Starting Recovery From Benzodiazepine Addiction

While benzodiazepines can effectively treat many conditions, they’re also highly addictive. It’s unfortunately common for patients to begin by taking these drugs as prescribed, and ultimately develop substance use disorders.

The process of recovery from substance abuse looks different for every patient. With benzos, it’s particularly important to seek medical treatment in order to mitigate the effects of detox. And even after your body begins to heal, you may benefit from continued mental health care. Because benzos are used to treat such a wide variety of diagnoses, many patients with this addiction need to develop new skills in order to manage their underlying mental health concerns.

Why Patients Start Misusing Benzos

Benzodiazepines have a number of medical benefits. They may be prescribed for patients with insomnia, generalized anxiety disorder, social anxiety disorder, insomnia, seizure disorders (like epilepsy), and more. Some of the most commonly prescribed benzos are Ativan, Halcion, Klonopin, Valium, and Xanax.

Their short-term use can be very helpful for some patients—including those in recovery from other substance use disorders. For other patients, though, the risks associated with benzos outweigh the benefits.¹ Although benzodiazepines provide short-term relief, their long-term use can produce serious side effects.

You can develop a tolerance to the sedative effects of benzodiazepines² relatively quickly, which makes their misuse more tempting to some patients. When your tolerance goes up, you need a higher and higher dose to achieve the desired result. If you’re vulnerable to addiction, this pattern can escalate quickly.

Among all the people who take them, 17.1% have misused benzodiazepines³ at some point. And the manner in which they’re prescribed may contribute to that. Some experts are concerned that benzos are being overprescribed,⁴ as more and more patients are diagnosed with anxiety. And because they can be prescribed by primary care doctors, and not just psychiatrists, some patients take them without additional mental health treatment.

If your doctor doesn’t specialize in treating addiction or other mental health concerns, you may not receive adequate supervision after being given a prescription for benzos. This is especially dangerous for patients who are vulnerable to developing substance use disorders.

Risks of Benzodiazepine Use and Misuse

Some patients may be more susceptible to developing an addiction to benzos. For example, experts believe that “women may be particularly susceptible to abusing benzodiazepines to manage anxiety.”⁵ Although more research is needed, some data suggest that in fact, benzos may be more harmful than helpful for patients with severe mental health conditions, including anxiety.⁶

Using benzodiazepines long-term also carries significant risks⁷ —even when they’re taken as directed. In particular, benzos can lead to “substantial cognitive decline” which does not resolve within 3 months of detox. They are also associated with a higher incidence of car accidents and—for older adults—hip fractures.

Even in the short term, these drugs are potentially dangerous. For example, benzodiazepines amplify the effects of alcohol,⁸ and vice versa. Experts caution that “many anxious patients may take advantage of that fact,” intentionally mixing the 2 substances to numb their symptoms of anxiety. This incautious use of benzos can put you at risk of overdose. And overdosing on benzos to the point of toxicity⁹ can induce a coma, cause respiratory depression (trouble breathing), and may even be fatal.

But the knowledge of these risks is not always a deterrent to misusing substances. After developing an addiction, many patients need expert support in order to recover. Fortunately, there are many treatments for substance use disorders, and some have been specifically designed to treat benzodiazepine misuse.

Benzodiazepine Addiction Treatment

The process of healing from a substance use disorder is unique for every patient. When you’re ready to begin recovery, you can choose from a variety of treatment options. You may have different needs depending on the severity of your condition, how long you’ve used these drugs, and your other health concerns.

Tapering and Detox

If you’re actively misusing benzos, it’s important to talk to your doctor before you begin detox. Because you can become physiologically—not just psychologically—dependent on these medications, you may experience withdrawal when you stop taking them. Some patients are at risk for developing benzodiazepine withdrawal syndrome,¹⁰ which can be extremely dangerous. If possible, it’s best to go through detox under close medical supervision.

If you started taking benzos as a prescription for a co-occurring disorder, like anxiety, it can be especially hard to imagine life without them. Your medical team may be able to prescribe you non-addictive medications to treat the symptoms of withdrawal, and/or to treat your underlying symptoms.

Pharmaceutical Treatment for Benzodiazepine Dependence

During recovery from benzo misuse, medication can be helpful¹¹ in a number of ways. In a detox program, for example, your doctor may taper down your dose of one type of benzodiazepine, and temporarily replace it with a similar medication. “A common approach is substituting these shorter half-life drugs, such as alprazolam, with longer half-life drugs, such as diazepam.” Over time, your medical team will most likely support you in stopping use of all benzos.

Other prescriptions, such as anti-nausea medications, may help alleviate the physical discomfort of withdrawal. And after your body stabilizes, a psychiatrist may help you find the right medication to treat your ongoing mental health needs.
Not every person can or should rely on the long-term use of pharmaceuticals, however. And whether or not medication-assisted treatment is a good fit, many patients benefit from engaging in therapeutic modality at the same time.

Psychotherapy (Talk Therapy)

Psychotherapy can be extremely valuable during any stage of recovery. In particular, patients with an addiction to benzos may benefit from cognitive behavioral therapy (CBT). In this type of talk therapy, patients learn skills that help them navigate difficult thought patterns or other triggers. Some studies suggest that patients who are treated with CBT during withdrawal from benzodiazepines¹² may reach a state of abstinence more quickly.

Some experts also recommend motivational interviewing (MI) to manage benzo misuse.¹¹ In this approach, any healthcare provider—including a therapist, psychiatrist, or even a medical doctor—helps the patient navigate feelings of ambivalence. However more research is needed into MI’s effectiveness in treating benzodiazepine addiction. One review found that there is little evidence to support the idea that MI hastens recovery. However, the researchers cited the poor quality of available data, recommending further inquiry.

Talk therapy of any kind can offer you deeper insight into your mental health. For example, you may have begun misusing benzos in response to trauma or in the attempt to self-medicate another diagnosis, like anxiety. A skilled therapist can help you develop healthier and more sustainable ways of coping with your ongoing symptoms.