You didn’t think running out of Xanax several days ago was going to be a big deal. But now you’re having headaches, tremors, and you can’t sleep. You say to yourself, “This can’t be withdrawal – right?”

We began our three part need to know series on benzodiazepines with an introductory piece loaded with general information. And then we took on dependence.

It’s time to wrap up the series. And we’ll do it with a discussion about withdrawal.

Fact is, way too many people have no clue that using benzodiazepines can lead to dependence – and withdrawal misery.

Benzodiazepine withdrawal

First of all, to understand benzo withdrawal you need to be comfortable with the dynamics of benzo dependence. If you haven’t read the dependence piece, be sure to do so.

So how often does a difficult benzo withdrawal occur? Well, it’s hard to say. And that’s because there are numerous benzos, with actions, half-lifes, and dosages all over the place.

But if I had to venture a guess, I’d say a little less than 50% of those receiving a therapeutic benzo dose will have issues with a reduction or discontinuation.

Withdrawal symptoms typically arrive within three to seven days of an abrupt dosage reduction or cessation. And they can occur even if one has been taking a benzo for just three to four weeks.

What does benzodiazepine withdrawal look like?

The most frequently reported symptoms of benzo withdrawal are insomnia, impaired perception of movement, headache, gastric issues, tremors, sweating, and muscle spams.

One may also experience agitation, irritability, derealization, depersonalization, depression, hypersensitivity to light, smell, noise, strange skin sensations, auditory/visual hallucinations, paranoid thoughts/feelings of persecution, seizures, delirium tremems (DTs), and suicidal ideation and behavior.

Generally speaking, the more abrupt or over-rapid the withdrawal, the more intense and disturbing the symptoms.

What’s the best way to withdraw from benzodiazepines?

No doubt, benzo withdrawal has a nasty reputation. And that’s largely due to poor withdrawal management.

The best way to withdraw from benzos is slowly and gradually – in a customized regimen. No way would I do it without the assistance of a physician and counselor.

“I can’t do this anymore. I mean, there has to be a better way. I need help.”

How slow and gradual? I’ve read about cases that have taken several years to resolve. And I’ve seen it happen in four weeks.

Nonetheless, the recommended time frame is less than six months.

See, it all has to do with the action (sleep-inducing, anxiety-relieving, anticonvulsant, muscle-relaxing, etc.) of the benzo being used.

And then it’s about dosage, half-life, and more. Of course, lifestyle, personality, environmental stressors, and available support enter into the equation.

By the way, I’m intentionally staying away from recommending withdrawal protocols. It’s just too dicey to handle in an article.

But I’ll tell you what, between your doc, counselor, and online resources, you’ll be able to consider all sorts of options.

Should I check-in to a hospital?

An inpatient stay for benzo withdrawal is a good idea if you have a history of severe withdrawal symptoms, particularly psychotic features (hallucintations, persecutorial delusions, etc.) and/or seizures.

An inpatient stay may also be indicated if you’ve been taking high doses for a long period of time.

Opinion: Benzodiazepine use for anxiety

In presenting an opinion regarding the use of benzos for anxiety, I’m coming to you from two perspectives: an anxiety lifer and former user and a mental health professional.

Though there are a lot of fine lines to draw, I believe there’s a place for benzo use in the treatment of anxiety. Unfortunately, they’re all too often prescribed without much of a discussion regarding goals, alternatives, proper use, supplemental treatment, cessation, and withdrawal concerns.

Sometimes I wonder what happened to informed consent.

I think benzos are best used in the short-term – even on an as needed basis. In the presence of crippling anxiety and agitation, they can buy time while psychotherapy, as well as other meds and treatment options, prove their worth.

It’s time for more decision-making with your doc if alternatives don’t cut it.

My greatest concern with benzo use, aside from dependence, is it can do away with the motivation to find and implement effective non-med coping strategies and techniques.

I mean, why would one bother?

We’re done here

Well, that’ll do it for our need to know series on benzodiazepines. We’ve discussed what they are, how they work, dependence, and withdrawal.

It’s important to have resource material like this readily available. So many people need it.

Hey, on the lookout for more Chipur mood and anxiety info and inspiration articles? It’s as simple as reviewing the titles.

Bill White does not intend to replace the care of a licensed medical or mental health professional. The material is provided for informational purposes only. Always talk with your medical and/or mental health provider before making decisions.