Benzodiazepine Addiction: Signs, Symptoms, + Withdrawal

Benzodiazepines — often called benzos — are prescription medications doctors use to treat anxiety, insomnia, seizures, and panic attacks. They can be incredibly effective for short‑term relief. But there’s a catch: using them for too long or without close medical supervision can lead to benzodiazepine addiction.

If you or someone you care about has been taking benzos for a while, you might be wondering: “Am I dependent? What does withdrawal look like? Is it dangerous?” Let’s explore the answers to these questions and more.

What Are Benzodiazepines?

Benzodiazepines are a class of prescription medications that act on the central nervous system (CNS) to produce sedative, anti‑anxiety, muscle‑relaxing, and anticonvulsant effects.

They work by enhancing the effect of gamma‑aminobutyric acid (GABA), a neurotransmitter in the brain that helps calm nerve activity. This is why they’re effective for conditions where the brain and body are “overactive,” such as:

• Anxiety disorders (generalized anxiety, panic attacks)
• Insomnia and other sleep problems
• Seizure disorders (like epilepsy)
• Muscle spasms
• Alcohol withdrawal symptoms
• Pre‑surgical sedation

Common Types of Benzodiazepines

Benzodiazepines are usually prescribed in pill or tablet form and taken by mouth, though some are available as liquids, injections, or rectal gels for specific medical situations (such as seizure emergencies). Pill form is most common because it’s convenient, easy to dose, and provides a steady absorption rate. The choice of benzodiazepine often depends on how quickly relief is needed, how long the effects should last, and the specific condition being treated.

The most commonly prescribed benzos include:

• Alprazolam (Xanax) – A short‑acting benzo often prescribed for generalized anxiety disorder and panic disorder. It works quickly but also leaves the system faster, which can increase the risk of withdrawal symptoms.
• Diazepam (Valium) – A long‑acting benzo used for anxiety, muscle spasms, and certain seizure disorders. Because it stays in the body longer, it’s sometimes used to help taper individuals off other benzodiazepines.
• Lorazepam (Ativan) – An intermediate‑acting benzo commonly used for anxiety and as a pre‑surgical sedative. It’s also available in injectable form for hospital use.
• Clonazepam (Klonopin) – An intermediate‑ to long‑acting benzo often prescribed for panic disorder and seizure control.
• Temazepam (Restoril) – Primarily used to treat insomnia, this benzo is taken at bedtime due to its sedating properties.

Although each of these medications works in a similar way — by enhancing the calming effects of GABA in the brain — they differ in potency, onset of action, and duration, which influences how doctors choose the right one for a patient’s needs.

Illegal Benzodiazepines

In most cases, individuals who misuse benzodiazepines start with prescription versions (either their own or ones diverted from friends, family, or other legitimate sources) rather than obtaining them directly from the street.

Street benzos are becoming increasingly available, but are still less common than those prescribed by medical providers. Even so, counterfeit and illicitly manufactured benzodiazepines are increasingly showing up in drug seizures — especially pills.

1. Counterfeit or “Designer” Benzodiazepines

These are illegally manufactured benzos, often made in clandestine labs, sometimes pressed into pills that look like legitimate medications. Many are more potent and unpredictable than prescription versions, making them especially dangerous. Common examples include:

• Etizolam – Not approved for medical use in the US (legal in a few countries as an anxiety or insomnia treatment). Often sold as a “research chemical” online.
• Flualprazolam – A potent analog of alprazolam (Xanax) with a higher risk of sedation and overdose.
• Clonazolam – Extremely potent; even microgram doses can cause profound sedation, blackouts, or respiratory depression.
• Diclazepam – Long‑acting and not FDA‑approved; sometimes sold online as a “legal high.”
• Bromazolam – Structurally similar to alprazolam but unapproved for medical use; increasingly detected in illicit pill seizures.

2. Diverted Prescription Benzodiazepines

A diverted prescription is a medication that was originally prescribed legally by a healthcare provider but ends up being used in an illegal or unauthorized way, either by someone it wasn’t prescribed to, or for reasons other than the intended medical purpose.

In the case of benzodiazepines, prescription diversion happens in a few ways:

• Sharing – An individual gives their prescribed medication to a friend or family member “to help them relax” or sleep.
• Selling – The prescribed medication is sold to someone without a prescription.
• Theft – Pills are stolen from a person’s home, a pharmacy, or a medical facility.
• Doctor shopping – An individual visits multiple doctors to get extra prescriptions, often without telling them about existing prescriptions.

What is Benzodiazepine Addiction?

Benzodiazepine addiction is what happens when your body and brain become so used to these medications that you feel like you can’t function without them. It’s not just about liking the way they make you feel — it’s about your brain rewiring itself to depend on them.

Most people start taking benzos for legitimate reasons, maybe to calm panic attacks, help with sleep, or manage muscle spasms. Initially, they can be incredibly effective. The problem is that your brain is always seeking balance. Over time, you might need higher doses to get the same effect (that’s called tolerance), or you might find it hard to cut back even when you want to.

