Is Benzo Withdrawal Life Threatening?

Benzodiazepines, commonly known as benzos, are prescription drugs for treating anxiety, insomnia, and seizures. Common brand names include Valium, Xanax, and Klonopin. Benzos are classified as controlled substances because they have a high potential for abuse and addiction.

While effective when used as prescribed, benzodiazepines are also among the most frequently abused prescription drugs. Those who use them for a prolonged time are at risk of developing tolerance and dependence. Withdrawal symptoms can be challenging to endure, and in some cases, they can be life-threatening. In addition, taking benzodiazepines can be dangerous if taken with other substances. They are a contributing factor in 14 percent of opioid overdoses. When taken with alcohol, the sedative effects of both substances are amplified and can lead to accidents and injuries.

Benzo Withdrawal Symptoms

Benzodiazepine withdrawal symptoms can be severe, especially for those who have been using the drug for a long time or misusing it. Symptoms usually begin within a few hours to several days after the last dose and can last for weeks or months. Symptoms of benzo withdrawal include:

  • Anxiety and panic attacks
  • Insomnia and nightmares
  • Agitation and restlessness
  • Muscle spasms and tremors
  • Sweating and chills
  • Nausea and vomiting
  • Headaches and dizziness
  • Hallucinations and delusions
  • Seizures

Benzodiazepine Withdrawal Symptoms Phases

The earliest stages of benzo withdrawal may be relatively mild, including symptoms such as anxiety and insomnia or interrupted sleep patterns. Individuals may also experience headaches, sweating, and gastrointestinal distress. While these symptoms may seem manageable, seeking medical supervision to avoid complications is important.

Once the benzodiazepines have left the body completely, the onset of acute withdrawal begins. This phase can be particularly challenging and is associated with various symptoms, including increased agitation, trouble concentrating, and anxiety. Without proper medical care, this is also the phase in which many individuals experience withdrawal-induced grand mal seizures, which can be life-threatening.

During acute withdrawal, individuals may also experience various physical and psychological symptoms, including tremors, migraines, muscle pain, and heart palpitations. Psychological symptoms may include hyper-vigilance, paranoia, and the onset of mood disorders such as depression and anxiety. In severe cases, psychosis or suicidal thoughts may also occur.

Protracted withdrawal refers to long-term symptoms a person may experience after successfully abstaining from benzos. This phase can include a range of symptoms that persist for months or even up to a year, including severe mood swings, increased sleep problems, anxiety, and muscle cramps. Individuals may also experience memory problems and difficulty concentrating, which can make it challenging to work or engage in daily activities.

Long-Term Effects of Benzodiazepines on Mental Health

Some of the long-term effects of benzo use on mental health can include:

  • Studies have shown that long-term benzo use is associated with an increased risk of depression. This may be because benzos can alter the levels of certain neurotransmitters in the brain, leading to mood disturbances.
  • Paradoxically, long-term benzo use can also lead to increased anxiety. This is because the brain becomes accustomed to the presence of the drug and may become more sensitive to stress and anxiety when the drug is withdrawn.
  • Long-term benzo use has been associated with various cognitive issues, including memory loss, difficulty concentrating, and confusion. These effects can be particularly problematic in older adults, who may already be experiencing age-related cognitive decline.
  • While benzos are often prescribed for insomnia, long-term use can lead to sleep disturbances and other sleep-related problems. This is because the brain may become less able to regulate sleep patterns without the drug.
  • Perhaps the most significant long-term effect of benzo use is an increased risk of addiction. Long-term use can lead to physical dependence, meaning the body requires the drug to function normally. This will lead to increased withdrawal symptoms and a cycle of addiction and withdrawal that can be difficult to break without professional help.

Risk Factors for Benzo Addiction

Several factors can increase the risk of benzo dependence and its associated mental health effects, including:

  • Taking higher doses of benzos than prescribed can increase the risk of developing a physical dependence on the drug. This can occur when the brain becomes accustomed to the presence of the drug and requires it to function normally. Over time, this can lead to increased tolerance to benzodiazepines, which may cause individuals to take higher doses to achieve the same effect.
  • Using benzos recreationally can increase the risk of developing addiction and long-term mental health effects. When taken for non-medical purposes, the drug can be more likely to be abused, leading to physical dependence, tolerance, and withdrawal symptoms.
  • Individuals with a history of addiction or substance abuse may be more likely to develop a dependence on benzos. This is because addiction is a chronic disease that can affect the brain’s reward system, making it more difficult to stop using drugs once dependence develops.
  • Individuals with co-occurring mental health disorders, such as depression or anxiety, may be more likely to develop a dependence on benzos. This is because benzos can relieve these symptoms, making them more likely to be used long-term.

