Benzodiazepine Addiction Detox, Treatment, Rehab & Long-Term Recovery

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Benzodiazepine addiction refers to the development of physiological and psychological dependence on certain anti-anxiety medications and continued use despite the incurrence of adverse consequences. Benzodiazepines (benzos) are a class of prescription drugs typically prescribed to treat anxiety and panic disorders, insomnia, muscle spasms, seizures, and alcohol withdrawal symptoms. Commonly used benzos include Xanax, Valium, Klonopin, and Ativan.

At Guardian Recovery, our comprehensive addiction and detox programs provide a safe and supportive environment for those seeking to overcome the misuse of substances such as benzos. Our behavioral health services focus on co-occurring mental health conditions, such as anxiety, and are designed to address the unique needs and goals of each individual.

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Most Commonly Misused Benzodiazepine Medications

Benzodiazepines are prescription drugs that affect the brain and body by interacting with certain neurochemicals in the central nervous system responsible for feelings of relaxation, pleasure, and reward. Several benzos are frequently misused due to their high potential for dependence and addiction. Examples include Xanax, Ativan, and Valium.

These Include:

  • Xanax (alprazolam)—A short-acting medication, Xanax is used to treat anxiety and panic disorders with a rapid onset of action that includes strong sedative and euphoric effects. 
  • Valium (diazepam)—A relatively long-acting medication, Valium is used to treat anxiety, muscle spasms, and seizures with an intermediate onset of action that includes sedative and mildly euphoric effects.
  • Ativan (lorazepam)—An intermediate-acting medication, Ativan is used to treat anxiety, insomnia, and seizure disorders and has a rapid onset of action that includes sedation and reduced anxiety.
  • Klonopin (clonazepam)—A relatively long-acting medication, Klonopin is used to treat seizure and panic disorders and has a slow onset of action that includes sedation and mild euphoria.
  • Ativan (lorazepam)—A long-acting medication, Ativan is used to treat anxiety, insomnia, and seizure disorders, and has a relatively rapid onset of action that includes sedation and mild euphoria.
  • Restoril (temazepam)—An intermediate-acting medication, Restoril is used to treat insomnia with a relatively rapid onset of action and potent sedative effects.
  • Librium (chlordiazepoxide)— A long-acting medication, Librium is used to treat anxiety disorders and alcohol withdrawal syndrome and is available in both immediate- and extended-release versions.

Symptoms & Side Effects of Benzo Dependence

Benzodiazepine dependence may present with many physical and psychological symptoms and side effects. This can occur when a person has been taking benzos routinely and their brain and body begin to rely on them.

Symptoms & Side Effects Include:

  • Withdrawal symptoms upon discontinuation (e.g., anxiety, irritability, insomnia, tremors, nausea, etc.).
  • Increased tolerance, leading to a need to use an increasing amount to achieve the same effects.
  • Drug-seeking behavior, including doctor-shopping to obtain multiple prescriptions.
  • Loss of control over use, including using more than planned.
  • Neglect of responsibilities, such as familial, professional, and social obligations.
  • Cognitive impairments such as confusion and difficulty with memory and concentration.
  • Psychological effects include mood swings, depression, anxiety, and emotional dysregulation.
  • Social withdrawal, isolation, and avoidance of activities once enjoyed in lieu of benzo use.

Benzodiazepine Addiction Detox & Rehab Process

The rehab and detox process for benzo misuse and addiction often involves devising a tapering method in which the medication’s dose is decreased under medical supervision. A tapering schedule is typically complemented with or followed by therapy, counseling, and group support to help the individual identify the underlying contributors to addiction and improve coping mechanisms.

Medically Detoxing the Body From Benzodiazepine Misuse or Overdose 

During medical detox for benzos, the main goal is to safely and effectively remove the drug and other toxins from the person’s system. Typically, this takes place in a clinical setting under the supervision of healthcare professionals who supervise the patient round-the-clock, administer medications, and address any potential complications. 

Duration of Withdrawal Symptoms 

Several factors can affect the length and severity of benzo withdrawal symptoms, including the typical dosage, the specific medication, and the frequency and duration of use. Withdrawal symptoms can onset within a few hours after the last dose and persist for 1-2 weeks or longer in cases of post-acute withdrawal syndrome (PAWS). (1) These effects can vary in intensity from mild discomfort to more severe and even life-threatening.

Benzodiazepine Withdrawal Timeline

Each benzo medication has a specific half-life that dictates the length of time it takes for the drug to leave the body. (2) For short-acting benzos, such as Xanax, withdrawal can begin within 12 hours of cessation. For longer-acting benzos, such as Valium, it can take 24 hours or more for symptoms to manifest. In general, short-acting benzos tend to produce withdrawal effects sooner and with more intensity than their counterparts with longer half-lives.