In many countries, 2–3% of the population regularly uses benzodiazepines. Among older adults, this number can rise to nearly one-third (Jobert et al., 2020; Zandstra et al., 2002). And if someone takes them for months on end, the risk of dependence skyrockets — research suggests 40–80% of long‑term users develop some degree of addiction or dependence.

How Addiction Happens

Benzos work by enhancing the effects of a natural calming chemical in your brain called GABA (gamma‑aminobutyric acid). GABA’s job is to slow down overactive nerve activity, which is why benzos can quiet anxiety or help you sleep. But if you take them regularly for weeks or months, your brain starts to produce less of its own GABA and even reduces the number of GABA receptors. In other words, the brain “outsources” its calming system to the drug.

Over time, two big changes happen:

1. Tolerance – The same dose doesn’t work as well anymore, so you need more to get the same calming effect.
2. Dependence – Without the drug, your brain struggles to keep things in balance, leading to withdrawal symptoms like anxiety, insomnia, shaking, or even seizures.

Signs + Symptoms of Benzodiazepine Addiction

Benzodiazepine dependence doesn’t always look the way people expect. It doesn’t necessarily involve reckless behavior, cravings for a “high,” or obvious behavioral changes overnight. In fact, many individuals who develop a dependence on benzos — often through common prescription medications like Xanax, Ativan, or Valium — start out using them exactly as prescribed, often to manage legitimate health issues like anxiety, panic attacks, or insomnia.

Over time, however, something changes. A person struggling with benzo addiction may not feel quite like themselves without the medication in their system. Eventually, they start to rely on it just to feel steady, calm, or functional. This is where the subtle shift from therapeutic use to dependence or addiction often begins.

• Needing more to get the same relief: The usual dose isn’t helping with anxiety or sleep like it used to, and you’re often tempted to take additional medication to achieve the same effects
• Feeling “off” without it: If you’ve tried to cut back on your dose or skip a dose, only to experience heightened anxiety and restlessness, trouble sleeping, irritability, mood swings, sweating, or elevated heart rate, you’re likely experiencing withdrawal — a clear sign your body has developed a physical dependence on benzodiazepines.
• Emotional + behavioral changes: Addiction isn’t just physical; it affects your thoughts, habits, and emotions. Some signs include:
  • Experiencing anxiety and panic when your medication is running low
  • Worrying excessively about obtaining your next prescription
  • Avoiding travel or social situations if you don’t have your medication
  • Hiding/downplaying the amount or frequency of your use
  • Feeling ashamed, stuck, or afraid of what could happen if you tried to stop
• Doctor shopping: This can include visiting multiple providers to get prescriptions filled, asking family members and friends for leftover pills, and looking for benzos through unofficial channels, like online pharmacies or black market websites. This behavior stems from desperation, not deception. Withdrawal can feel unbearable, and an individual struggling with addiction is simply trying to find relief from their distress.
• Wanting to stop, but being unable to: Feeling a loss of control is a defining sign of a substance use disorder. Many people struggling with benzo addiction try to taper off before quitting, but feel overwhelmed by withdrawal symptoms or fear of how life will look without the drug.

It’s critical to remember that benzodiazepines change the way your brain functions. Quitting them suddenly or without support can lead to serious medical and emotional consequences.

Symptoms of Withdrawal

The clearest sign of benzodiazepine addiction often shows up when you try to stop or cut back — through withdrawal. Benzodiazepine withdrawal isn’t just uncomfortable. It can be dangerous without medical guidance.

How Common is Benzodiazepine Withdrawal?

Withdrawal can happen even if you’ve been taking benzos exactly as prescribed. The numbers are sobering:

• 40–80% of long‑term users experience withdrawal if they stop suddenly (Lader, 2024).
• Approximately 20–50% experience extremely distressing symptoms (Finlayson, 2022).
• For short‑acting benzos, withdrawal often starts within hours or days, peaks in the first two weeks, and can last for weeks — or even months (Verywell Mind, 2018).
• Some individuals experience protracted withdrawal, with symptoms lasting a year or more (Finlayson, 2022).
• Older adults are especially at risk. In one study, 78% of people over 65 who stopped benzos experienced withdrawal symptoms, mostly psychological (Jobert et al., 2020).

How Long Does Benzodiazepine Withdrawal Last?

Benzodiazepine withdrawal can last anywhere from a few weeks to many months, depending on the individual. Here’s a breakdown of what to expect:

Acute Withdrawal Phase

This is the most intense phase and typically lasts 2 to 4 weeks after stopping or starting a taper. Common symptoms include:

• Anxiety
• Insomnia
• Irritability
• Sweating
• Muscle pain
• Panic attacks

For short-acting benzos (like Xanax/alprazolam), symptoms may begin within 6–24 hours.
For long-acting benzos (like Valium/diazepam), withdrawal may not start until 2–7 days after the last dose.

Protracted Withdrawal (Post-Acute Withdrawal Syndrome)

In some individuals — especially those who used benzos long term or tapered too quickly — symptoms can linger for months or even a year or more. This is known as protracted withdrawal and may include:

• Anxiety or mood swings
• “Brain fog” or poor concentration
• Sleep disturbances
• Sensory sensitivity
• Muscle tension
• Depression

Studies and patient reports suggest that 10–15% of people experience long-lasting symptoms, though they tend to gradually improve over time.

