What to Expect: Benzodiazepines Withdrawal Symptoms

Rachel always struggled with anxiety. It was a problem that began in her early teens and continued to grow well into her early adulthood. She worried about little things like being on time for an appointment, big things like terrorist attacks, and everything in between. Her anxiety issues often stopped her from getting on airplanes or allowing her children to play outside without her direct supervision, but it wasn’t until her family became the victims of a home invasion that her anxiety levels reached a crescendo.

Suddenly, Rachel wasn’t able to leave the house but she didn’t feel safe at home either. When she stopped taking the children to school and took to keeping the shades drawn throughout the day because of her anxiety, her husband took her to get help.

After a thorough evaluation and diagnosis, Rachel was diagnosed with generalized anxiety disorder and prescribed Xanax. It wasn’t very helpful; even when she took more than prescribed, she wasn’t able to combat her anxiety symptoms. Next, she was prescribed a slew of different medications in different doses and combinations. She often ended up with extra pills when one didn’t work or the dosage was changed. Soon, she was taking these in addition to her current prescription, frustrated when she was unable to manage her symptoms. Over time, she sought help from more than one doctor and had more than on prescription at a time.

Her psychological and physical dependence grew rapidly in intensity. Soon, she felt like she couldn’t function without a specific combination of pills at various times of the day. She was heavily focused on maintaining her self-imposed pill schedule, to the detriment of everything else in her life, and when she was under the influence of these highly sedative drugs, she could barely function.

If your loved one is addicted to benzodiazepines – no matter how that dependence developed – reach out to us at Alta Mira now. Our intensive addiction treatment program can help them to stop taking pills today and stay drug-free for the long-term. Learn more now when you call the phone number above.

Benzodiazepine Abuse and Addiction

Benzodiazepines are prescribed for their sedative, muscle relaxant, anti-convulsant, and hypnotic effects.

Patients who are diagnosed with anxiety disorders and panic disorders are most often prescribed these medications, but those who struggle with alcohol withdrawal symptoms may also be prescribed benzodiazepines.

Unfortunately, benzodiazepines are highly addictive drugs, and those who take them by prescription or recreationally are at risk for the development of a life-altering drug dependence and/or overdose.

Very often, patients who are dependent upon benzos abuse other substances as well. It is not uncommon for patients who are on methadone to take these pills to increase their “high,” or for cocaine addicts to take benzos to address the negative side effects of chronic cocaine abuse. Many drink while taking the medication as well. All of these contribute to the risks associated with the addiction and increase the chances of death due to overdose.

The Drug Enforcement Administration (DEA) reported the following information about benzodiazepine abuse and addiction in 2010 and 2011:

  • More than 81,400 calls were made to poison control centers across the county due to problems with benzodiazepines.
  • More than 345,690 emergency room visits were connected to benzodiazepine use and abuse – much higher than the 271,698 reported ER visits for the same purpose in 2008.
  • An estimated 20.4 million Americans over the age of 12 report misuse of benzodiazepines at some point in their lives.

The DEA also reports that the following were the five most commonly prescribed benzodiazepines on the market in 2011:

  • Alprazolam (or Xanax): 49 million prescriptions
  • Lorazepam (or Ativan): 27.6 million prescriptions
  • Clonazepam (or Klonopin): 26.9 million prescriptions
  • Diazepam (or Valium): 15 million prescriptions
  • Temazepam (or Restoril): 8.5 million prescriptions

Rachel’s Story: Attempting to Kick the Habit

benzo addictionRachel was under no illusions about her use of benzodiazepines or the problems caused by her improperly treated anxiety disorder. Though she attempted to justify it when her husband talked to her about getting more intensive help, she knew that she needed to consider her options in treatment. When her youngest daughter, only 4 at the time, found Rachel’s pills and ended up in the emergency room, Rachel knew it was time to seek help for her addiction to benzos.

