Read on to learn more about benzodiazepine withdrawal, including the signs, how long it lasts, and how to get support with tapering off safely. Depending on your treatment goals, the end goal of this may be to taper off benzodiazepines completely, or to be maintained on a low dose of a long-acting benzodiazepine. Protracted withdrawal may be treated through a combination of behavioral therapy, medicine, or benzodiazepine maintenance therapy with a long-acting benzodiazepine drug like diazepam. Benzodiazepine detox is recommended for anyone who’s physically dependent on benzos, either through chronic use for a medical reason or chronic drug misuse. Secondly, approximately 20% of the children in the intensive care unit given BZD during sedation, more specifically midazolam, have been shown to exhibit withdrawal effects. The severity of the withdrawal sequelae depends on the total dose and duration of infusion and usually presents as agitation, tremors, difficulty sleeping, and inconsolable crying [60].
- Another study found that abrupt discontinuation and daily administration of propranolol in severely dependent patients was not a more successful treatment plan than current practice [65].
- The experimental treatment also included a BZD diary, a drinking diary, BZD withdrawal education, and assessments for ways of coping and “progressive relaxation exercise” [72].
- Future research is warranted for further exploration into alternative methods of treating BZD withdrawal.
- Medical detox involves tapering off the benzo drug under the supervision of a doctor.
One of the debilitating side effects of BZDs is their addictive potential. The dependence on BZDs generally leads to withdrawal symptoms, requiring careful tapering of the medication when prescribed. Regular use of BZDs has been shown to cause severe, harmful psychological and physical dependence, leading to withdrawal symptoms similar to that of alcohol withdrawal. The current treatment for withdrawal is through tapering with clonazepam.
For up to a month after ceasing inhalant use, the patient may experience confusion and have difficulty concentrating. This should be taken into consideration in planning treatment involvement. Patients withdrawing from inhalants should be observed every three-four hours to assess for complications such as hallucinations, which may require barbiturate withdrawal medication. If agitation persists and the patient cannot be adequately sedated with oral diazepam, transfer the patient to a hospital setting for psychiatric care. Symptoms begin within 24 hours of last use of stimulants and last for 3-5 days. An addiction specialist can answer your questions and guide you through your options.
Types Of Benzodiazepine Detox
The length of time between each dose reduction should be based on the presence and severity of withdrawal symptoms. The longer the interval between reductions, the more comfortable and safer the withdrawal. The safest way to manage benzodiazepine withdrawal is to give benzodiazepines in gradually decreasing amounts. This helps to relieve benzodiazepine withdrawal symptoms and prevent the development of seizures. When used appropriately they are very effective in treating these disorders.
Benzodiazepine Overuse Pathology, Misuses, and Complications
Symptoms that are not satisfactorily reduced by codeine phosphate can be managed with symptomatic treatment as required (see Table 3). PAWS triggers sharp withdrawal symptoms long after a person has taken their last dose. Severe addictions can result in withdrawal symptoms that last up to three months.
A study analyzing over 1000 cases of oxycodone-related drug abuse deaths showed that BZDs are among the most abused drugs by individuals using multiple drugs of abuse. The study showed that in oxycodone users, combination use with diazepam was the most prevalent [44]. This was further supported by data from Rooney et al. which reported that 54% of abusers of oxycodone are also dependent on a BZD [45]. The study also showed that 64% of heroin users are also abusing BZD [46]. In 2018, between 8.3% and 12.8% of BZD users in Switzerland have prescriptions from multiple physicians which resulted in the inability to track the number of prescriptions a patient is given yearly [40].
Benzodiazepine Detox Timeline
Benzodiazepine withdrawal can be managed with a gradual dose reduction, which will cause milder symptoms that come and go in waves. The 2022 survey mentioned above also asked respondents to what extent withdrawal symptoms affected their lives. They could rate each problem as nonexistent, mild, moderate, severe, quite severe, or enormous.
7. WITHDRAWAL MANAGEMENT FOR INHALANT DEPENDENCE
The higher dose may help ease your symptoms, but it can also increase your risk of overdose and severe withdrawal symptoms. One view is that many of the short-term effects continue into the long-term and may even worsen, and are not resolved after stopping benzodiazepine usage. Another view maintains that cognitive deficits in chronic benzodiazepine users occur only for a short period after the dose, or that the anxiety disorder is the cause of these deficits. Other studies have assessed different methods of counseling on BZD dangers and alternatives to patients alongside a gradual taper off the drugs. One study compared the mainstay of treatment with a standardized interview/counselling approach to treatment [72].
In addition to the immediate health risk, benzodiazepine withdrawal can seriously affect your quality of life. If someone has been taking a short- or intermediate-acting benzo (e.g. Xanax), a doctor may also recommend switching to a long-acting benzo (e.g. diazepam) during this tapering process. These can become severe if you try to detox alone, or if you try to stop taking benzodiazepines very suddenly and all at once.
The time it takes for withdrawal symptoms to occur depends on what type of benzos was taken. The longer someone has been using, the worse withdrawal symptoms will be. It works by blocking the effects of benzos and relieving withdrawal symptoms by attaching to the same pleasure centers in the brain. Other therapies, including counseling and cognitive behavioral therapy (CBT), may be helpful for people looking to manage symptoms without relying on other drugs. If withdrawal symptoms become severe, doctors may prescribe other medications.
There is also some evidence that it reduces the withdrawal symptoms of long-acting benzos. BZDs represent one of the most widely prescribed drug classes in the United States. They are used for immediate alcoholism rehab symptom relief of anxiety, epilepsy and other seizure disorders, spasticity from CNS pathology, catatonia, sleep disorders such as insomnia, and withdrawal from alcohol and other BZDs [3].
The subjects were interviewed with surgery-based consultations for approximately 10 min [12]. This study found that patients undergoing this structured intervention were 5-fold more likely to successfully discontinue BZD than those who just tapered off the drug [73]. Interestingly, a lower prevalence of withdrawal symptoms was noted in the experimental group without any change in pharmacologic treatment from control group [73].
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