Recovery Timeline Summary

• Short-term users (under a few weeks): symptoms may resolve in days to a few weeks
• Long-term users (months or years): withdrawal can last several months
• Some cases: symptoms may wax and wane for a year or longer

Long-Term Effects of Benzodiazepine Addiction

1. Cognitive + Memory Problems

One of the most well-documented long-term effects of benzo addiction is impaired brain function — especially related to memory and attention. Common issues include:

• Short-term memory loss
• Difficulty concentrating or focusing
• Slower mental processing
• Trouble learning new information

Studies have shown that chronic benzodiazepine use is associated with cognitive decline, especially in older adults. In some cases, these problems improve after stopping the drug, but recovery can be slow — and for some, incomplete (Barker et al., 2004).

2. Emotional Blunting + Mood Disorders

Benzos work by dampening nervous system activity. Over time, this can lead to emotional numbing, where you don’t feel deeply anxious, but you also don’t experience joy, motivation, or connection. Possible effects:

• Emotional flatness or indifference
• Increased depression
• Irritability or mood swings
• Anxiety rebound (worse anxiety after stopping)

Ironically, individuals often take benzos to manage anxiety or stress — but with long-term use, the brain becomes less able to regulate mood naturally, making anxiety worse without the drug.

3. Sleep Disturbances

While benzos can help people fall asleep in the short term, long-term use disrupts natural sleep architecture — especially deep, restorative REM sleep. People addicted to benzos often report:

• Insomnia
• Non-restorative sleep
• Nighttime panic attacks
• Dependency on the drug to fall asleep

Even after quitting, sleep problems can persist, and the body may take a considerable amount of time to restore normal circadian rhythms.

4. Increased Risk of Accidents + Injuries

Benzodiazepines slow reaction time and impair coordination, even at prescribed doses. Long-term users are more likely to experience:

• Falls (especially in older adults)
• Car accidents
• Workplace injuries
• Balance and mobility problems

This risk increases dramatically when benzos are combined with alcohol, opioids, or other sedatives — a common occurrence among individuals with polydrug dependence.

5. Increased Risk of Death (Especially When Combined with Other Drugs)

Benzodiazepines alone don’t often cause fatal overdoses — but when combined with opioids or alcohol, the risk increases dramatically. These substances all depress the central nervous system, and using them together can slow or stop breathing.

According to the CDC, over 90% of benzo-related overdose deaths also involve an opioid. Long-term addiction increases the likelihood of polydrug use and risky behaviors.

Read more: The Dangers of Combining Benzodiazepines + Opioids

Safely Detoxing from Benzodiazepines

The safest way to detox from benzodiazepines is through a slow, medically supervised tapering process — not a quick or sudden stop. Because benzodiazepines directly affect the brain’s calming system (GABA), quitting too fast or going “cold turkey” can lead to serious complications, including seizures, psychosis, or life-threatening withdrawal symptoms.

Inpatient medical detox provides:

• 24/7 medical monitoring
• Emergency seizure precautions
• Mental health stabilization
• Safe transition to a tapering or recovery program

STR Behavioral Health Silver Pines is a Joint Commission-accredited detox center and rehabilitation center specializing in drug and alcohol treatment. Our detox and rehab programs are offered in a single location, ensuring a seamless transition to intensive addiction treatment when you’re ready to take the next step toward recovery.

We also provide specialized tapering schedules for individuals in benzodiazepine detox, so they can continue with intensive addiction treatment while navigating the detox process.

Compassionate Care, Grounded in Hope

If you or someone you know is struggling with benzodiazepine abuse or addiction, there is hope for healing and recovery. At STR Behavioral Health, addiction treatment is tailored to your unique needs, starting with a comprehensive assessment and a personalized care plan to help you find the best path forward.

Contact our admissions team today to learn more about how our detox and rehab programs can support you or your loved one in healing from benzodiazepine addiction.

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References

• American Addiction Centers editorial staff. Benzodiazepine Addiction: Symptoms & Signs of Dependence. Updated Jun. 21, 2024.
• Jobert A, Laforgue E‑J, Grall‑Bronnec M et al. Benzodiazepine withdrawal in older people: what is the prevalence, what are the signs, and which patients? Eur J Clin Pharmacol, 2020.
• Rickels K, Schweizer E, Garcia‑Espana F et al. Strategies for discontinuing long‑term benzodiazepine use. Br J Psychiatry, 2006.
• Rickels K, Schweizer E, Weiss S et al. Long‑term therapeutic use of benzodiazepines II: effects of gradual taper. Arch Gen Psychiatry, 1991.
• Lader M. Estimates of Patients Experiencing Withdrawal — Benzodiazepine. [benzoinfo.com], 1990.
• Zandstra SM, Van Rijswijk E, Rijnders CA et al. Long‑term benzodiazepine users in family practice: differences from short‑term users in mental health… Family Practice, 2002.
• Finlayson R et al. Benzodiazepine withdrawal symptoms are more common than most clinicians realize, Psychology Today, 2022.