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Diazepam Withdrawal Symptoms

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CONTENTS

Diazepam or valium is a popular benzodiazepine drug commonly used to treat anxiety disorders, convulsive disorders, and skeletal muscle spasms. Despite its high efficacy and success rates, one must be highly cautious about diazepam, mainly due to its high risk of associated tolerance, dependence, and addiction. Once someone develops a significant level of physical and physiological dependence, stopping it may become extremely challenging due to the uncomfortable withdrawal as soon as they miss a dose.

A diazepam withdrawal can be excruciating and draining, even dangerous in some cases. Suppose you are addicted to diazepam and wish to discontinue it. In that case, it’s essential that you familiarise yourself with how this withdrawal process occurs, what it entails, and how to get rid of it.

Diazepam addiction can develop even in those using it as prescribed by healthcare professionals. One of the main reasons why this medication is so addictive is how quickly the body develops tolerance to it. As a user’s body becomes used to a specific dose of diazepam, they develop tolerance and eventually start requiring it in progressively higher quantities to achieve the same effect. This is why most experts avoid prescribing diazepam for more than two to four weeks.

A period any longer than four weeks leads to dependence as the body starts heavily relying on the chemical effect diazepam has on the brain. It works to upregulate the levels of GABA in the brain, which immediately subsides the minute a user stops using this drug. The body cannot function normally without high GABA levels, ultimately leading to addiction.

The symptoms of diazepam withdrawal can be emotionally and physically painful, even life-threatening, if someone stops using the medication cold turkey. People abusing diazepam for years or at very high doses develop the worst withdrawal symptoms. The exact symptoms are highly variable and may come and go. They also vary in terms of frequency and severity but generally include the following:

Sleep disturbances
Anxiety
Increased tension
Heart palpitations
Panic attacks
Excessive sweating
Difficulty concentrating
Muscular stiffness or discomfort
Headache
Changes in perception
Hand tremors
Cravings

The less common and more severe symptoms associated with diazepam withdrawal include the following:

Hallucinations
Psychosis or psychotic reactions
Seizures
Increased risk of suicidal ideation

The first step in treating a diazepam addiction involves removing this drug from an addict’s body. Also known as detoxification, it can be hazardous and may trigger multiple side effects if not performed correctly. Quitting this medication cold turkey can even prove fatal in some circumstances. Hence, it is essential to perform detox in a dedicated facility under the supervision of an expert to monitor and manage potentially fatal symptoms like suicidal behaviour and seizures.

The thought of undergoing detox in a clinical setting can intimidate many people. There is also a common misconception that individuals who go to a hab for their addiction are simply given a few replacement drugs and sent home. However, this is far from reality as most of the addicts that seek help from rehab require admission, where they spend at least ten days ridding their bodies of diazepam. The process usually involves using a different kind of benzodiazepine at doses high enough to control withdrawal but low enough not to cause euphoria.

As a part of the detox process, an addiction expert provides the addicts with a schedule for slowly coming off diazepam instead of suddenly quitting it. This process is known as tapering down, which means slowly reducing the dose or potency of the benzo drug you are using. The rate at which tapering happens depends on the severity and duration of addiction. However, for most people, experts recommend reducing their current dose by 50 per cent during the first two to four weeks of usage. Maintaining this dose for at least a month is recommended before reducing it by 25 per cent every week unless an individual gradually stops taking it.

Diazepam withdrawal is generally divided into the following stages:

Early withdrawal stage

While diazepam withdrawal affects people differently, most start experiencing uncomfortable symptoms within 24-72 hours from the last dose. Heavy users may develop these symptoms a little later due to the long-lasting effects of diazepam on their bodies. The early signs of withdrawal include restlessness and anxiety that constantly swing between mild and intense and can be highly distressing.

Acute withdrawal stage

The diazepam withdrawal symptoms generally peak during the second week from the last dose. The psychological and physical symptoms during this stage include sweating, nausea, vomiting, insomnia, and muscle spasms. The acute withdrawal stage is critical as the amplified symptoms tempt addicts to end the discomfort by taking a dose of diazepam. Detoxing in a medical facility greatly reduces this temptation by providing sufficient distractions and managing uncomfortable symptoms through medications.

Late withdrawal stage

For most people, the acute stage lasts up to a month, with symptoms becoming milder to non-existent in severity around the fourth week. However, a small number of addicts, especially those who detox on their own, may continue to experience the lingering side effects for months. This constitutes a late withdrawal stage that can make lives uncomfortable unless medical help is sought.

For some people, detox is all they need to overcome the addiction. However, most of them require a follow-up in an inpatient or outpatient rehab, where they learn how to reduce their risk of acquiring the addiction.

