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BenzodiazepinesBenzodiazepines

Benzodiazepines, also commonly referred to as “benzos,” are used to treat alcoholism and alcohol withdrawal symptoms. These prescriptions come in a tablet form that can be swallowed or dissolved under the tongue, as well as a liquid form that is injected.

During the first few weeks of treatment, a higher dosage of benzos may be used to help decrease withdrawal symptoms and reduce any cravings to drink. After withdrawal symptoms subside, doses are typically tapered back until a patient’s treatment specialist determines it is no longer needed.

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Benzodiazepines in Treating Alcoholism

Unlike other medicines used to treat alcoholism, such as disulfiram and naltrexone, benzodiazepines can be used during the detox phase of recovery. The symptoms of alcohol withdrawal typically arise during detox, which is when alcohol is completely cleared from your body. The detox process can last anywhere from a few days to a few weeks, depending on the severity of the alcohol use disorder (AUD).

Due to the unpredictable nature of withdrawal symptoms, it is highly recommended to detox under the care of medical professionals. Treatment specialists are able to administer prescription drugs, such as benzos, to help reduce any uncomfortable and painful withdrawal symptoms that may arise during detox.

Some of the alcohol withdrawal symptoms that benzos can prevent and treat include:

  • Headaches
  • Nausea and vomiting
  • Insomnia
  • Aggravation and irritability
  • Chills and sweats
  • Seizures

There are several different types of benzodiazepines used in alcohol rehab facilities, including diazepam, chlordiazepoxide, oxazepam and lorazepam. Here is a breakdown of these drugs and how they are used in the treatment of an AUD.

 Diazepam

(Valium)

Diazepam is one of the most common medications used to treat alcoholism. It comes in two forms: tablet and injection. The medicine helps reduce the chance of recurrent withdrawal symptoms. Since it’s a long-acting benzo, a single dose can last up to three days. Starts taking effect quickly – roughly five minutes for the injectable form and 30 to 60 minutes for tablet form. This medication helps reduce withdrawal symptoms including anxiety, muscle spasms, seizures and insomnia.

Chlordiazepoxide

(Librium)

This medication is administered daily by tablet to relieve unpleasant withdrawal symptoms. Similar to other long-lasting benzos, chlordiazepoxide remains in the body for about three days. Due to its prolonged effects, patients taking this medication often feel much more comfortable during the rest of the withdrawal process. It takes roughly 30 minutes for a patient to feel the effects of chlordiazepoxide. The prescription lowers symptoms of anxiety and muscle spasms caused by alcohol withdrawal. Talk with your treatment specialist about other possible uses of this drug and how it benefits recovery.

Oxazepam

(Serax)

Classified as a short-to intermediate-acting benzo, the effects of oxazepam last around one day. It comes in a tablet form and is usually taken daily. This drug is typically administered under medical supervision so that a patient’s vitals and health can be monitored. After taking this drug, it takes around an hour for patients to feel relief from withdrawal symptoms. It helps relieve anxiety caused by alcohol withdrawal and detox. This allows a person’s body to relax so they can focus on sobriety and other beneficial aspects of treatment.   

Lorazepam

(Ativan)

Lorazepam is used by rehab facilities across the nation to help patients overcome an AUD. The medicine comes in a tablet and injection form. As an intermediate-acting drug, it has a duration of roughly 11 to 20 hours. It’s commonly used in older patients and individuals with liver failure. The tablet form takes effect within 30 minutes, whereas the injectable form can take effect as early as 15 minutes. The drug helps alleviate anxiety associated with alcohol withdrawal. Treatment specialists may also prescribe it to reduce the risk of seizures.

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How Do Benzodiazepines Work?

There are several different types of benzos that are used to treat alcoholism, and help patients throughout the withdrawal and recovery process. Benzodiazepines are typically administered in an inpatient rehab facility. This is because acute withdrawal symptoms – those experienced in the first week or two of detox – can become progressively worse or even life-threatening at their peak. By selecting an inpatient rehab facility, patients can rest assured knowing they will have around-the-clock care during this sensitive time.