Benzo Withdrawal Symptoms Include:

  • Nausea, vomiting, and diarrhea.
  • Anxiety and panic attacks.
  • Depression and suicidal thoughts.
  • Insomnia.
  • Tremors.
  • Sweating.
  • Headaches.
  • Heart palpitations.
  • Muscle pain.
  • Cognitive impairments.
  • Drug cravings.
  • Seizures.
  • Hallucinations

Benzo withdrawal typically occurs in three primary phases–early withdrawal, acute withdrawal, and PAWS, also known as protracted withdrawal. During early withdrawal, rebound anxiety, insomnia, and other symptoms can occur as the brain attempts to reestablish a balance of chemicals without the presence of benzos. The tapering method used during detox can be used to even out these effects.

Acute withdrawal usually begins within a few days and includes the bulk of the symptoms associated with detox. It can last for a few weeks in severe cases. PAWS symptoms can persist for months, and consist of mostly psychological symptoms, including cognitive deficits, anxiety, depression, mood swings, and insomnia.

Can You Detox From Benzodiazepine Dependence on Your Own? 

Medical professionals do not advise attempting to detox from benzos without medical supervision, as it can be both challenging and potentially dangerous. Like alcohol, detox from benzos can be life-threatening and result in a condition similar to severe alcohol withdrawal syndrome. (3)

The Treatment Approach for Benzodiazepine Dependence 

Various treatment options are available for benzo dependence based on the person’s unique needs and circumstances. In addition to detox, these can include comprehensive programs heavily based on evidence-based therapies, group support, and lifestyle changes.

Medications Used in Benzo Treatment Include:

  • Long-acting benzodiazepines, such as Valium for tapering dosages.
  • Anticonvulsants, such as Tegretol (carbamazepine) or Neuronton (gabapentin), to relieve withdrawal symptoms and prevent seizures.
  • Beta-blockers, such as propranolol, to relieve anxiety, tremors, and rapid heart rate.
  • Antidepressants, such as SSRIs, to mitigate depression and anxiety during withdrawal. (4)
  • Sleep aids, such as Ambien (zolpidem) or trazodone, to help with insomnia and sleep disturbances.
  • Muscle relaxants, such as Flexeril (cyclobenzaprine), to relieve muscle spasms or discomfort.

The pharmacological approach used varies depending on individual factors, including the person’s medical history and the severity of dependence.

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How Long Are Benzodiazepine Detox & Addiction Treatment Programs?

The length of detox and addiction treatment programs varies according to the individual’s needs. Detox programs typically last as long as needed to ensure that acute withdrawal symptoms are under control and the person is not expected to experience severe complications. 

Addiction treatment programs can vary significantly in length, but residential inpatient treatment commonly requires 28–90 days or longer of participation. Some programs can last longer, from six months to one year. Partial hospitalization programs (PHP) are generally 4–12 weeks in duration, and outpatient treatment can last for several weeks or several months.

Rehab Options & Treatment Programs for Benzodiazepine Addiction Include:

Inpatient Rehab

Also known as a residential program, inpatient rehab provides 24/7 care and support in a safe, controlled environment. It typically begins with medical detox and also includes a full continuum of care with essential interventions such as therapy, medication management, support groups, and aftercare planning. 

One of the primary functions of this type of program is to allow individuals to concentrate on their recovery without distractions or temptations that exist in the outside world. Inpatient rehab essentially prevents relapse due to round-the-clock professional supervision, and is suitable for those with severe dependencies or co-occurring psychiatric issues.

Partial Hospitalization Programs (PHP)

PHP is similar to inpatient programs in terms of the services they offer. However, instead of receiving 24/7 treatment and support, they are provided with various therapeutic methodologies but are allowed to return to their private residences overnight. This option is most beneficial for those who have completed an inpatient level of care and/or require more intensive treatment than outpatient programs offer.

Intensive Outpatient Program (IOP)

In IOP, individuals usually attend treatment sessions for a few hours per day, several days per week. As the name implies, IOP is more intensive than regular outpatient and is often considered an excellent step-down level of care from inpatient programs, or PHP. This option is relatively flexible but still requires some level of accountability while the person transitions from a higher level of care into their normal daily lives. It usually consists of ongoing therapy and support, similar to more intensive programs. 

Outpatient Rehab (OP)

Outpatient treatment is a very flexible option in which individuals are allowed to live at home while participating in regular therapy sessions and receiving support. These programs are most appropriate for those with less severe addictions who have access to a stable living situation and support system. They offer ongoing therapy and counseling and are often used as step-down treatment options for those who have completed higher levels of intensity.

Virtual & Online Treatment & Counseling

Virtual treatment, also known as telehealth care, allows individuals to receive therapy, counseling, and other support services at home using various communication technologies, such as Skype. These options eliminate the need for travel in many cases and can be very beneficial for those who have disabilities or live in remote areas.

