Can You Die from Benzodiazepine Withdrawal?

Benzodiazepines are commonly prescribed medications, but they can be addictive and cause withdrawal symptoms when their use is stopped. Even when they are taken as prescribed, withdrawal symptoms can occur.  In some cases, benzodiazepine withdrawal can be dangerous and rarely, deadly.

What Are Benzodiazepines?

Benzodiazepines slow down the activity of the brain and nervous system and are commonly prescribed for anxiety, seizures, muscle spasms, and insomnia. They work by causing the brain to release a neurotransmitter called gamma-aminobutyric acid, which makes your nervous system less active.

Benzodiazepines can make you feel relaxed and sleepy, but they also come with side effects including:

• Light headedness
• Confusion
• Dizziness
• Unsteadiness
• Muscle weakness
• Slurred speech
• Memory issues
• Dry mouth
• Nausea
• Blurred vision
• Constipation

Brand names of benzodiazepines include Xanax, Valium, Ativan, Klonopin, and Restoril.

Benzodiazepine Withdrawal Symptoms

The severity of benzodiazepine withdrawal symptoms depends on the length, frequency, and amount of use.  Symptoms may include:

• Anxiety
• Agitation
• Sweating
• Increased heart rate
• Insomnia
• Hand tremors
• Hallucinations or other perceptual disturbances
• Seizures
• Delirium
• Rhabdomyolysis

Can You Die from Benzodiazepine Withdrawal?

Seizures are one of the main risks of benzodiazepine withdrawal, but the most serious complication is rhabdomyolysis, which is a condition in which the muscle tissue breaks down, releasing harmful substances into the bloodstream. This can lead to kidney failure.

Symptoms of rhabdomyolysis include:

• Muscle pain, weakness, trouble moving
• Urine that is dark, red, or cola colored
• Decreased or stopped urination
• Nausea and vomiting
• Fever
• Rapid heart rate
• Confusion
• Fatigue

If you experience these symptoms, seek immediate medical attention. When untreated, the condition can be fatal.

Note that withdrawal is even more dangerous if you are also withdrawing from another substance like alcohol or opioids.

Medically Supervised Benzodiazepine Detox

The safest way to withdraw from benzodiazepines is in an inpatient, medically supervised setting. If you have an addiction to benzodiazepines and seek treatment, this period of medically supervised detox will be the first step.  In detox, you may receive gradually lower doses of benzodiazepines to reduce the withdrawal symptoms or be given other medications to ease symptoms.

Benzodiazepine Misuse, Addiction, and Overdose

Benzodiazepines are commonly misused, meaning that they are taken in higher doses than prescribed or taken recreationally. Sometimes they are used to enhance or counter the effects of other drugs. For example, someone might take Xanax to come down from a cocaine high.

When benzodiazepines are misused, or even taken as prescribed, they can lead to addiction, also known as a substance use disorder. Addiction to benzodiazepines is defined using 11 criteria specified by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

The criteria are:

1. Taking more of the drug than intended or for longer than intended
2. Wanting to reduce or stop drug use but not being able to
3. Spending excessive amounts of time taking the drug or recovering from taking the drug
4. Feeling cravings for the drug
5. Failing to live up to responsibilities due to drug use
6. Having relationship problems because of drug use
7. Giving up activities that you enjoy in order to take the drug instead
8. Engaging in risky behaviors like driving while taking the drug
9. Continuing to take the drug in spite of negative consequences like health issues
10. Needing more of the drug to get the same effects
11. Having withdrawal symptoms when you are not taking the drug

Meeting two to three of these criteria indicates a mild substance use disorder, four to five is considered moderate, while six or more is severe.

It is possible to overdose on benzodiazepines, which can be fatal, particularly if combined with other drugs such as opioids.

Signs of overdose include:

• Confusion
• Extreme drowsiness
• Impaired coordination
• Slurred speech
• Respiratory depression
• Loss of reflexes
• Loss of consciousness or coma

Benzodiazepine Addiction Treatment

Treatment for benzodiazepine addiction starts with a period of medically supervised detox, followed by intensive therapy. Therapy can occur in one of three treatment options.

1. Inpatient: Inpatient programs are 30 to 90 days long, or you can opt for inpatient detox only, which may last for 7 to 10 days. Most of your time in inpatient treatment will be spent in group therapy, with some individual therapy.
2. Partial Hospitalization Program (PHP): A partial hospitalization program (PHP) allows you to live at home while attending treatment for four to six hours per day, usually five days a week. The program may last anywhere from four weeks to ten weeks. More often than not, a PHP program is a transitional step that occurs after inpatient treatment, although it can be an alternative to inpatient treatment.
3. An intensive outpatient program (IOP) consists of two to three hours of therapy several days a week for eight to twelve weeks. Often, sessions are held in the evenings so that you can still go to work or attend school. IOPs can be standalone treatments, or they can be attended after inpatient treatment, a PHP, or both.

Group therapy is used in all three programs and is critical to the treatment process. It gives you the opportunity to share emotions, experiences, and challenges with peers. You’ll likely form mutually supportive relationships with some of these peers which may last beyond treatment.

The type of therapy most commonly used in addiction treatment, both individually and in groups, is cognitive behavioral therapy (CBT). CBT teaches you to recognize your own irrational thoughts and negative emotions and to challenge them using more reality based, positive thinking. It also teaches healthy coping skills to face life’s challenges without drugs.

The most effective treatment for addiction, particularly if it is severe, is a comprehensive treatment program that consists of an inpatient program, a PHP, and an IOP. Research shows that success rates increase the longer the treatment program. Even after IOP, support should continue through support groups, individual therapy, or both. Recovery from any addiction is a lifelong process that requires dedication and a strong support network.

In Closing

In rare cases, benzodiazepine withdrawal can be fatal. It’s highly recommended that you attend an inpatient detox program if you are stopping the use of benzodiazepines after a long period of time. At Bridges of Hope we offer several treatment options. We are committed to providing personalized, comprehensive, and compassionate care so that you can live a healthier, more fulfilling life. Give us a call today to learn more.