods, and lower dosages are associated with shorter detox periods.
  • Length of addiction: Similar to dosage, long-term use usually leads to longer detox periods, and short-term use is associated with shorter detox periods.
  • Individual chemistry: Some people are more heavily impacted by benzos than others. This has to do with an individual’s body and brain chemistry.
  • Professional setting: The safest way to detox from benzos is to do so under the supervision of a team of medical professionals. While this can be done at a hospital, doctors at a detox center or rehab facility will typically have the most experience with benzo withdrawal treatment.

Benzodiazepine Detox Treatment Options

It is recommended to consult with a medical professional before beginning the detox process. This is not only more effective for your recovery process but also safer.

A popular way to begin a benzodiazepine detox is through tapering, which involves gradually weaning off of benzo usage. It is recommended to conduct this method alongside a doctor so that safe amounts are removed each week. This way, your body has a chance to rid itself of benzos slowly, and the withdrawal symptoms will not be as intense.

Another way that people attempt to detox is by quitting “cold turkey,” which is when benzo use is cut off altogether. This method can have more negative effects than positive ones. Stopping the drug so abruptly will cause a person to have very intense withdrawal symptoms that can occur very quickly.

The Detoxification Process

It is best to do a benzodiazepine detox under medical supervision and in the care of addiction professionals with established safety protocols. The experienced medical staff at The Recovery Village offers patients the resources needed for an effective detoxification process. At The Recovery Village, benzodiazepine addiction treatment involves three steps:

  • Detoxification Abusing substances fills the body with toxins. Detoxification is the body’s natural process of removing toxic substances from its system.
  • Inpatient or Outpatient Rehab Both inpatient and outpatient substance abuse treatment have unique benefits and drawbacks. Learn the differences to decide which is best.
  • Aftercare Aftercare and sober living programs promote self-efficacy, coping skills and relapse prevention in long-term recovery.

Benzodiazepine Detox Medications

Doctors may use certain medications to manage drug cravings and withdrawal symptoms during medical detox. The benzodiazepine withdrawal treatment guidelines at The Recovery Village allow some patients to be treated with medications. Though there are no specific medications designed specifically for treating benzodiazepine withdrawal symptoms, there are several drugs that help relieve the discomfort and/or pain of some withdrawal symptoms and assist in recovery.

Some commonly used detox medications are:

Buspirone:

Buspirone is a non-addictive drug that helps relieve anxiety, a symptom that is very closely tied with benzo detox. This medication can take several weeks to kick in, and not everyone is willing to wait it out. In many cases, a doctor may decide to use buspirone after a person has already gone through the primary stages of detox.

Flumazenil:

Although flumazenil is more often used as an overdose remedy, this fast-acting drug can assist in detox as well. It blocks the chemical actions of benzos by attaching to the brain’s GABA receptors — the same receptors affected by benzos. Essentially, this medication “tricks” the body into thinking that it is still receiving doses of benzodiazepines. In reality, it is receiving something much less harmful. Flumazenil takes over the GABA receptors, ridding the body of the existing benzodiazepine drugs that remain.

Acamprosate:

Although this medication is used primarily when treating the symptoms of alcohol withdrawal syndrome, that condition shares multiple similarities with benzodiazepine withdrawal. Both alcohol and benzos are central nervous system depressants. Acamprosate may be able to treat benzodiazepine withdrawal symptoms such as anxiety, sleeplessness, and jitteriness.

Alternatives:

Some medical professionals recommend unregulated supplements, such as vitamins, minerals and herbal remedies, as they have shown positive results in a clinical setting. However, these remedies have not been proven scientifically. These substances may help people regain their physical health and lessen withdrawal symptoms.

Benzodiazepine Detox Centers

With facilities located in Florida, Ohio, Maryland, Colorado, New Jersey, and Washington, The Recovery Village offers different programs to help treat benzodiazepine addiction and get you on the path to a drug-free life. The Recovery Village exists to assist you through each step of the detoxification process, as well as help you acquire the skills needed to continue living in sobriety. Contact us today to learn more about treatment plans and programs that can work well for your needs.

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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
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Medically Reviewed By – Eric Patterson, LPC
Eric Patterson is a licensed professional counselor in the Pittsburgh area who is dedicated to helping children, adults, and families meet their treatment goals. Read more
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Jaffe, Adi. “Alcohol, Benzos, and Opiates—Withdr[…]t Might Kill You.” Psychology Today, January 13, 2010. Accessed June 26, 2020.

MedlinePlus. “Acamprosate.” May 15, 2016. Accessed June 26, 2020.

MedlinePlus. “Buspirone.” April 15, 2019. Accessed June 26, 2020.

U.S. Food and Drug Administration. “Romazicon (flumazenil) Injection.” February 2007. Accessed June 26, 2020.

Trevisan, Louis; et al. “Complications of Alcohol Withdrawal.” Alcohol Health & Research World, 1998. Accessed June 26, 2020.

Brett, Jonathan; et al. “Management of benzodiazepine misuse and dependence.” Australian Prescriber, October 1, 2015. Accessed June 26, 2020.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.