Rachel started by flushing all her pills. Without her prescriptions, she thought she would just return to the old levels of anxiety that she experienced prior to taking the medication. That was not the case. Withdrawal symptoms began within a few hours of her last dose. It started with a headache, followed by problems with her vision. She felt restless and agitated and began twitching and shaking. Her heart began to pound and her anxiety levels began to rise.

Over the next 24 hours, Rachel began to experience stomach cramps and diarrhea. Her jaw began to hurt, and she started grinding her teeth. Her agitation rose and she began to hallucinate. Increasingly, her agitation turned into hysteria, and her husband had to take her to the emergency room to stabilize her. Medical personnel advised her to enroll in an inpatient detox program to help her get through the remainder of the symptoms and monitor her for any further complications.

Benzodiazepine Withdrawal Symptoms

Typically, benzodiazepine withdrawal symptoms begin a few hours after the last dose. Everyone’s experience will be different, but most find that the first 18 to 24 hours are less intense as the symptoms begin to build and that symptoms peak between 48 and 72 hours. The intensity can stay at this level for up to a week or more and then slowly, the symptoms begin to fade.

Benzodiazepine withdrawal symptoms can include any combination and intensity of the following:

  • Stomach cramping and diarrhea
  • Bloating and constipation
  • Headaches
  • Jaw/tooth pain and teeth grinding
  • Agitation
  • Hysteria
  • Irritability
  • Restlessness
  • Shaking
  • Rage and/or violence
  • Overwhelming fear and anxiety
  • Panic attacks
  • Skin reactions (e.g., rashes, redness, etc.)
  • Extreme sensitivity to light, sound and texture
  • Lack of balance
  • Loss of appetite
  • Numbness or feeling “pins and needles” in extremities
  • Hallucinations
  • Impaired memory
  • Difficulty carrying on a conversation
  • Extreme changes in blood pressure
  • Heart palpitations or increased heart rate
  • Morbid or suicidal thoughts
  • Obsessive or repetitive thoughts

Rachel’s Story: Getting Professional Help

When Rachel entered a comprehensive detox program, she was immediately put under medical supervision and monitored around the clock. Medical personnel gave her medication designed to mitigate the intensity of her withdrawal symptoms and to manage physical symptoms and stood by to see that they had the intended effect, adjusting doses as needed.

When she felt up to it, Rachel had the opportunity to sit in on a few different group therapy sessions with others who were struggling with benzodiazepine addiction. Though she did not have the energy to actively participate, she began to see that she was not alone and it helped to begin the process of feeling better about her situation – she knew that there was hope for the future.

At-Home Detox vs. Detox Programs

detox-helpIt is never recommended that patients attempt to detox from any addictive substance at home alone – especially when the primary substances of abuse are prescription medications. The withdrawal symptoms can often cause serious medical problems, especially if there are underlying physical or mental health issues, as there often are when a benzodiazepine addiction begins during mental health treatment. These complications can be deadly or they can be so overwhelming that the patient feels forced to relapse in order to escape them. Many overdose after an attempted at-home detox because they take too many pills after their body’s tolerance has dropped during the brief detox period and suffer a fatal medical event.

By comparison, a professional detox program offers comprehensive medical care provided by professionals with years of experience in substance treatment and detox. Medication can help to diminish the discomfort felt by the patient due to withdrawal symptoms, and constant monitoring means that the patient has immediate medical care available should an emergency arise.

Rachel’s Story: Working Toward a Brighter Future Through Treatment

As her withdrawal symptoms began to fade, Rachel was able to increase the number of therapy sessions she attended at her drug rehab program. She attended group therapy sessions that included others in residence at the rehab and one-on-one therapy sessions with a private therapist to address her personal issues with both anxiety and addiction. She continued to check in with a medical doctor to manage her medications, and she took on a range of therapeutic treatments and interventions to help her learn how to manage her stress and anxiety levels to further decrease her need for medication including nutritional counseling, yoga, meditation and practical coping skills. This also served to lower her cravings for the pills because she felt more in control of her anxiety symptoms.

