Benzodiazepines are a class of drug containing many medications that doctors prescribe to treat anxiety disorders, insomnia, and seizures. You might recognize them by some of their brand names, which include Xanax, Klonopin, and Valium.1
While benzodiazepines can effectively manage symptoms on a short-term basis, using them longer increases the risk of physical dependence, patterns of abuse, and eventually, addiction. Some people have become physically dependent in as little as 4 weeks. People who are physically dependent on a medication are likely to experience some degree of acute withdrawal should they try to stop taking the drug, which may consist of several unpleasant and sometimes dangerous side effects.1
Due to these potential dangers, and because many people who try to stop on their own quickly relapse due to intense cravings for the drug, benzodiazepine detox should occur under medical supervision in a treatment program.
What Are the Signs of Benzo Addiction?
Benzodiazepine addiction is a problematic pattern of use leading to significant impairment or distress, with at least 2 of the following signs or symptoms present in a 12-month period:2
- Taking benzodiazepines in larger amounts than originally intended
- Consistently wishing to stop using, or having made failed attempts to cut back
- Spending a significant amount of time taking benzodiazepines, looking for them, or recovering from using them
- Experiencing strong cravings to use
- Having significant problems functioning in life roles (work, school, family) because of benzodiazepine use
- Continuing using benzodiazepines even when you experience negative consequences in your personal life because of them
- Stopping participating (or significantly reducing time spent) in activities that were once important and enjoyable, to use the drug
- Using benzodiazepines even when they have a harmful impact on a psychological or physical problem
- Continuing to use the drug in situations where it is harmful to do so, such as driving
- Developing a tolerance to benzodiazepines, by either:
- Taking more and more of the drug to get the desired effects, or
- When taking the usual amount of the drug, there is a noticeable reduction in the desired effects
- Experiencing physical symptoms of withdrawal when you stop taking benzodiazepines, or taking the drug to avoid withdrawal symptoms
Withdrawal Symptoms and Detox Timeline
Benzodiazepine withdrawal symptoms vary depending on how severe the addiction is. Often, people with benzodiazepine addiction also abuse alcohol or other drugs, which can further complicate the detoxification process. Some people experience withdrawal within a few hours of stopping benzodiazepines; generally, anxiety and insomnia occur within 1 to 4 days of stopping the drug.1,3 Others experience more severe withdrawal symptoms that can last 10 to 14 days or even go on for many weeks.3
Benzodiazepine withdrawal symptoms vary depending on how severe the addiction is. When you want to recover from a benzodiazepine addiction, it may be tempting to try to quit using the drug on your own. However, when you either stop or severely cut back on benzodiazepines, unpleasant or frightening withdrawal symptoms can occur, including:3
- Nausea or vomiting.
- Excessive sweating.
- Rapid pulse (more than 100 beats per minute).
- Auditory or visual hallucinations.
Of these withdrawal symptoms, seizures are the most concerning and potentially life-threatening. Elderly people may additionally experience a heightened risk of falls and heart attacks when going through benzodiazepine detox.4
What Does a Detox Program Entail?
Detox is a word that may conjure up frightening images for many people, having seen lurid portrayals of drug withdrawal in movies or on television. So it’s natural that anyone considering detox will have many questions of what is actually involved in the process.
The purpose of detox is not to provide thorough drug addiction treatment. Rather, detox is a brief process that lasts a few days, at most, and involves getting a substance out of your body. When properly supervised, your withdrawal symptoms can be managed safely and with the least amount of discomfort possible.
When you or your loved one enters a benzodiazepine detox program, the team of professionals assigned to your case—called your treatment team—meets with you to explain what to expect during detox. In general, detox serves 3 purposes, including:5
- Evaluation, which involves a thorough assessment of your medical and psychological health, determining your level of addiction, and charting the best course of treatment for your addiction.
- Stabilization, which involves helping you through the physical process of withdrawal as your body rids itself of the drug.
- Transition, which helps ease the entry from detox into longer-term treatment. You learn that a detox program is not the whole of treatment, but the first step in your recovery journey.
