Addiction | 4 min read
Medically Reviewed By
On September 3, 2024
Written By
On February 27, 2019
Benzodiazepines, also known as benzos, are central nervous system (CNS) depressant drugs that have medical uses, but they’re often abused recreationally for their relaxing effects. With prolonged use, benzos can lead to dependence and addiction.
If you try to stop taking benzos after prolonged use, you may experience intense withdrawal symptoms – some of which can be life-threatening. Learn more about benzo withdrawal symptoms, timeline, and detox.
Benzodiazepines are medications that make the nervous system less active, treating anxiety disorders, panic disorders, and seizure disorders. Commonly used benzo prescriptions are Valium, Xanax, Halcion, Ativan, and Klonopin.
The nervous system uses chemical and electrical signals to send and relay messages throughout the body, known as neurotransmitters. Benzos tell the brain to release the neurotransmitter gamma-aminobutyric acid (GABA), which makes your nervous system less active, leading to relaxation and sedation.[1]
Benzos are available with a prescription and have legitimate medical uses, but they’re controlled because they can have dangerous effects, especially when misused. Benzos have a high potential for dependence, abuse, and addiction, and can have dangerous side effects, especially when misused.
Benzos can be safe when used as directed, but they do have side effects and risks. The common side effects of benzos include:[2]
There are several serious side effects to benzos, including:[3]
There is some evidence suggesting a potential increased risk of dementia with long-term use, though this is still being studied.
Benzos are not intended for long-term use. The longer you stay on benzos, the more the brain becomes physically and psychologically dependent on them. This means your body has become used to the presence of the drug to function, and withdrawal symptoms can occur if you stop suddenly.
Benzo withdrawal symptoms can range from physical symptoms like nausea and diarrhea to uncomfortable psychological symptoms. Withdrawal symptoms can be extremely dangerous if the withdrawal period isn’t properly managed.
The symptoms of benzo withdrawal may include:[4]
Benzodiazepines are all central nervous system depressants, but different drugs may have different effects. The benzos prescribed for insomnia, such as Restoril and Dalmane, are hypnotics, while anxiolytics like Ativan and Xanax are primarily used to treat anxiety.
These drugs all have different metabolites, which may affect how long they last in the body. While this may affect when the withdrawal symptoms first begin, benzo withdrawal has similar symptoms. There is the possibility of more severe symptoms related to the condition the drug treats, however, such as worsening sleep patterns during withdrawal from a hypnotic benzo.
Benzo withdrawal symptoms may start about 24 hours after the last dose, but they can continue for weeks or months. This can vary by the length of use and the specific benzo you take. Prolonged withdrawal is common with benzos.
Each benzodiazepine medication has a different half-life that affects how quickly the drug leaves the bloodstream. Withdrawal begins once the last dose wears off, which may appear within the first 24 hours after stopping a short-acting benzodiazepine like Xanax or other benzodiazepine.[5] A longer-acting benzodiazepine like Valium may take a few days for symptoms to begin. The action of the drug can affect how intense and prolonged the withdrawal symptoms are.
Benzo withdrawal occurs in three phases: early, acute, and protracted. The early withdrawal phase begins a few hours or a few days after stopping the medication and may continue after a few days. It’s common to experience rebound symptoms from the condition the benzo treats, such as insomnia or anxiety.
Within a few days, acute withdrawal begins. This is the peak of the withdrawal period and may include symptoms like:[6]
Though rare, protracted withdrawal may occur after the acute withdrawal period and may last several months or years. This involves primarily psychological symptoms like depression, anxiety, and mood swings that come and go without warning.
The duration and intensity of benzo withdrawal can vary based on the length of time you’ve been taking a benzo, the dosage amount, the type of drug you’ve taken, any underlying medical or mental health conditions, and any other drugs you abuse.
Benzos are often abused for their relaxing effects, both on their own and with other drugs or alcohol. This is known as polysubstance abuse or polydrug abuse. If you’re using other drugs with benzos, it can affect how easily you become dependent and the withdrawal symptoms you may experience.
