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Benzodiazepine Detox: The First Step Towards Recovery

Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN

Written By: Gary Bowers

Article Updated: 09/14/2020

Number of References: 3 Sources

Benzodiazepine detox centers are extremely helpful in managing withdrawal. While complications can exist during the withdrawal process, recovery is absolutely possible! Before undertaking these meaningful steps, it’s of vital importance to understand when benzodiazepine detox is recommended, what underlying medical and mental health aspects can affect detox, and what steps will need to be taken to reduce or address the withdrawal symptoms. Medicinal and behavioral therapies will also play an important role in recovery, and a benzodiazepine detox will help you navigate this process, from intake to discharge.

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When is Benzodiazepine Detox Recommended?

Without the support of medical professionals employed in benzodiazepine detox centers, withdrawal can be very dangerous. The chances of becoming physically and psychologically dependent upon benzodiazepines increase with prolonged use – even if under normally prescribed situations, and at normally prescribed doses. Sudden cessation from benzodiazepines can result in a shock to the body that can be fatal in extreme cases.

Additionally, for someone who has become addicted or dependent upon benzodiazepines, the symptoms of benzo withdrawal can often become confused with the symptoms the drug was originally prescribed to treat, including insomnia and anxiety. Because of the wide range of physical and mental effects that accompany withdrawal, medically monitored detox is highly recommended.

It is even more critical for individuals who fit one or more of the following criteria:

Individuals with Clinical Anxiety

Benzodiazepines are primarily prescribed to treat anxiety disorders. Regardless of why someone was taking benzos, they possess anxiolytic, or anti-anxiety properties, promoting calm, relaxation, and lowered levels of anxiety. When someone stops taking benzos, a phenomenon known as “rebound anxiety” may occur. This is an increased anxious state that can manifest as panic attacks in severe cases. If someone had suffered from a preexisting anxiety disorder, then this is heightened further and can result in very intense levels of anxiety during withdrawal. This can make the experience much more uncomfortable and challenging to manage without the care of a medical benzo detox facility.

People With Epilepsy Or A History of Seizures

While the process of detoxing from benzodiazepines can trigger seizures in anyone, those who have epilepsy or a history of seizures are at a much higher risk. Benzodiazepines fall under the umbrella of GABA agents which are drugs that suppress and inhibit neural transmissions in our brains. Removal of the anticonvulsant and anxiolytic effects of benzodiazepines can lower the seizure threshold, making it more likely for a seizure to occur.

People With A History Of Mental Illness

Detox from benzodiazepines can lead to dramatic and negative changes in the mental state of patients, and those who suffer from previously diagnosed mental disorders are especially vulnerable to these negative effects. As benzodiazepine tolerance builds, a mental and psychological dependence on the drug can grow. Detox from these drugs can result in more acute or sudden cases of anxiety, aggression, and mood swings which are known as the rebound effect. For someone who has become addicted to a benzodiazepine, the drug has gradually and effectively changed their brain chemistry, and thus their response to stimuli and real or perceived threats. Additionally, the fact that someone has built a tolerance to the drug that was used to treat their condition means that the initial symptoms will reemerge, possibly at an amplified level.

Benzodiazepine Use and Mental Health

Benzodiazepines are a category of drug that produces a calming effect, and for many people, they work incredibly well. However, even for those who take benzodiazepines as prescribed, tolerance to this class of drug can build very quickly. This means that the amounts of benzodiazepines needed to produce the original effect increases over time. This tolerance can often lead to dependence and associated mental health disorders when benzo use is ceased, including increased anxiety. A benzodiazepine detox center is essential in achieving recovery from dependence on benzodiazepines and any co-occurring mental health disorders.

Intake: Benzodiazepine Detox at a Glance

Your first experience entering a benzodiazepine detox center can be both a scary and an affirming event. This is a crucial step in recovery, and those participating in the intake process can expect the staff to ask questions, or conduct an interview to better understand the severity of the addiction and the associated symptoms, which can be an important step in determining the proper care. These interviews may sometimes be difficult, as the staff often ask deeply personal questions that someone may not have had to answer before. It is for someone’s own good, as these questions are crucial in determining the level of care someone requires. While specific questions will vary, the intent of the interview will likely seek to understand the following:

  • The extent of benzodiazepine use (history, dosage, etc.)
  • Medical history (mental illness, other conditions including epilepsy)
  • Use or addiction to other substances including alcohol

Basic vital signs (like heart rate and blood pressure) will also be checked to gain a more complete picture of the overall health of the patient. Additionally, you can also expect blood work to assist in completing the health assessment. While this may seem routine, it is an important step in identifying the physical symptoms associated with detox, and for charting a path forward towards recovery. Depending on the nature of the situation, or the severity of the symptoms exhibited, the staff may determine that additional tests are necessary.