Rachel stayed in residence at her treatment program for 60 days. Though she missed her family, she knew that her daughters would be better off if she got the help she needed to stay sober when she came home. She often visited with them, and her husband took an active role in her recovery, attending family support groups and couples counseling sessions with her.

Medications Used to Treat Benzodiazepine Withdrawal Symptoms

There are a number of medications that have been shown to be effective in reducing the experience of withdrawal symptoms in patients undergoing benzodiazepine detox. A couple of these include:

  • Propanolol. A study published in the journal Lancet found that the medication did not affect the dropout rate of patients in detox but it did significantly diminish their withdrawal symptoms.
  • Carbamazepine. A study published in the journal European Archives of Psychiatry and Clinical Neuroscience found that the use of carbamazepine lowered the intensity of withdrawal symptoms among patients, especially after day nine of detox.

Rachel’s Story: Starting Over

When Rachel returned home, her first responsibility was to herself. She knew she had to make big changes in order to protect her sobriety and thus her family. Part of that was to implement a thorough aftercare program that gave her the structure and accountability necessary to stay on track no matter how overwhelming her anxiety became. As a part of her aftercare treatment, she attended:

  • Weekly alumni meetings at her drug rehab
  • Regular therapy sessions with a personal therapist
  • 12-step meetings
  • Three yoga classes per week
  • Daily meditation
  • Support group for anxiety disorder patients
  • Personal training sessions
  • Monthly meetings with a nutritionist
  • Couples counseling with her husband

Regular engagement with her addiction recovery and anxiety disorder treatment as well as inclusion of her husband every step of the way allowed Rachel to build up confidence in her ability to manage her anxiety symptoms and prioritize her family’s overall health and well-being as well as her own.

Aftercare Options

Aftercare Recovery Support GroupsEspecially when co-occurring disorders are present, it is important that a dual diagnosis treatment program be chosen that addresses both issues simultaneously. In aftercare as well, it is important to remain actively engaged in treatment for both disorders in order to maintain equilibrium in recovery. Patients are encouraged to develop a plan for aftercare before leaving residential treatment. For example, here at Alta Mira, we offer a Lifetime Continuing Care program for all our patients whether they opt for a 30-day, 60-day, 90-day or longer program.

Additionally, patients are encouraged to include a range of treatment services in their weekly schedule in order to remain actively engaged in their recovery and focused on the hope that comes with sobriety. Some options include:

  • Traditional therapy. A regular one-on-one session with a psychotherapy professional who is experienced in both addiction and any underlying disorder is recommended. This allows the patient to have a “home base” to check in regularly, troubleshoot obstacles in recovery as they arise, and practice new coping skills.
  • Holistic treatment. Reducing stress levels and increasing overall well-being decrease cravings for illicit substances and help the patient to successfully manage potential triggers for relapse. Options include yoga, meditation, acupuncture, acupressure, massage and bodywork, and more.
  • Alternative therapy. Depending upon the patient’s individual interests and comfort level, a number of different alternative therapies can not only serve to promote continued progress in recovery but also to build a community of supportive peers as well. Options can include sports therapy, outdoors and adventure therapy, nutritional therapy, writing therapy, art therapy, dance therapy, life coaching, and countless others.
  • Support group options. There are support groups for those in recovery from addiction (e.g., 12-step groups) but there are also a range of support groups for co-occurring disorders, codependency, and other issues that often co-occur with substance abuse.

Alta Mira: Hope for the Future

If your loved one is struggling with dependence upon benzodiazepines and is in need of a medically monitored detox and addiction treatment, contact us at Alta Mira today. We offer a comprehensive program designed to be tailored to the needs of each individual patient, which means that your loved one will have access to the resources they need to heal, including:

  • Intensive evaluation and diagnosis at the onset of treatment
  • Personal therapy and a unique treatment plan
  • Group support
  • Holistic and alternative treatment options
  • Family support
  • Ongoing aftercare support through our Lifetime Continuing Care program for alumni

Contact us today at the phone number listed above to learn more about us at Alta Mira. Let us help your family begin the healing process today.