Benzodiazepines, commonly referred to as benzos, are highly addictive. If a person who has been using benzos regularly attempts to suddenly cease use, they will likely experience withdrawal symptoms. These withdrawal symptoms can be severe and even life-threatening, so users should never attempt to stop taking benzodiazepines on their own without professional medical help. Withdrawal from benzodiazepines varies greatly from person to person, depending on personal factors as well as the specific benzodiazepine taken.
Factors That Affect Withdrawal
Several factors affect the length and intensity of the withdrawal process from benzodiazepines:
- Dosage taken
- Length of time taking benzos
- Method of use (taking the drug orally as prescribed or abusing the medication)
- The specific type of benzo used (long-acting versus short-acting benzos)
- Abuse of other drugs while using benzodiazepines
- Any underlying mental health or medical conditions
- Personal or family history of substance abuse or addiction
Early withdrawal begins within a few hours for shorter-acting medications, such as Xanax. Withdrawal symptoms may not appear for a few days with Valium, which is a long-acting medication.
Those who have taken benzodiazepines for longer periods of time, or who have been taking higher doses, will feel more intense symptoms of withdrawal. The actual dosage of the drug taken regularly has the biggest effect on the timeline of the withdrawal process, according to the Food and Drug Administration. In one study, patients taking 4 mg per day or more of Xanax had significantly more difficulty detoxing from the drug than those taking less than 4 mg per day. About 7-29 percent of those taking more than 4 mg were unable to completely taper off Xanax.
A Tapered Approach
Since benzodiazepines can lead to life-threatening withdrawal symptoms, a tapered approach is generally employed during detox. Individuals do not stop taking the medication suddenly; instead, they are slowly tapered off the medication over a period of weeks or months under medical supervision. In some instances, if the person has been taking or abusing short-acting benzos, they may be switched to a long-acting benzo and then tapered off that medication.
There isn’t a set withdrawal timeline for all benzodiazepine medications. There are great variations in how long withdrawal takes between long-acting and short-acting benzodiazepines.
In addition, the personal factors mentioned above greatly affect specific withdrawal timelines. The specific tapering schedule will also affect the withdrawal process; if a person begins to experience significant withdrawal symptoms, they can be moved back on the tapering schedule and taken forward at a slower pace.
People withdrawing from benzodiazepines may experience what is known as a rebound effect. This is when the symptoms the benzodiazepines were initially intended to treat, such as anxiety, re-occur, often more intensely, during withdrawal. If there is a strong rebound effect, the tapering process can be slowed.
Within a few days of stopping a long-acting benzodiazepine, or within a few hours of stopping a short-acting benzo, withdrawal symptoms may begin. These symptoms may include:
- Blurred vision
- Memory issues
- Mood swings
- Difficulty thinking
- Muscle spasms
The acute withdrawal phase, during which the most intense symptoms of withdrawal take place, can take a few weeks to months, depending on the tapering schedule. Generally, those on a tapering schedule will not experience intense withdrawal symptoms. Instead, this phase may last for several months but the symptoms may be mild.
In some instances, people may experience a protracted withdrawal syndrome. In these cases, withdrawal symptoms may continue for several months or even years after stopping use of benzos. According to ABC News, protracted withdrawal may occur in up to 10 percent of people who quit taking benzo-type medications suddenly. Again, a tapering schedule monitored by professionals can mitigate all withdrawal symptoms, including issues with protracted withdrawal.
Since there is so much variation in the benzo withdrawal timeline, treatment professionals can give individual clients a better idea of what to expect during the detox process. The treatment team will consider the individual’s physical composition, history of benzodiazepine use, as well as any other related factors (e.g., polydrug abuse, mental health issues, past treatment attempts, etc.). After that assessment, the team will be able to give a better estimate of how long the withdrawal process might take. This estimate may change as the client progresses through detox and treatment, as care should always be adaptable according to individual progress.