Why is Benzo Withdrawal so Bad?

Benzodiazepines, or Benzos, are known as a group of substances that are used to treat anxiety, panic attacks, seizures and other medical disorders. These types of drugs are extremely addictive and habit forming, because of the effects they have on the body.

“Benzodiazepine drugs (also called benzos) are habit forming and can lead to addiction. Long-term use also can lead to tolerance, which means that lower doses will become ineffective and patients will need higher doses. These drugs are abused to get ‘high’ due to their effects on the brain.” (Ogbru, 2019)

Benzos are typically prescribed to treat anxiety disorders, and work by enhancing neurotransmitters in the brain. These neurotransmitters are used to send different messages from one part of the brain to another.

Common benzos include:

Alprazolam (Xanax)
Diazepam (Valium)
Clonazepam (Klonopin)
Lorazepam (Ativan)

Side Effects of Benzo Use

Lightheadedness
Fatigue
Reduced libido
Dry mouth
Weight gain
Constipation
Drowsiness
Vomiting
Confusion
Nausea
Increase or decrease in appetite
Sedation
Improper body balance
Memory impairment

Withdrawal from Benzodiazepines

When you begin to build a tolerance to a drug, your body starts to need it to function at a normal level. If you stop or discontinue use of the drug abruptly, it will cause your body to go into a withdrawal phase, often resulting with uncomfortable side effects.

“Withdrawing from benzos can be a difficult, even dangerous process. You can expect to feel anxious and on-edge for several weeks. You might feel irritable and hypersensitive to everything around you. Insomnia is also common. During the first week, you can also expect physical symptoms like headaches and hand tremors.” (Osborn, 2020)

Benzo withdrawal can be managed better when there is a gradual decrease in dosage for the person taking it. This will help to cause milder symptoms that typically will come and go. It’s important to understand that if you have been using benzos for longer than 6 months and quickly stop using them, your body can possibly go into shock causing seizures or delirium. If you plan to stop using benzos, the best option is to contact a detox or treatment facility where a group of medical professionals can be there to assist you.

Timeline of Withdrawal

There is no definite timeline of how a person will experience their benzo withdrawal, how long it will last or how severe it will be. This all depends on the person and many factors including the amount of the drug that was taken, the duration of time it was taken, if other medications were taken along with it and other underlying medical conditions.

There is a distinct timeline for how long a withdrawal will last and the stages that will happen when withdrawal occurs. Below is the timeline to expect during a benzo withdrawal.

Immediate Withdrawal

Shortly after a person stops using benzodiazepines, early or immediate withdrawal occurs. The severity of the withdrawal depends on whatever the half-life of the drug is. This means, the amount of time it takes the drug to exit and clear the body. Certain drugs such as, Xanax may have a shorter half-life and cause withdrawal symptoms to occur at a quicker rate than other drugs.

Using other medications as drug replacements, can make it more manageable for a person to go through the withdrawals that occur when discontinuing particular substances.

Acute Withdrawal

Within a few days after the immediate withdrawal takes place, acute withdrawal will begin. Typically, these symptoms will last anywhere from 5-28 days but could also continue for months after stopping use.

This is the phase of withdrawal where most of the symptoms take place, and people often say this phase is the most challenging to go through. It’s common for doctors to monitor the person during this time to ensure safety and prescribe any necessary medications to help the patient going through withdrawal.

Protracted Withdrawal

Most side effects begin to taper off after the acute withdrawal phase, but sometimes there are some additional symptoms that can occur and linger. A research study done by the British Journal of Clinical Pharmacology indicated that a person who regularly used benzos for an extended period of time could experience withdrawal symptoms that last a year or longer.

“Protracted withdrawals may cause their own set of symptoms, often called post-acute withdrawal symptoms, or PAWS.” (Johnson, 2020) These include:

insomnia
mood swings
depression
loss of sex drive
poor concentration
anxiety

Why is Benzo Withdrawal so Bad?

Withdrawals can occur even after one month of using benzos, with small doses that were prescribed by a doctor. Out of people who have used benzodiazepines for longer than 6 months about 40% experienced moderate to severe withdrawal symptoms when they stopped using. The other 60% also experienced withdrawal symptoms, but they were milder.

Addiction expert Kenneth Anderson says, “The two types of withdrawal most likely to put people at risk of death are benzodiazepine withdrawal and alcohol withdrawal. This is because both affect the GABA system. Both of these require a taper to stop safely. And although an alcohol taper can usually be done in a matter of days, a benzo taper requires as many weeks. This is because alcohol occurs everywhere in nature and we have evolved to process it with our bodies and our brains, whereas benzos are a man-made drug and our bodies and brains do not have a built in mechanism to process them.”

There are many factors that determine what your withdrawal from benzos will look like. Some of these indicators include: