The study reported an 89% reduction in benzodiazepine prescriptions over two years, with no decrease in patient caseloads 62. Two qualitative studies explored individuals’ perceptions of benzodiazepine use and treatment 57, 58. The first study found participants preferred prescribed benzodiazepines over illicit use, citing benefits such as reduced costs, criminal activity, and the risk of contaminated pills 57. Notably, some participants in this study reported treatment termination from their prescriber if nonmedical benzodiazepine use was suspected or disclosed. The second study found most participants saw the benefits of agonist treatment, such as reduced criminal behaviour and greater stability 58.

• Among people taking benzodiazepines for longer than six months, about 40% experience moderate to severe withdrawal symptoms when they quit suddenly.
• This week ASAM released the new Joint Clinical Practice Guideline on Benzodiazepine Tapering.
• Studies focusing primarily on other substances were excluded to maintain relevance and specificity.
• If you have been using benzodiazepines for longer than six months, suddenly stopping your dose can cause grand mal seizures and delirium—this is why it’s best to involve your doctor or healthcare professional in your withdrawal process.
• Whether you are struggling with addiction, mental health or both, our expert team is here to guide you every step of the way.

Drug checking

Another patient who has been taking BZD for less time may experience significant and persistent withdrawal symptoms even with a much slower taper. The Guideline emphasizes the importance of a patient-centered approach to tapering, starting slowly and adjusting the pace of the taper based on the patient’s response. The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes.

Denying Our Mental Health: Why We Do It and How To Move Past It

However, benzodiazepines can cause physical dependence and withdrawal even when they are taken as directed. Importantly, the Guideline emphasizes that residential or inpatient treatment may be necessary for patients with SUD who are unlikely to safely and effectively participate in outpatient tapering. It also emphasizes that BZD prescribing and tapering considerations should never be used as a reason to discontinue or disrupt a patient’s medications for SUD treatment, including buprenorphine and methadone. Withfacilities locatedin Florida, Ohio, Maryland, Colorado, New Jersey, and Washington, The Recovery Village offers different programs to help treat benzodiazepine addiction and get you on the path to a drug-free life. The Recovery Village exists to assist you through each step of the detoxification process, as well as help you acquire the skills needed to continue living in sobriety.Contact ustoday to learn more about treatment plans and programs that can work well for your needs.

• Existing guidelines generally recommend limiting duration of BZD use to 2-4 weeks (except for limited conditions such as severe treatment-resistant generalized anxiety disorder, complex seizure disorders, spasticity, and sleep disorders involving abnormal movements).
• Inclusion of an approach with this framing of harm reduction points to the range of perspectives and practices in the field.
• Chronic use of alcohol leads to an increase in the number of NMDA receptors (up regulation) and production of more glutamate to maintain CNS homeostasis Figure 1c.
• This way, your body has a chance to rid itself of benzos slowly, and the withdrawal symptoms will not be as intense.

Newer antipsychotics like risperidone (1-5 mg/day) or olanzapine (5-10 mg/day) may have a better safety profile than haloperidol (2, 5-10 mg/day)7 and are preferred as adjuncts to benzodiazepine treatment. A review by Hack et al.32 suggests that a high requirement of intravenous diazepam (more than 50 mg in the 1sth, or 200 mg or more within the first 3 h) with poor control of withdrawal symptoms is a marker of non-response of DT to benzodiazepines. Existing guidelines generally recommend limiting duration of BZD use to 2-4 weeks (except for limited conditions such as severe treatment-resistant generalized anxiety disorder, complex seizure disorders, spasticity, and sleep disorders involving abnormal movements). A popular way to begin a benzodiazepine detox is through tapering, which involvesgradually weaning off of benzo usage.

The best way to quit benzodiazepines is to avoid withdrawal by asking your doctor to taper down your dose. Tapering means taking progressively smaller doses over the course of a few weeks or months. Estimates suggest that 10 to 25% of people who take benzodiazepines for extended periods experience what’s known as protracted withdrawal. When you are physically dependent on a drug, it means your body can’t operate normally without it.

Prescribing and policy interventions demonstrated variable impacts, often influenced by broader systemic factors. Critically, a clear gap remains in harm reduction approaches for those not seeking treatment, highlighting a need for inclusive, flexible and pragmatic responses. There is also a need for more robust evaluation of harm reduction interventions to strengthen the evidence base and inform practice.

Severe symptoms and reactions can occur, and working with a professional can help a person avoid or manage these symptoms. Tapering the drug by slowly reducing the prescription strength may help make withdrawal symptoms much easier to manage. Additionally, medical supervision allows doctors to respond much more quickly to potential side effects and withdrawal symptoms. Research indicates that physical dependence may begin in just a few weeks, even while taking the drugs in low therapeutic doses. There are three possible phases for benzo withdrawals, each with an estimated timeline.

A person should always withdraw from benzos under the guidance of a healthcare professional. They should never quit benzos suddenly without first consulting a professional and developing a plan with them. The primary difference between these drugs is the length of time they stay active in the body.

Clinical management of alcohol withdrawal: A systematic review

Since benzodiazepines impact the mind and body, the drug’s withdrawal symptoms do as well. The severity of these symptoms depends on the duration of a person’s drug use, their dosage amounts, and the method of ingestion. Their levels of physical dependency and psychological addiction also come into play when determining the severity of withdrawal symptoms. Clearly people taking one tablet a day for years require a different approach from the heavy user under discussion here.

The second study, as part of the EDNAV project, examined 1112 emergency department presentations (2020–2022), identifying 183 cases (16.5%) involving novel benzodiazepines, predominantly in young males (median age 24) 66. Twelve different novel benzodiazepines were detected, with clonazolam and etizolam most common. Nearly half of the cases involved multiple novel benzodiazepines, often combined with psychostimulants like methylamphetamine. Prescription benzodiazepines and psychotropic medications were also frequently co-detected, often without patient disclosure. The third study from EDNAV focused on drug toxicity at music festivals 67, reviewing 1603 medical presentations, of which 228 involved illicit drug toxicity.

Management of moderate to severe alcohol withdrawal syndrome

Addiction specialists, psychiatrists, and medical toxicologists have the specialty expertise to help our colleagues in primary care and other disciplines effectively support their patients through BZD tapering. As this Guideline is released and implemented, we hope that you will explore ways to help other clinicians in your community rise to this challenge. Using this simple protocol, short-acting benzodiazepines can be safely discontinued. Our state-specific resource guides offer a comprehensive overview of drug and alcohol addiction treatment options available in your area. Physical symptoms of benzodiazepine withdrawal are slurred speech, impaired vision, vomiting, and flu-like symptoms.

TREATMENT OF ACUTE ALCOHOL WITHDRAWAL SYNDROME

There is a clear need for population-specific approaches, particularly for groups disproportionately affected by benzodiazepine-related harm. Critically, there is a notable absence of harm reduction interventions for individuals who are not seeking abstinence or formal treatment. This gap reflects a broader misalignment between existing service models and the realities of benzodiazepine use, particularly when it intersects with other structural vulnerabilities such as homelessness, stigma, and criminalisation. Future work should prioritise the development and evaluation of nonjudgmental, flexible interventions that meet people where they are. This includes expanding drug checking accessibility, exploring safer supply models, and codesigning services with people who use benzodiazepines. As the unregulated drug supply continues to evolve, so too must our harm reduction response.

It forms a major part of referrals received by a consultation-liaison psychiatrist. This article aims to review the evidence base for appropriate clinical management of the alcohol withdrawal syndrome. We searched Pubmed for articles published in English on pharmacological management of alcohol withdrawal in humans with no limit on the date of publication.

The service reached 6635 individuals potentially at risk from nonmedical use of prescription medications. The intervention was found to be practical, feasible, and quickly implementable. An alternative adjunctive medication useful in patients with refractory DT is haloperidol given in Benzodiazepine withdrawal doses of 0.5-5 mg by intramuscular route every min29 or 2-20 mg/h34 while continuing to give diazepam mg every 1-2 h.

Benzodiazepine Withdrawal & Detox Options

They reported adopting other harm reduction practices, such as using smaller doses, avoiding solitary use, and carrying naloxone 44, 51. Most participants who used FTS incorporated it into their daily routines because of their convenience 52. A separate study revealed that, after using FTS, participants reduced their injection frequency, avoided solitary drug use, and decreased benzodiazepine use 51.