Benzos work by binding to the same neurotransmitters in the brain as alcohol, including the gamma-aminobutyric acid (GABA). GABA is responsible for controlling a person’s anxiety levels and is shown to contribute to the development of some psychological disorders. Certain medications, such as benzodiazepines, can help increase GABA activity. This helps suppress the nervous system and provide a sense of calmness.

The sedative effects of benzos help alleviate painful and uncomfortable withdrawal symptoms. There are three primary uses for this type of prescription in alcohol rehab: fixed tapering dose regimen, symptom triggered regimen and loading dose regimen.

  • Fixed tapering dose regimen (FTDR): With FTDR, patients are given a fixed dose of a benzo. Because this regimen is not adjusted based on the severity of withdrawal symptoms, it is best suited for people with mild symptoms recovering in outpatient rehab settings.
  • Symptom triggered regimen (STR): STR is often used in an inpatient treatment program where symptoms can be monitored by medical staff. This method provides a scale in which patients rate the pain associated with withdrawal symptoms. The medication dosage is based on the answers they provide – unbearable symptoms warrant higher doses, whereas minor symptoms involve lower doses.
  • Loading dose regimen (LDR): A LDR involves the use of long-acting benzos. These types of medications usually stay in the body for several days and reduce the risk of seizures during detox. LDR is commonly used in inpatient rehab so treatment specialists can monitor a patient’s vitals and withdrawal symptoms.

Benzodiazepines Side Effects

The use of benzodiazepines during alcohol treatment can come with a range of side effects – from minor to severe. This type of drug can cause an adverse reaction when combined with other medications, so it’s important to discuss any prescriptions you are currently taking with your doctor.

Minor, but common side effects of benzos include:

  • Drowsiness
  • Dizziness
  • Diarrhea
  • Changes in appetite
  • Dry mouth
  • Weakness

Although rare, the medication can trigger more serious side effects. These include:

  • Difficulty or frequent urination
  • Blurred or doubled vision
  • Respiratory problems
  • Trouble with coordination
  • Yellowing of skin or eyes
  • Severe skin rash

If symptoms are serious or become worse while on the medication, contact your health provider or seek immediate medical attention. Stopping the use of benzos cold turkey can also trigger dangerous side effects, so be sure to talk with your treatment specialist before coming off the medication.

Treatment Programs for Alcoholism

Alcohol recovery plans that involve medication-assisted therapy, such as the use of benzos, have proven to be effective for many people. However, every person’s recovery is unique, so it’s important to seek the guidance of a treatment specialist to determine the best program for you.

Self-treating an AUD is dangerous and can be life-threatening. As a result, alcohol withdrawal and other phases of treatment should only be conducted in a rehab facility. This will provide you with a safe haven while overcoming alcohol abuse, as well as give you the tools needed to maintain sobriety long-term.

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Author

Carol Galbicsek

Carol Galbicsek

Content Marketing Manager

Carol is the lead writer for Alcohol Rehab Guide. She is passionate about helping people who are struggling with alcohol abuse and addiction. Her past experience in the medical field has led to a deep knowledge of the struggles facing those with a substance use disorder (SUD), and a desire to do something to help.

Sources

Sachdeva, Choudhary, Chandra. (2015). Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. February 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606320/

Bayard, Mcintyre, Hill, Woodside. (2004). Alcohol Withdrawal Syndrome. February 2017. http://www.aafp.org/afp/2004/0315/p1443.html

U.S. National Library of Medicine. (2016). Chlordiazepoxide. February 2017. https://medlineplus.gov/druginfo/meds/a682078.html

U.S. National Library of Medicine. (2016). Oxazepam. February 2017. https://medlineplus.gov/druginfo/meds/a682050.html

U.S. National Library of Medicine. (2016). Lorazepam. February 2017. https://medlineplus.gov/druginfo/meds/a682053.html