What Therapies & Treatment Strategies Are Used in Addiction Treatment?

Numerous strategies and therapies are used in the treatment of addiction, with the goal of developing a holistic approach that addresses substance misuse from multiple angles. Examples include cognitive behavioral therapy, group support, dual diagnosis treatment, and several others.

Cognitive-Behavioral Therapy (CBT)

CBT is the most popular, widely-used form of psychotherapy that concentrates on addressing the ways in which thoughts, feelings, and behaviors interact. The overarching goal of this strategy is to help individuals identify and transform unhealthy thought patterns and behaviors that trigger emotional distress. CBT is designed to address many mental health conditions and substance use disorders, as this approach has been found to be consistently effective for the treatment of co-occurring disorders.

Motivational Interviewing (MI)

Motivational interviewing is a strategy devised to help individuals resolve their ambivalence toward enacting healthy changes in their lives, especially those related to problematic habits and behaviors. One of the key aspects of MI is for therapists to provide a non-judgmental, supportive environment where they can offer understanding and empathy for the person’s values, perspectives, and experiences. However, instead of fighting against their clients’ resistance to change, therapists use techniques intended to reduce their defensiveness and consider other points of view.

Mindfulness Meditation

Mindfulness meditation is a practice that consists of focusing attention on the present moment without judgment. The primary goal is to cultivate awareness and a non-biased observation of thoughts, feelings, and the surrounding environment. The individual sits or lies in a comfortable, quiet space where they pay close attention to their breathing, body sensations, and a chosen point of focus. Benefits of this technique include reducing anxiety and stress, and improving attention, concentration, and self-awareness.

Group Support

Support groups are commonly—but not always—associated with 12-step programs in which participants who share similar challenges and experiences gather to share and support each other. In the context of treatment programs, support groups are often facilitated by mental health professionals or other individuals who have undergone training. These groups are designed to provide a safe and supportive space for peers to connect, gain insights, and receive encouragement and accountability.

Dual Diagnosis Treatment

Dual diagnosis treatment is designed to address co-occurring mental health and substance use disorders simultaneously. Because individuals suffering from addiction often have underlying psychiatric issues, treating both conditions under one umbrella approach leads to more effective and long-lasting outcomes. To facilitate this treatment, a multidisciplined team of professionals collaborates to develop a comprehensive treatment plan that addresses both disorders. The idea is to intervene in the vicious cycle individuals experience when one condition perpetuates or worsens the other.

Aftercare Planning

Aftercare planning is a process in which healthcare and addiction professionals design a personalized treatment plan that includes ongoing therapy, other treatments, and support for the sustainment of recovery after an individual has completed a formal treatment program. 

In addition to therapies, aftercare planning typically involves relapse prevention strategies, support group participation, medication management, and sober living arrangements, if desired. (5) It is considered to be an ongoing, and possibly lifelong process that may require adjustments over time to ensure its relevance as the individual progresses in their recovery.

Benzodiazepine Addiction Relapse Prevention

Relapse prevention is equally important as standard inpatient and outpatient treatment, because recovery doesn’t end when formal treatment is completed. When individuals begin transitioning back to their everyday lives, they often routinely experience triggers and drug cravings that contribute to relapses. While relapse is considered a normal part of the recovery process, it necessitates prompt intervention. Instead of viewing relapse as a catastrophic failure, individuals are urged to treat these as mere setbacks that require modification of their current treatment plan.

The goal of relapse prevention is to provide individuals with the support they need to maintain sobriety when they are exposed to triggers such as former friends who enable drug-using behaviors. These strategies usually consist of ongoing therapy and support groups, which can reinforce and build upon healthy coping mechanisms that have already been provided at various points during formal treatment.

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Guardian Recovery Can Help You Overcome Benzodiazepine Addiction 

At Guardian Recovery, we specialize in helping individuals overcome benzo dependence using comprehensive programs and personalized treatment plans. Our compassionate team of medical and mental health professionals aims to ensure that everyone we treat receives the care they need to achieve abstinence, implement healthy coping skills, and maintain long-lasting sobriety.  Our supportive staff is equipped with a full spectrum of clinically proven treatment approaches designed to address the physical, psychological, and spiritual aspects that lead to addiction.

We understand the obstacles you are facing and are fully committed to your well-being and recovery. Contact us today for a free, no-obligation health insurance benefits check and start your journey to a more fulfilling, addiction-free life.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://www.webmd.com/mental-health/addiction/opioids-post-acute-withdrawal-syndrome
  2. https://www.drugs.com/medical-answers/what-do-you-mean-by-the-half-life-of-a-drug-458946/
  3. https://familydoctor.org/alcohol-withdrawal-syndrome/
  4. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825
  5. https://treatmentmagazine.com/the-pros-and-cons-of-sober-living-houses/

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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