As you move forward with an inpatient or outpatient treatment program, you will uncover and work through the underlying issues that led to your addiction in the first place. Without this process, many people go back to using substances when they are faced with these issues in the future.
Where Can I Find Detox for Benzodiazepines?
There are many different types of detox programs, and the best setting depends on your specific needs. It is important to have all the information about the different types of programs available in your area so you can make the most informed decision.
Generally speaking, the most common types of detox programs are:4
- Inpatient care. This type of setting may be necessary if you need around-the-clock monitoring due to potential withdrawal complications. It is generally recommended that those with a significant benzodiazepine addiction attend an inpatient treatment program, and this is especially true if you have addictions to multiple substances.
- Hospital-based detox programs. As the name implies, services are offered in a medical hospital setting.
- Outpatient programs. Typically, you participate in treatment several times per week while living at home and commuting in to a treatment facility, but it is not for everyone. Whether or not outpatient treatment is appropriate depends on several factors, including:
- Your commitment to treatment.
- The quality of social support you have at home.
- Your general health.
- Your risk of experiencing withdrawal complications.
- Any previous history of complicated withdrawal.
- The presence of co-occurring psychiatric disorders.
- Other health issues.
- Having addictions to additional substances.
- Physician’s office. This setting may be viable for some people, but a careful assessment and evaluation of this approach is needed to ensure safety in the detox process.
Medications Typically Used
There are limited medications appropriate for managing benzodiazepine withdrawal symptoms. Generally, a slow taper off a benzodiazepine is the preferred approach.4
What Happens After Detox?
An appropriate post-detox treatment program is necessary to give you the best chance of avoiding relapse. During your detox program, your treatment team develops a plan to transition you or your loved one into a treatment program that best suits your needs.
- Inpatient programs offer 24/7 support, which could prove especially important if you have an addiction to other substances or have not been successful in outpatient treatment for benzodiazepine addiction.
- Outpatient treatment is offered at different levels, including partial hospitalization programs (PHPs), which you attend for several hours a day for as many as 7 days per week. Intensive outpatient programs (IOPs) usually require you to attend treatment 2 to 3 times a week for 2 to 4 hours a day. During all outpatient programs, you attend treatment during the day but continue to live at home.
- Luxury programs are typically more expensive than standard programs because they offer extra amenities to make treatment more comfortable, such as specially prepared meals, single rooms, or massage therapy.
- Executive programs cater to the needs of busy professionals. Some of these programs may offer an intensive weekend format or a hybrid of a few days of inpatient treatment followed by several hours of outpatient treatment on weekends or in the evening.
- Holistic programs address your treatment needs through the lens of mind-body-spirit wellness. These programs may offer yoga, mindfulness training, weight management, meditation, acupuncture, aromatherapy, and other complementary therapies.
- Demographic-specific programs serve certain groups, such as the LGBT population, military veterans, or adolescents. Some people find these programs helpful because they can identify more closely with their peers in treatment. Many women, for example, may find a women-only program fits their needs better if they have underlying issues of sexual abuse that they do not feel comfortable sharing in groups with men.
- 12-step programs are the basis of many treatment programs using the 12-step model of Alcoholics Anonymous.
- Non–12-step programs provide a secular alternative for people seeking a similar recovery environment as that offered by traditional 12-step programs.
Not everyone wants the same type of detox program, nor does one program fit everyone’s needs. Researching your options and speaking to specialists in the recovery field can help you find the best fit for you.
- Tan, K.R., Rudolph, U., & Lüscher, C. (2011). Hooked on benzodiazepines: GABA A receptor subtypes and addiction. Trends in Neurosciences, 34(4), 188–197.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Washington, D.C.: American Psychiatric Publishing.
- Pétursson, H. (1994). The benzodiazepine withdrawal syndrome. Addiction, 89(11), 1455–1459.
- Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration.
- Center for Substance Abuse Treatment. (2006). Quick Guide for Clinicians: Based on TIP 45: Detoxification and Substance Abuse Treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration.