Benzodiazepine Addiction Recovery
Benzodiazepine dependence and misuse is common. Some research shows that over 5 million people who take benzodiazepines abuse them. While benzos have legitimate medical uses, benzodiazepine dependence on these prescription drugs—both psychological and physical—can develop quickly. If you or a loved one are misusing benzos or suffering from benzo addiction, it’s important to get professional addiction treatment to safely detox, address the reasons you’re abusing substances, and learn skills and practices that help you sustain recovery from drug or alcohol abuse.
What Are Benzodiazepines?
Benzodiazepines, or benzos, are in a class of drugs known as sedative-hypnotics. Medically, benzos are prescribed for:
- Generalized anxiety disorder
- Seizures
- Social phobia
- Insomnia
- Premedication for medical procedures
- Panic disorder
In the last few years, the medical community has moved toward prescribing benzodiazepines for short-term use only. As the wide misuse and risk of benzodiazepine dependency became more clear, the FDA required an update to the boxed warning on all benzodiazepines. Addiction organizations like The Substance Abuse and Mental Health Services Administration (SAMHSA) have also raised red flags about prescribing benzos for long-term treatment.
Brief History of Benzodiazepines
Benzodiazepines have been around for less than 75 years. Chemist Leo Sternbach—who worked for Hoffmann-LaRoche, a pharmaceutical and healthcare company—discovered benzodiazepines in 1955. The first benzo that was marketed and sold by the company was chlordiazepoxide (Librium).
In 1963 Valium was released. It was the second benzo on the market. At that time, Valium was thought to be a better and safer alternative to barbiturates. Many people taking barbiturates were becoming addicted. This was especially risky because of the way barbiturates slow breathing, which can prompt overdose and cardiac arrest.
By the 1970s, benzos were widely prescribed for mental health conditions. It wasn’t until the 1980s that some physicians and psychiatrists noticed patients developing benzodiazepine dependencies or abusing the drug.
The Drug Enforcement Agency (DEA) currently classifies benzodiazepines as a schedule IV drug. This means they may have the potential for abuse, but the risk is lower than other drugs, such as narcotics or illicit drugs.
Types of Benzodiazepines
There are about a dozen benzodiazepines today. Benzodiazepines have similar effects. Benzodiazepines are most commonly prescribed for anxiety and panic disorders. Some benzos are also used to treat muscle spasms or seizures and help calm and sedate people before surgeries. Certain benzos come in immediate or long-acting forms. All have the potential for abuse and benzo addiction.
Types of benzodiazepines include:
Alprazolam (Xanax)
Xanax may be the most well-known benzo. The effects of Xanax depend on how much you take and your physical make-up. Xanax can help you feel more relaxed or calm to counteract symptoms of anxiety or insomnia.
Diazepam (Valium)
Another well-known benzo, Valium provides relief for insomnia and anxiety. It is often used for sedation before medical procedures or to relieve alcohol withdrawal effects. In high doses, Valium affects your memory so you don’t recall a medical procedure.
Clonazepam (Klonopin)
Klonopin can decrease anxiety or help prevent convulsions. Doctors prescribe Klonopin to ease symptoms of anxiety or panic disorder. Klonopin is also sometimes prescribed to treat:
- Epilepsy
- Restless leg syndrome
- Tourette syndrome
Lorazepam (Ativan)
The effects of Ativan take longer to kick in than more fast-acting benzos like Valium. Its effects also last longer than short-acting benzos like Xanax. Doctors may prescribe Ativan for conditions like:
- Insomnia
- Anxiety associated with depressive symptoms
- Panic attacks
- Muscle spasms
- Alcohol withdrawal
Less common benzodiazepines include:
- Oxazepam (Serax) – prescribed for symptoms of anxiety disorders, insomnia, and agitation in older adults
- Temazepam (Restoril) – prescribed for insomnia
- Midazolam (Versed) – prescribed for surgery or extreme agitation
How Do Benzodiazepines Work?
Side Effects of Benzodiazepine Prescription Drugs
Like all prescription medications, benzodiazepines come with a risk of side effects. There is little difference between side effects in the types of benzos.
Benzo adverse effects may include:
- Poor coordination
- Problems with short-term memory
- Rebound insomnia
- Changes in appetite
- Daytime drowsiness
- Dry mouth
- Constipation
- Libido changes
- Psychological dependence
- Physical dependence and withdrawal
Benzodiazepine Rebound Symptoms
A common side effect of benzodiazepines is the return of the original symptoms being treated. For instance, people prescribed benzos for insomnia may experience sleeplessness again when they stop taking benzos. This is more of a risk with long-term benzodiazepine use.
Benzodiazepine rebound symptoms may include:
- Insomnia
- Anxiety
- Depression
- Confusing thoughts
- Anhedonia (unable to feel content)
- Agoraphobia (fear of open spaces)
Do I Have a Benzo Addiction?
Any use of benzodiazepines other than as a doctor prescribed is considered drug abuse. Examples of benzodiazepine dependence or misuse include:
- Taking larger doses of benzos than prescribed
- Taking benzos for a longer period of time than prescribed
- Taking benzos when they’re not needed for a mental or medical condition
- Taking benzos while drinking alcohol or using other substances to get a certain effect
It is possible to develop a physical chemical dependency on benzos, even if you have been taking them long-term as prescribed. This is different from having a benzo addiction. Addiction involves drug-seeking behaviors and misuse.
People who have depression, anxiety symptoms, or excessive stress may find the calming effect of benzos alluring. This puts them at greater risk for benzo abuse. People who are prescribed benzos for treatment of anxiety symptoms may find the effects of the drug pleasurable, which can lead to misuse. People who already struggle with substance use disorders are also at greater risk for benzo addiction.
Signs of benzodiazepine addiction include:
- Visiting multiple doctors to obtain more benzodiazepine prescriptions (doctor shopping)
- Inability to discontinue benzodiazepine use on your own
- Taking benzos with alcohol or drugs
- Experiencing withdrawal symptoms without benzos
- Regularly feeling drowsy, dizzy, or out of sorts
- Taking more benzodiazepines than prescribed
- Taking benzodiazepines longer than prescribed
Benzodiazepine Alternatives
In recent years medical professionals have looked for alternatives to benzos and other addictive prescription drugs. Now, most physicians will only prescribe benzodiazepines when there isn’t a clinically appropriate alternative. Alternative long-term treatments for sleep disorders, anxiety, and other symptoms benzos are prescribed to treat may include a combination of the following:
What Are Benzodiazepine Withdrawal Symptoms?
You should never stop taking benzos without the help of a doctor. Depending on the dose and amount of time you’ve been using benzos, you may need a gradual taper schedule and medications to ease withdrawal symptoms. Benzo withdrawal symptoms depend on factors like:
- How long you’ve been taking benzos
- The benzo dosage you’ve been taking
- If you have co-occurring medical conditions
- If you have co-occurring mental health disorders
- Your age and physical health
Potential benzo withdrawal symptoms include:
- Seizures
- Nausea
- Headache
- Depression
- Cognitive impairments
- Panic attacks
- Insomnia
Only a medical professional knows the safest benzo taper schedule for you and which withdrawal medications are safe for your individual health and situation. Tapering involves gradually reducing the dose of benzodiazepines. The effective management of benzodiazepine withdrawal syndrome can make the difference between continuing on to treatment or relapsing.
Treatment for Benzodiazepine Addiction
If you’ve been using benzos for a long time, you’ll begin substance abuse treatment with medical detox. You’ll then enter professional addiction treatment, where you’ll explore the underlying reasons behind your addiction, get help for co-occurring disorders, and learn healthy coping skills.
Components of an effective treatment plan for addiction recovery include:
Substance Abuse Assessment
A physician will give you an exam to assess your health. You’ll also answer questions about your medical history and substance use patterns. You may also receive a psychiatric assessment for diagnosis or treatment of co-occurring mental health disorders.
Drug Detox
While benzodiazepine withdrawal is typically more psychological than physical, it can be uncomfortable. Some people have experienced severe benzo withdrawal symptoms like seizures. You need to undergo drug and alcohol detox under the care of medical professionals who can attend to emergencies.
Detoxing in a treatment facility like Vogue Recovery Center also ensures you’re as comfortable as possible. People with benzodiazepine dependence who try to quit benzos cold turkey on their own often relapse because they’re desperate to get rid of the withdrawal symptoms. In a treatment facility you’ll be cared for around the clock and receive medications to ease withdrawal symptoms, so you have fewer cravings for the drug.
Residential Treatment
Inpatient treatment is the highest level of care at a drug rehab. You live at the treatment facility where you attend individual and group therapy during the day. In the evenings you retire to apartment-style residences. You will likely share a room with another client. Support groups and activities are typically part of evening programming.
Many people find going to an inpatient rehab center is the most effective way to begin their recovery journeys. While it may seem like a big commitment, it provides:
- Round-the-clock access to addiction support staff
- A high level of structure
- Distance from triggers to use drugs and alcohol
- No access to drugs or alcohol
- Time and space to focus on yourself and getting better
Following residential treatment, you can move through varying levels of outpatient addiction treatment until you feel confident in your sobriety outside of a structured substance abuse program.
Partial Hospitalization Program (PHP)
The highest level of outpatient treatment, a partial hospitalization program meets for full days of treatment during the week. You receive similar programming as a residential treatment program, but you live at home instead of at the drug and alcohol rehab. Many people find that living in a sober recovery home is most supportive of their sobriety during outpatient rehab.
Intensive Outpatient Program (IOP)
An intensive outpatient program includes fewer hours than a partial hospitalization program but still provides a good amount of professional addiction support during the week. IOPs typically meet for at least 10 hours a week. Schedules may vary. A common IOP schedule includes three to five days a week for three hours a day. Most IOPs offer morning and evening programs, so you can choose what best fits with your work, school, or home responsibilities.
An intensive outpatient program provides critical recovery support as you ease back into everyday life. You’re encouraged to return to or obtain employment or volunteer. The goal is to help you build the structure and support in your life that sets you up for success in sobriety.
Outpatient Treatment
The last step in professional treatment at a drug rehab is an outpatient program. At this point, you have fully emerged back into your life. An outpatient program serves as a regular checkpoint in early sobriety.
Most outpatient programs for benzo addiction meet one to three hours a week. This gives you regular support from addiction professionals and peers in recovery and provides accountability in recovery. You can get help navigating triggers and continue working on relapse-prevention skills.
Sober Living Homes
Sober living homes or recovery homes are residences where only people in recovery live. Recovery homes can be more conducive to sobriety than your regular living environment because they keep you away from triggers to use benzos.
Many of these residences have onsite staff. They provide recovery support and resources like:
- House meetings
- Sober social events
- Alcohol and drug screenings
- In-house 12-step meetings or transportation to meetings
What Happens After Treatment for Benzo Abuse?
Recovery is lifelong work. During addiction treatment for benzodiazepines, you’ll work with a case manager or therapist to make sure you have the necessary recovery support and healthy practices in place before you leave. Aftercare for addiction can include things like:
- Individual therapy
- Group therapy
- Couples or family counseling
- Medication management from a psychiatrist
- 12-step groups or 12-step alternatives like SMART Recovery
- Alumni programs, meetings, and events at your treatment center
Self-care is also an important component of recovery. This includes practices like:
- Getting enough sleep
- Eating nutritious meals at regular times
- Fitness
- Mindfulness
- Hobbies
- Journaling
Pursuing treatment for benzo addiction can give you a strong foundation for adding these things to your life.
Benzo Addiction Treatment at Vogue Recovery Center
- Individual therapy
- Group therapy
- Family therapy
- Acceptance and commitment therapy (ACT)
- Cognitive behavioral therapy (CBT)
- Trauma-focused CBT
- Cognitive processing therapy (CPT)
- Dialectical behavior therapy (DBT)
- Art or music therapy
- Yoga
- Mindfulness
- Eye movement desensitization and reprocessing (EMDR)
- Motivational Interviewing
- Relapse-prevention and life skills training
- Anger management
- Nutrition services
- Fitness
- 12-step groups and 12-step alternatives
Does Insurance Pay for Benzodiazepine Treatment?
Get Help for Benzo Addiction
If you think you have a problem with benzos, you probably do. Continuing to use a substance despite the negative effects on your life is a key sign of addiction. Don’t wait to get the help you need to get better. If you or a loved one is struggling, call us today for a free, confidential consultation.
References
- https://pubmed.ncbi.nlm.nih.gov/30554562/
- https://www.integration.samhsa.gov/about-us/Benzodiazepines_Presentation.pdf
- https://www.fda.gov/drugs/fda-drug-safety-podcasts/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class
- https://pubmed.ncbi.nlm.nih.gov/24007886/
- https://pubmed.ncbi.nlm.nih.gov/24007886/
- https://www.dea.gov/sites/default/files/2020-06/Benzodiazepenes-2020_1.pdf
- https://www.health.harvard.edu/mind-and-mood/benzodiazepines_and_the_alternatives
- https://pubmed.ncbi.nlm.nih.gov/31030902/
- https://pubmed.ncbi.nlm.nih.gov/27479478/
- https://www.aafp.org/afp/2000/0401/p2121.html
- https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
Medically Reviewed by Jessica Elbe, LCSW