Published May 18, 2020

The Drug Enforcement Administration (DEA) classifies benzodiazepines, or “benzo” drugs, as depressants. They treat anxiety, muscle spasms and seizure disorders, and they are sometimes used in treatment and detoxification from alcohol. They are legal when a doctor prescribes them, but some people may misuse these prescriptions or buy benzos illegally.

Benzos have real medical uses. Taken long enough, though, the body adapts, and cutting the dose or stopping brings on withdrawal. Some people get withdrawal symptoms while still taking benzos exactly as a doctor prescribed them.

What are symptoms of benzodiazepine withdrawal?

Some withdrawal symptoms associated with benzo withdrawal include:

These symptoms usually appear two to four days after a patient stops taking benzos.

Because the symptoms can be this rough, many people go through detox programs, where nurses and doctors manage the symptoms while the drug leaves the body. If you are taking benzos and want to stop, the question is usually whether you can do it at home. That depends on your dose, how long you have been taking them, and which benzo it is.

Benzo detox safety considerations

Benzo withdrawal is unpleasant for almost everyone, and for most people it stays at unpleasant. The symptoms alone can make detoxing at home hard without medical help, though being uncomfortable is not the same as being in danger. Some cases do go further than discomfort, and those are the ones that put a person at real risk if they try to do it at home.

Withdrawal happens because the nervous system has been sedated for a long time. Take the sedation away and it swings hyperactive. On top of the symptoms above, people in benzo detox often get blurry vision, dry mouth, a fast heart rate, tense muscles and sweating. Stopping suddenly makes seizures fairly common, and in severe cases people experience delirium, paranoia and hallucinations.

Seizures are the thing everyone worries about, and the worry is reasonable. Withdrawal seizures show up across the whole benzo class. They are most common in people who took high doses for a long stretch, but they have happened to people on lower doses after only a short course. Some people have one seizure. Others have several, and a few end in coma or death.

Deciding whether to detox from benzos at home

Some people going through benzo detox have severe complications, including seizures that can kill. Others have mild symptoms and nothing worse. That is why home detox is reasonable for one person and not for another. Talk to a doctor before you start, whichever way you end up going. A doctor can look at your symptoms, go through your medication history, and say whether detoxing at home is safe for you.

Withdrawal is worse for people on high doses, and worse again for people on short-acting benzos, the ones that wear off quickly. If either describes you, home detox is probably not safe. Whatever you decide, tell the doctor the truth about how much you have been taking and for how long. That history is what the plan of care is built on, and leaving part of it out makes the plan worse.

What will benzo detox look like?

Mild to moderate symptoms can usually be managed at home. Moderate to severe cases need a hospital. At home, a doctor supervises while the patient steps the daily dose down until the medication is no longer needed.

How long does benzo detox last?

Benzo detox is a taper. The dose comes down in stages that the prescribing doctor sets, and how long that takes depends on the drug, the starting dose and how the patient handles each reduction. People on shorter-acting benzos like alprazolam or lorazepam are often switched to diazepam first, because diazepam leaves the body more slowly and the drops are easier to tolerate. A taper only works outside a hospital if the patient sticks to the reductions and stays with the plan.

Is benzo withdrawal worse if you take higher doses?

Yes. The higher the dose, the harder the withdrawal, which is why high-dose benzo detox is usually done in a hospital. Anyone taking the equivalent of 100 mg or more of diazepam a day should not be detoxing at home. In hospital, staff watch the symptoms while the dose comes down step by step, and they can reduce it without the patient knowing the exact amount they are getting. Not knowing takes some of the anticipation out of it.

Doctors sometimes use other medications during the taper instead of benzos. Anticonvulsants such as carbamazepine and pregabalin can be useful during benzo detox.

Life after benzo detox

Detox gets the drug out. The reason the drug was there is still waiting afterwards. If the dependence grew out of severe anxiety, the anxiety needs its own treatment, usually counseling. If it grew out of trauma or another stressor, therapy has to reach that.

Cognitive behavioral therapy does well after benzo detox. It teaches coping skills and gives people something to use against the anxiety that is often underneath the dependence, and it can run alongside the taper instead of waiting until the end. Some research finds it works best combined with a gradual dose reduction. Educational groups that teach relaxation and healthy sleep habits help as well. 12 step programs like Narcotics Anonymous or Pills Anonymous may be helpful in overcoming benzo addiction as well.

So, is it safe to detox from benzos at home? Sometimes, with a doctor supervising the taper. Never on your own, and never by stopping suddenly. Whatever you decide about where it happens, the first step is the same, which is to talk to a doctor.

Mild cases exist. So do seizures, and psychological symptoms like paranoia and hallucinations that can put a person in real danger during withdrawal. Detoxing at home can be safe under a doctor’s care, and it is never safe without one. If you are planning to come off benzos, get medical advice before you change a single dose, and do not stop on your own.

If you or someone you love is struggling with benzo withdrawal, Pines Recovery Life can help. Contact us today.

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