Once a person completes detoxification, it becomes imperative for them to seek treatment for their underlying benzodiazepine addiction. Remember that detox can only tend to the physical symptoms, and therapy must be commenced as soon as possible to manage the psychological symptoms. During therapy, an individual and a therapist work together to develop new and healthy coping strategies to cope with craves and thrive in everyday life without relying on drugs.

A mental health expert may take several angles to address addiction and use many methods, some of which may work for one but not for another. Most addiction therapies aim to explore the causes that led an individual towards addiction and to help them address these causes with healthy thought patterns and behaviours.

Some commonly used therapies for fighting valium addiction include:

Dialectical behavioural therapy (DBT)

DBT works similarly to cognitive behavioural therapy (CBT) to treat people with an underlying diazepam addiction. It aims to uncover the root causes behind negative processes that lead to harmful behaviours like addiction. Moreover, DBT also emphasises how to achieve equilibrium in opposing forces.

Traditional 12-step programmes

The 12-step programmes have been touted as one of the most effective treatments for alcoholism. Because diazepam and alcohol exert similar pharmacological effects, the programme works equally well. The 12-step approach integrates self-acceptance and group therapy with surrendering to a higher power to give meaning to the lives of those suffering from addictions.

Family therapy

Family therapy is particularly beneficial for young adults and adolescents facing diazepam addiction. With the whole family working towards finding practical solutions, the path to recovery becomes more manageable.

Behaviour modification and realignment

Behaviour modification therapy is a more traditional method of beating addiction with the help of classical conditioning. In this type of therapy, a therapist uses positive reinforcement to motivate a client towards recovery. The therapist may use rewards, which include materialistic goods like cash or vouchers, to help clients focus on their positive traits and overcome the negative ones.

FAQs

What is the legal status of diazepam in the UK?

Diazepam comes under the controlled substance category in the UK, which means you cannot obtain it without a prescription. By drug class, it comes under Class C, meaning it is illegal to sell, give, or possess benzodiazepines in a non-medical context. Any illegal possession can lead to a punishment of up to two years.

How addictive is diazepam?

Benzodiazepines such as diazepam were first created in the 1930s but the public did not have access to it until the 1960s. Before their introduction, most people with anxiety relied on opiates and barbiturates to manage their anxiety symptoms. Because benzodiazepines were considered safer and less addictive than these drug classes, the use of this drug class surged. This was until the 1980s when scientists discovered how they affected the neurotransmitter GABA and realised they had grossly underestimated their addiction potential. So far, we know that as long as you use benzodiazepines precisely as prescribed by a doctor, the risk of developing an addiction is minimal. Nevertheless, gradually tapering off this drug even after you have used it for a short time might be necessary to avoid experiencing a diazepam withdrawal. For someone who starts consuming more of this drug than the prescribed amount or seems preoccupied with obtaining and using it, help must be sought for a detox.

What is the proposed diazepam withdrawal timeline for detox?

For most people, coming off diazepam 2mg takes around four weeks. The proposed guideline for the process is mentioned below:
Week One: Because valium is a long-acting medicine, most users take up to a week to experience the withdrawal effects. Some early symptoms include high blood pressure, fever, and elevated heart rate.
Week Two: Most withdrawal symptoms peak during the second week and commonly include anxiety, tremors, hallucinations, agitation, seizures, and sweating.
Week Three to Four: Most people notice their symptoms gradually reducing from week three and completely resolving until the end of week four.

What do you mean by post-acute withdrawal symptoms?

Also known as PAWS, the term indicates the prolongation of the withdrawal symptoms beyond six months after ceasing the use of an offending drug. Some common symptoms that people may develop as a part of PAWS related to diazepam include:
Clinical insomnia
Depression
Difficulty performing complex tasks
Persistent anxiety
Loss of sex drive
Poor concentration

What determines the severity of the withdrawal symptom of diazepam?

The severity of withdrawal from valium depends on multiple factors, some of which include the following:
The severity of addiction
The duration of addiction
The typically abused dose of valium
Current mental health status
Current physical health
Any co-occurring use of other drugs

Will I be given any medication during the diazepam withdrawal detox?

Even though most people do overcome their diazepam withdrawal and addiction with slow tapering, some require medications to relieve the uncomfortable symptoms. Some common examples of these medications include the following:

Buspirone is commonly used by people with anxiety and a history of substance abuse. This drug is not capable of causing physical symptoms and can effectively relieve the emotional symptoms of a diazepam withdrawal. The only downside of this drug is that it may take a few weeks before helping the user.
Flumazenil is a drug that primarily treats diazepam overdose but can also reduce its withdrawal symptoms to a reasonable extent. It works by blocking the effects of benzos on the brain as it attaches itself to the same pleasure centres as these drugs.

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