Stopping a benzo “cold turkey” is never recommended. Withdrawal from benzos can have potentially life-threatening physical symptoms, such as seizures, and intense psychological symptoms that may increase the risk of suicide. If you want to stop benzo use or reduce your dose, a taper schedule is the safest way.
For many, benzo withdrawal is best managed in a medical detox setting. This ensures you taper off the drug with medical care and support to alleviate uncomfortable withdrawal symptoms and prevent dangerous complications. In some cases, detox may include using long-acting benzo during the tapering process to reduce withdrawal symptoms.
If you’re abusing benzos or have a benzo addiction, detox isn’t enough on its own. You need to complete an addiction treatment program to address the psychological aspects of your substance abuse and learn healthier habits. Depending on the severity of your benzo addiction, how long you’ll be in treatment and the specific treatment methods can vary. Typically, addiction treatment includes a combination of individual and group counseling, behavioral therapies, and support groups to break free of negative behaviors.
Benzos are prescribed regularly for anxiety, insomnia, and seizure disorders. Though these drugs can be safe when used as prescribed, they have a high potential for dependence, abuse, and addiction. Benzo withdrawal can have potentially life-threatening symptoms that may require treatment to prevent complications.
If you’ve been taking benzos for an extended period, stopping them abruptly is never recommended. Benzos can have intense and potentially dangerous withdrawal symptoms. If you want to stop taking benzos, speak to your doctor about a taper schedule and consider medical detox.
Benzo withdrawal can cause rebound symptoms, which means the symptoms you had before taking benzodiazepines come back stronger than before. The most common rebound symptoms are anxiety and insomnia.
Yes, benzos should never be stopped abruptly due to the withdrawal symptoms. A taper schedule is recommended to allow your body to readjust to the absence of the drug. You shouldn’t taper your dose on your own, however. Always speak to your doctor about how to taper benzos safely.
Benzos should only be taken for the shortest amount of time possible. Taking benzos for longer than a few weeks can increase the risk of dependence, so they’re typically prescribed for short-term use, often not exceeding 2-4 weeks.[7]
Benzodiazepine abuse can have negative effects on your brain function with long-term use. Cognitive function may improve with treatment, though some problems may be permanent or take an extended period to return to normal.[8]
Here at Ascendant New York, we understand the importance of having access to accurate medical information you can trust, especially when you or a loved one is suffering from addiction. Find out more on our policy.
[1] Griffin, C. E., Kaye, A. M., Bueno, F. R., & Kaye, A. D. (2013). Benzodiazepine pharmacology and central nervous system-mediated effects. Ochsner journal. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/ on 2024, July 26.
[2,3] MediLexicon International. (n.d.-b). Benzodiazepines: Uses, types, side effects, and risks. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/262809 on 2024, July 26.
[4] H;, P. (n.d.). The benzodiazepine withdrawal syndrome. Addiction (Abingdon, England). Retrieved from https://pubmed.ncbi.nlm.nih.gov/7841856/ on 2024, July 26.
[5] P.Wilson, T. Day. (n.d.-e) The Journal for Nurse Practitioners. Benzodiazepine Withdrawal in the Context of Benzodiazepine-Contaminated Opioids: Practice Implications https://www.npjournal.org/article/S1555-4155(23)00395-1/fulltext
[6] GoodRx. (n.d.). What is benzo withdrawal? symptoms, timeline, and treatment. GoodRx. Retrieved from https://www.goodrx.com/classes/benzodiazepines/benzo-withdrawal-symptoms-timeline-treatment on 2024, July 26.
[7] Kennedy, K. M., & O’Riordan, J. (2019, March). Prescribing benzodiazepines in general practice. The British journal of general practice : the journal of the Royal College of General Practitioners. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6400612/ on 2024, July 26.
[8] SA;, S. (n.d.). The effects of benzodiazepines on cognition. The Journal of clinical psychiatry. Retrieved from https://pubmed.ncbi.nlm.nih.gov/15762814/ on 2024, July 26.