Medications for Benzo Withdrawal

When it comes to benzo withdrawal treatment, medication can be a valuable tool for managing withdrawal symptoms and supporting recovery. However, it’s important to note that a healthcare professional should closely monitor medication-assisted treatment to ensure safety and effectiveness. Some medications administered during benzodiazepine withdrawal treatment are:

  • Benzodiazepines: While it may seem counterintuitive to use a benzodiazepine during benzo withdrawal, in some cases, a longer-acting benzodiazepine may be prescribed to help manage withdrawal symptoms and prevent complications, such as seizures. This type of medication should only be used for a short period of time and under close medical supervision to avoid misuse of the drug.
  • Anticonvulsants: Certain anticonvulsant medications, such as gabapentin and pregabalin, can help manage withdrawal symptoms, such as seizures, anxiety, and insomnia. These medications work by reducing the hyperactivity in the brain that can contribute to these symptoms.
  • Antidepressants: Antidepressants, such as SSRIs and TCAs, can be useful for managing depression and anxiety symptoms that may arise during benzo withdrawal. These medications work by increasing the levels of certain neurotransmitters in the brain, which can help regulate mood and reduce anxiety.

Behavioral Therapy for Benzo Abuse

Behavioral therapy can be an effective component of benzo addiction treatment, as it can help individuals address the underlying causes of addiction and develop strategies to manage triggers and cravings. Some of the behavioral therapies that may be used during benzo addiction treatment include:

  • Cognitive-behavioral therapy (CBT): CBT can help individuals identify and change negative thought patterns and behaviors that may be contributing to their addiction. During CBT sessions, individuals work with a therapist to identify negative thought patterns, such as irrational beliefs or self-defeating thoughts, and learn to replace them with more positive, productive ways of thinking. This can help individuals develop healthier coping mechanisms and improve their overall mental health.
  • Dialectical behavior therapy (DBT): DBT can help individuals develop skills to manage distressing emotions and improve their relationships with others. DBT focuses on teaching individuals how to regulate their emotions, tolerate distress, and communicate effectively with others. It can benefit individuals with a history of trauma or other co-occurring mental health disorders
  • Motivational interviewing (MI): MI is a therapy that can help individuals build motivation and confidence to make positive life changes. During MI sessions, individuals work with a therapist to identify their goals and develop a plan to achieve them. This can help individuals feel more motivated to make positive life changes and improve their overall well-being.

The Impact of Social Support on Addiction Recovery

Addiction recovery can be challenging and complex, but having a solid support system can significantly increase the chances of success. Social support can come from various sources, including friends, family, peers, and healthcare professionals, and can provide emotional, practical, and informational assistance throughout the recovery journey.

Building and Maintaining a Strong Support Network

Building a solid support network can take time and effort but is integral to addiction recovery. Here are some tips for making and maintaining a strong support network:

  • Identify potential sources of support: This could include family members, friends, healthcare professionals, or peers who have experienced addiction and recovery.
  • Communicate your needs: Be clear about what kind of support you need and how others can help.
  • Attend support groups: Support groups can be a great way to connect with others going through similar experiences and provide a sense of community and belonging.

Detox and Rehabilitation

Detoxing from benzodiazepines can be challenging, but with the proper medical supervision and support, individuals can successfully manage withdrawal symptoms and achieve lasting recovery. Many people go to a rehab center because detox is safer and more comfortable with help from a professional team.

The detox phase of your visit to a rehab center usually takes two to three days. Afterward, a professional will work with you to develop your treatment plan. A residential program may be recommended if you have struggled with benzo misuse for a long time, have unsuccessfully tried to quit the drug multiple times, or your addiction includes other substances.

Rehab centers also offer outpatient programs. These might be appropriate if you do not have a severe addiction and have family and job obligations. Both resident and outpatient programs will likely involve behavioral therapy as part of your treatment plan. Professionals at a center will also help you develop a support network.

White Light Behavioral Health Can Help

White Light Behavioral Health offers comprehensive detox and rehabilitation programs tailored to meet each client’s unique needs and circumstances. To serve our clients, we provide a range of addiction treatment services, including benzo withdrawal management. Our team of medical professionals and addiction specialists will provide individualized care to help clients safely and comfortably manage withdrawal symptoms. We use evidence-based treatments such as medication-assisted and cognitive-behavioral therapy to help clients overcome addiction and start their road to recovery.

Reviewed By:

Dr. Ryan Wakim, M.D.

Dr. Wakim is a board-certified psychiatrist with a passion for and expertise in addiction, mood disorders, trauma-related disorders and the subspecialty of interventional psychiatry. He obtained his medical degree from West Virginia University where he also completed his residency training, finishing as chief resident. Dr. Wakim co-founded and served as the CEO of Transformations leading to a successful merger with Shore Capital in May 2021. He is purpose driven towards improving the standard of and removing stigma related to behavioral healthcare. Dr. Wakim enjoys golf, traveling and time spent with his two dogs, Lulu and Rayna.

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