Do not try to engage the patient in counselling or other psychological therapy at this stage. A person in withdrawal may be vulnerable and confused; this is not an appropriate time to commence counselling. People who are not dependent on drugs will not experience withdrawal and hence do not need WM. Refer to the patient’s assessment to determine if he or she is dependent and requires WM. Many countries, including the U.S., classify benzodiazepines (sometimes known by the slang term “benzos”) as controlled substances. It’s illegal to have or obtain them (depending on the laws where you are) if you don’t have a prescription.

Chapter 3: Benzodiazepine withdrawal symptoms, acute & protracted

In most cases of benzo withdrawal, suddenly stopping the medication is not recommended, as it can be dangerous. Supportive counseling and other targeted therapies or medications may help a person manage the symptoms and improve their quality of life. They bind (attach) to receptors in the brain called gamma-aminobutyric acid (GABA) receptors. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Requirements for water and salt vary with body size, environmental temperature, amount of exercise, etc. so cannot be stated categorically.

8. WITHDRAWAL MANAGEMENT FOR CANNABIS DEPENDENCE

This is a particular risk during benzodiazepine withdrawal when anxiety levels are usually high. To avoid aggravation of anxiety, it is important to start with the lowest possible dose of an antidepressant and then work up slowly, over two or three weeks. Do not be persuaded by your doctor to start immediately on the “therapeutic” dose for depression.

• We strive to create content that is clear, concise, and easy to understand.
• Particular concerns have been raised about impairment of cognitive functions (such as memory and reasoning) and other lingering problems such as muscle pains and gastrointestinal disturbances.
• However, there are some drugs which may help to control particular symptoms in withdrawal and which deserve consideration in certain situations though not recommended for routine use.
• BZDs represent one of the most widely prescribed drug classes in the United States.
• The control group and the experimental group had the same dropout rate in this study [69].

What are the advantages of benzodiazepines?

Very occasionally, they may persist (see section on protracted symptoms). Meanwhile, the same measures suggested under muscle symptoms (above) can do much to alleviate them, and they usually disappear after withdrawal. There are many measures that will alleviate these symptoms, such as muscle stretching exercises as taught in most gyms, moderate exercise, hot baths, massage and general relaxation exercises. Such measures may give only temporary relief at first, but if practised regularly can speed the recovery of normal muscle tone – which will eventually occur spontaneously.

Some people during benzodiazepine withdrawal report feeling unsteady on their feet; sometimes they feel they are being pushed to one side or feel giddy, as if things were going round and round. An important organ in controlling motor stability and maintaining equilibrium is a part of the brain called the cerebellum. This organ is densely packed with GABA and benzodiazepine receptors (See Chapter I) and is a prime site of action of benzodiazepines.

One lady described how thrilled she was when she could suddenly see individual blades of grass in her newly bright green lawn; it was like the lifting of a veil. Thus, these sensations need not give rise to fear; they can be viewed as signs of recovery. Secondly, approximately 20% of the children in the intensive care unit given BZD during sedation, more specifically midazolam, have been shown to exhibit withdrawal effects. The severity of the withdrawal sequelae depends on the total dose and duration of infusion and usually presents as agitation, tremors, difficulty sleeping, and inconsolable crying [60].

The benefits and risks of benzodiazepines

What are benzodiazepines used for?

• Benzodiazepine withdrawal can be risky, so it is best to work with a doctor.
• During the early stages of withdrawal, the person may notice the symptoms of the condition that the drug was treating start to return, or rebound.
• This was compared to a gradual taper without the other components of the treatment plan [72].
• In addition to the immediate health risk, benzodiazepine withdrawal can seriously affect your quality of life.
• Symptoms begin within 24 hours of last use of stimulants and last for 3-5 days.
• There is a large body of literature on BZWS, ranging from peer-reviewed publications to personal anecdotes.

Signs and Symptoms of Benzodiazepine Withdrawal