Benzodiazepine withdrawal is a series of physical, emotional and behavior changes experienced when a person tries to reduce its dose or cease taking the drug. If you have become physically dependent on benzodiazepines, your body and brain have become so accustomed to having the drug every day that you will experience withdrawal symptoms when you cut down the dose or stop the drug.
DID YOU KNOW?
You can experience benzodiazepine withdrawal symptoms even if you’re not decreasing your dose. This is known as “tolerance withdrawal” and “interdose withdrawal.”
An estimated 50-80% of people who have taken benzodiazepines continually for many months or longer will experience withdrawal symptoms when reducing the dose; a smaller percentage may experience severe withdrawal. People who have been taking benzodiazepines regularly for many years (and sometimes for shorter periods) can have symptoms of withdrawal most of the time, even when they have not reduced the dose— tolerance and/or interdose withdrawal. They can experience a phenomenon referred to as “medication spellbinding”, and do not connect that their poor physical and mental health is related to their long-term use of the benzodiazepines (or in the case of other prescribed drug dependencies, other psychoactive medications).
How severe are the symptoms of withdrawal?
The experience of withdrawal will vary from one person to the next. Not everyone who cuts down or stops taking benzodiazepines will experience withdrawal symptoms. Some people will get lucky and experience no withdrawal on discontinuation, even with cold-turkey cessation—although there is no way to know who these people will be ahead of time, so it is not recommended. Others might experience a few weeks or months of uncomfortable, but bearable, symptoms. Unfortunately, there is another group of individuals that may experience severe symptoms, often for months or years on end; for these people, the intensity of withdrawal can be overwhelming and in some cases lead to death – either as a direct result of the withdrawal syndrome itself or as a result of suicide. One known case of death directly resulting from an involuntary BZ cold turkey occurred as quickly as 17 days after cessation while the victim was in jail over a traffic ticket and deprived of his medication; this death was subsequently investigated by the FBI.
How long does withdrawal last?
Just like the intensity or severity of symptoms, the duration of withdrawal can vary as well. For some, the withdrawal can take weeks or months—and for a smaller percentage of people (10-15% of those withdrawing), it can last for years. Factors that might influence or contribute to the duration of withdrawal are: the length of time one has been taking the BZs, the amount of drug they have been taking (e.g., high-dose, long-term) and how the patient discontinued the drug (slow, controlled taper or over-rapid or cold-turkey withdrawal). Apart from those, there are no predictors for the severity or otherwise of the withdrawal. Slowly reducing the dose of the drug dose minimize the severity of the withdrawal symptoms and is the only recommended way to discontinue BZ safely.
What is it like to experience benzodiazepine withdrawal?
Often times those in withdrawal from BZs express that can be very erratic in nature. They may experience days when they are partially or totally free of symptoms (this period is called a “window”), followed by days of mild or more severe withdrawal symptoms (this period is called a “wave”). Aside from the severity of symptoms tending to fluctuate, people report a wide range of experiences. A particularly severe or troublesome symptom may predominate for a time or for the whole withdrawal episode. Many people, especially those who did not taper properly or slowly enough, are often seriously ill or distressed at times during withdrawal.
Improvement from the withdrawal syndromes gradually, sometimes as people taper (if they are tapering) or with time (if they came completely off the drug post-taper or in an over-rapid or cold-turkey withdrawal); more symptom–free days occur and symptoms reduce in severity and number for most people. Sometimes, however, some people remain in severe withdrawal that persists, without windows, as the “baseline” condition” for quite some time (years in some cases) until the “baseline” begins to improve. There have also been reports of withdrawal that spontaneously improves or vanishes overnight after the person had been suffering intensely just the day before. In time, the majority of people recover completely—often experiencing good mental and physical health for the first time in a long time, since many had been existing in tolerance withdrawal for a long time without knowing it. Some, however, have observed changes in their cognitive abilities following long-term benzodiazepine use. There is some research that indicates that some people who took benzodiazepines long-term prior to discontinuation may have persistent or permanent problems with concentration, learning, memory, and/or a reduced tolerance to stress.
In this audio clip (3:49), you will hear short clips, submitted by some of the victims of taken-as-prescribed benzodiazepines and their families, describing their withdrawal experiences:
What are the symptoms of withdrawal?
There are many symptoms that can be experienced during benzodiazepine withdrawal. The following is a condensed list of possible withdrawal symptoms. For a more comprehensive list that was compiled from existing lists and contributions from people experiencing benzodiazepine withdrawal themselves, click here.
It is unlikely that someone would experience everything on the list, and especially not all at once. Although cold-turkey and over-rapid taper victims have reported experiencing hundreds of symptoms, including some of the more severe ones. It is important to note that these symptom lists are not meant to diagnose or take the place of medical advice. They are for educational and awareness purposes only. If you are experiencing alarming symptoms, especially potentially dangerous ones like high blood pressure, one-sided weakness, slurred speech, drooping face, chest pain, shortness of breath, etc., please be evaluated at your nearest emergency room or clinic to rule out other causes.
To view a comprehensive A-Z list of benzodiazepine withdrawal symptoms, go here.