How to come off a Benzodiazepine
Benzodiazepines are commonly prescribed, yet addictive substances in the US. Many have searched for how to come off a benzodiazepine and have found that the best way is through a professional treatment program. Addiction to benzos impacts all age groups. In 2016, an estimated half a million Americans reported misusing sedative drugs such as benzos. They are central nervous system depressants used to treat conditions such as depression, anxiety, insomnia and seizures.
It can be very easy to develop a tolerance, dependence and addiction to benzos, even after taking them for a short period of time. Benzo withdrawal can easily occur. In as little as a month of use, benzos withdrawal can be painful both physically and emotionally. It is especially intense if the user decides to go cold turkey and abruptly stop drug use.
Studies have found that in those who have been taking benzos for longer than 6 months, an estimated 40% experience moderate to severe withdrawal symptoms when they suddenly quit the medication. To successfully come off benzos, the taper method under the care and support of a medical provider or professional treatment program is highly recommended. This helps to ensure the safety and success of coming off a benzodiazepine.
More about Benzodiazepines
From 1996 to 2013, the number of people filling benzo prescriptions increased by a whopping 67%. The anxiolytic drug is a Schedule IV controlled substance and has become more and more popular. Popularly prescribed benzos include Xanax, Valium, Klonopin, Ativan, Librium and Tranexene. An estimated 25% of people who take benzos for extended periods of time, will experience withdrawal symptoms. Some withdrawal symptoms can even come and go, lasting several months.
Coming off benzos can lead to uncomfortable withdrawal symptoms. Managing these symptoms can help prevent intense physical pain as well as other dangerous symptoms that can be life-threatening. Different types of benzos can be short-acting, and some can be long-acting. Short-acting benzos produce more intense and serious withdrawal symptoms. Long-acting benzos take a long time for withdrawal symptoms to begin.
Factors that impact the severity of Benzos withdrawal
- Your current dose
- How long you’ve been taking benzos medications
- Whether or not you’re on more than one type of benzos medication
- Whether or not you’re taking other sedative medications
- History of substance abuse
- Whether or not you’re trying to quit more than one substance at a time
Benzos Withdrawal Symptoms
When you stop taking a benzos or drastically reduce your medication dose, it can cause symptoms of withdrawal. In short-acting benzos, withdrawal can occur as soon as several hours after you’ve taken your last dose. On average, the first signs of withdrawal can start within 5-8 hours. In the case of long-acting benzos, withdrawal can begin as late as three weeks after the last dose. On average, the first signs of withdrawal can begin within 24-48 hours.
According to the American Psychiatric Association (APA), withdrawal symptoms from short-acting benzos peak on the second day and can improve by the 4th or 5th day. Short-acting benzos can sometimes be more difficult to come off of. Especially if they have been using the medication for a long time.
- Abdominal cramps
- Anxiety and depression
- Blurred vision
- Difficulty with concentration and memory loss
- Dizziness
- Headaches
- Increased sensitivity to light, noise and touch
- Loss of appetite and significant weight loss
- Nausea
- Panic and paranoia
- Restlessness
- Insomnia and sleep problems
- Tingling in hands and feet
- Confusion
- Delusions and hallucinations
- Seizures
- Psychosis
- Heart palpitations
- Muscle stiffness cravings
- Hand tremors
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How to come off a Benzodiazepine
Going cold turkey with benzos medications can result in dangerous and life-threatening effects. It is best to avoid this at all costs. A medically supervised detox is recommended. This can help reduce the discomfort and even the severity of withdrawal symptoms. It can also help reduce the risk of relapse. A medical detox for benzos involves the tapering method. Tapering is a method of drug detox, which consists of reducing a drug dose or prescribing a less potent medication.
The taper method
Gradually tapering off a benzos is the most effective way to come off the medication. The general recommendation for tapering is 4 weeks. However, many studies have found that it is not nearly enough time for the body to readjust. Rapid tapering was found ineffective for at least 37-42% of patients who were prescribed benzos for long-term use. An estimated 90% of these patients experienced withdrawal symptoms.
There is no standard tapering schedule. Most tapers are individualized based on the drug the patient is taking, how long they have been on the drug and how much of the drug they have taken. Studies are finding that a slower and more gradual taper reduction lessens the severity of withdrawal and risks of post-acute withdrawal symptoms (PAWS).
When tapering gradually off benzos it is important to regularly assess the patient. Weighing in the risks and benefits of continuing benzos treatment can impact how they detox from the drug. Begin tapering very slowly with very small dose reductions. This may take a while, but small incremental changes will be beneficial to the patient’s overall health. Routinely monitoring the patient and adjusting the taper as needed provides individualized care and can lead to a successful detox from benzos.
Common medications used for Benzos Tapering
Common benzos medications often used when tapering gradually off medication include Valium or Klonopin. These two specific benzos are long-acting and much less potent compared to other benzos drugs. They can help reduce and manage withdrawal symptoms while slowly reducing drug use.
Buspirone is a benzos used to treat generalized anxiety. It doesn’t carry the potential for physical dependence and can help relieve emotional effects of withdrawal. However, it can take about 2-3 weeks to take effect.
Flumazenil is a benzos used to treat overdose and blocks the effects of benzos. It helps to relieve withdrawal symptoms because it attaches to the same pleasure centers in the brain as benzos.
Types of taper methods
- Cut and Hold. This method involves reducing the current dose of medication by a set amount and holding the new dose until symptoms begin to subside. This process can take several weeks after reduction for the nervous system to readjust and settle.
- Micro Taper. This method requires small daily microgram reductions of the drug that amount to no more than 5-10% of the overall reduction from the current dose each month. This can help prevent some physical and psychological withdrawal symptoms in those who are very sensitive to benzos.
- Dry Taper. This method involves using a pill cutter or scale to physically remove pieces of the pill to make reductions.
- Skipping doses. This method recommends patients skip doses by decreasing one of their daily doses throughout the week over the course of several weeks. This is done until all doses of the drug have been removed.
- Using a manufacturer’s oral solution or turning to compounding pharmacies. This method involves predetermined and premeasured drug doses created by professional medical institutions.
Reach out to Hotel California by the Sea
We specialize in treating addiction and other co-occurring disorders, such as PTSD. Our Admissions specialists are available to walk you through the best options for treating your addiction.
Treatment for Substance Use Disorder
Benzodiazepines are some of the most addictive prescription medications. They can cause intense withdrawal symptoms when coming off the drugs. Because of this, a medically supervised detox that consists of a gradual taper, is the best course of action. A professional behavioral health treatment program such as Hotel California by the Sea, provides treatment for benzos addiction.
We offer treatment at all levels of care including detox, residential, PHP and IOP. We utilize evidence-based treatment methods such as CBT, DBT and EMDR therapy. Hotel California by the Sea is dedicated to helping clients reach their goals in sobriety and overcome their addiction.
References:
https://www.addictioncenter.com/benzodiazepines/benzodiazepine-withdrawal-and-detox
https://www.verywellmind.com/benzodiazepine-withdrawal-4588452
https://www.medscape.com/viewarticle/how-safely-taper-benzodiazepines-according-patient-response-2025a1000gcs
https://www.benzoinfo.com/benzodiazepine-tapering-strategies/