The intake process is most successful when the staff can gain the clearest overall understanding of the patient’s mental and physical health as well as their benzo use history upon arrival at the facility. Once this intake process is complete, the staff will begin coordinating care for the patient. This is the beginning of a healthy and stable road to recovery!

Medical Monitoring of Detox Related Dangers

Because withdrawal can be dangerous and unpredictable, benzodiazepine detox centers will have staff on hand to monitor patients at regular intervals. In addition to a daily check of vital signs and a general overall wellbeing check, patients can expect regular interactions with a staff psychiatrist. Medical and nursing staff will also be on hand to closely monitor patients. The staff at these detox centers is part of the bigger picture of recovery – no one should have to attempt detox alone.

Besides basic vital signs, mental wellbeing will be monitored regularly, and this would include assessments of the following withdrawal symptoms:

  • Seizure activity
  • Insomnia or changes in sleep patterns
  • Anxiety
  • Depression
  • Anger/irritability
  • Obsessive-compulsive symptoms

Effectively introducing medications as needed can greatly improve the chances of a complete and healthy recovery following the benzodiazepine detox process.

Benzodiazepine Withdrawal Symptoms & Effects

Medications Used by Benzo Detoxes

There are currently no drugs approved by the FDA to treat benzodiazepines addiction/dependence. The most common approach to treating a dependence or addiction to benzodiazepine will be to slowly taper doses over time using longer-acting or smaller doses of benzodiazepines. Since there are many potential side-effects during withdrawal, a benzodiazepine detox will take a systematic approach to treating any associated medical needs, including but not limited to, the following:

  • Non-Benzo Anti-Anxiety Medications: Also known as anxiolytics, anti-anxiety medications can be used to treat both the physical and mental effects of anxiety, addressing the underlying causes and how they manifest for the individual.
  • Antidepressants: Antidepressants are frequently prescribed to help address the neurological causes of depression. They work by affecting brain chemistry, improving or reducing the number of neurotransmitters as needed, resulting in improved outlook and attitudes.
  • Sleep Disorder Treatments: Sleep patterns are frequently disrupted during benzodiazepine detox. In many cases, doctors may treat this with melatonin or other non-benzodiazepine medication.
  • GABA Agents: GABA agents interact with brain chemistry by acting to slow and dampen brain activity. While benzodiazepines can similarly affect the brain, GABA agents can help address neurological symptoms as they arise.

Treatment During Detox

Therapy can help to address the many psychological symptoms of withdrawal and also play an important role in long-term recovery from benzodiazepine addiction. Some of the therapeutic options used by benzo detox facilities include:

-Relapse Prevention Therapy

There is a high potential for relapse among those addicted to benzos. This is due in part to the ease of obtaining prescriptions for them from doctors who aren’t fully aware of their potential for abuse. Relapse Prevention Therapy (RPT) can be an invaluable tool for battling this.

It addresses common issues that can lead to relapse such as coping skills, dealing with high-risk or associative situations, and minimizing impact to exposure to situations and environments which can trigger cravings.

-Behavioral Therapy

Cognitive Behavioral Therapy (CBT) can have lasting benefits for anyone who thoroughly and honestly applies the principles they gain from it. When administered by a licensed professional, CBT seeks to enlighten someone as to the way their thoughts and emotions impact their behaviors. This is particularly relevant for those in benzo detox, because of the intense emotional unrest inherent during the withdrawal process.

Additionally, CBT gives people the tools they need to work to change these behaviors before they get to thoughts that could lead them to use benzos again.

-Group Therapy

Group therapy is another form of treatment that someone in a benzodiazepine detox center may experience. It is an indispensable tool in treating the mental and social disorders that can often accompany benzo addiction. Group therapy works so well because it de-stigmatizes aspects of addiction by acknowledging and addressing related topics in a group setting.

This also works to create personal bonds, which can combat the anxiety and isolation that will often accompany the benzo detox process.

Continuing Care

Ongoing and long-lasting recovery from benzodiazepine addiction requires a plan to continually work on addressing the underlying and root causes that lead to the addiction.

Upon leaving benzodiazepine detox, continued care will likely take the form of inpatient or outpatient drug rehab. These treatment centers provide medical care and review from a doctor, ensuring prescriptions are up-to-date and accurate. Additionally, they provide regular individual and group therapy to address underlying issues, while assisting in building a network of similarly afflicted individuals who can hold themselves accountable and support one another.

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