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Benzodiazepine addiction information

Written by Drew Redd. Mina Draskovic, B.Psy., reviewed this content for accuracy.

Benzodiazepines are effective for treating anxiety and insomnia when prescribed by doctors. A 2019 systematic review revealed that benzodiazepine misuse affects approximately 2.2% of Americans (about 6 million people). Most people who take benzodiazepines use them as prescribed, with less than 2% escalating to high doses. 

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For those who do develop problematic use, benzodiazepines create one of the most severe forms of substance use disorder (SUD). If you’re one of them, our benzodiazepine addiction treatment center provides the focused support you need to overcome dependence and start building a healthier future.

What is benzodiazepine addiction?

Benzodiazepines are prescription medications that work by enhancing the effects of GABA, a natural calming chemical in the brain. Doctors prescribe them to treat anxiety, panic disorders, insomnia, and seizures because they produce feelings of relaxation and sedation. Common benzodiazepines include:

  • Xanax (alprazolam).
  • Valium (diazepam).
  • Klonopin (clonazepam).
  • Ativan (lorazepam).
  • Serax (oxazepam).

Many people develop addiction to these medications even when taking them as prescribed. They all create powerful effects on the brain’s reward system that lead to physical and psychological dependence. The calming effects, combined with increasing tolerance can lead to a cycle of escalating use.

There’s an important difference between being physically dependent on benzodiazepines and being addicted to them. When someone takes benzodiazepines regularly, even as prescribed by their doctor, their body naturally adapts to the medication; this is physical dependence. It means they’ll experience withdrawal symptoms if they stop suddenly, but it doesn’t mean they’re addicted.

Benzodiazepine addiction is when someone loses control over their use. They might feel a strong urge to take more than prescribed, continue using despite problems in their life, or find themselves unable to stop even when they try. When these problems persist for a year or more and significantly disrupt someone’s life, doctors typically diagnose it as a benzodiazepine use disorder.

If your benzo use feels like it’s getting out of control, whether you’re struggling with misuse or addiction, the first step is to seek help. Ardu’s drug addiction treatment provides the support and care you need.

Contact Ardu online or via phone at (801-810-1234), and we will guide you through every step of your recovery.

Signs of benzodiazepine addiction

When benzodiazepine use transitions from therapeutic to problematic, certain behavioral and physical changes become noticeable. Physical signs someone is addicted to benzodiazepines include:

  • Persistent fatigue with cognitive impairments
  • Slurred speech and difficulty communicating
  • Poor coordination with sensory hypersensitivity
  • Blurred vision and memory loss
  • Memory impairment and difficulty concentrating
  • Tremors
  • General weakness and cognitive decline
  • Anterograde amnesia (difficulty forming new memories)

Other psychological or behavioral symptoms of problematic benzodiazepine use may look like this: 

  • Physiologic dependence with inability to stop despite adverse effects
  • Obsessive thoughts about daily dose and next use
  • Depressive symptoms and mood changes
  • Social withdrawal and loss of interest in activities
  • Deceptive behavior about prescription drug abuse
  • Increased panic attacks and anxiety disorders when medication isn’t available
  • Doctor shopping (seeking multiple prescriptions for benzodiazepines)
  • Dosage escalation beyond therapeutic doses or illicit drug use
  • Mental health deterioration that affects relationships
  • Impaired performance at work or school as a result of cognitive impairments

Benzodiazepine withdrawal syndromes are often the clearest indicators of substance abuse and dependence. When someone abruptly discontinues or attempts to reduce their use, these withdrawal symptoms typically emerge:

  • Severe anxiety
  • Insomnia
  • Tremors
  • Sweating
  • Nausea and vomiting
  • Elevated blood pressure and heart rate
  • Potential seizures (in severe cases)
  • Intense cravings
  • Respiratory depression

Attempting to stop benzodiazepines without medical supervision can be dangerous. If you recognize these signs in someone you care about, encourage them to seek professional help. 

At our benzodiazepine detox center, we provide specialized care to help you safely navigate withdrawal and recovery with the support of our experienced medical team.

How do benzodiazepines work?

Benzodiazepines enhance the effects of GABA (gamma-aminobutyric acid), the brain’s primary inhibitory neurotransmitter. When GABA binds to its receptors, it opens chloride channels in nerve cells, making them less likely to fire. Benzodiazepines bind to a specific site on the GABA receptor complex and amplify this calming effect to produce sedation, anxiety relief, and muscle relaxation.

With long-term use, physical dependence develops as the brain adjusts its natural GABA production. This starts a cycle of drug dependence: people develop tolerance, and they need higher doses to achieve the same effects. Eventually, the brain relies on these prescription drugs to function, because without them, withdrawal symptoms emerge.

The addiction potential is particularly high with short-acting benzodiazepine prescriptions that affect the brain’s reward system. This creates a cycle of substance abuse where benzodiazepine dependence strengthens as people seek relief from both anxiety and withdrawal syndromes. The effects of benzodiazepines on mood and anxiety create a powerful reinforcement that can lead to benzodiazepine use disorder. These dangerous drugs create a cycle of dosage escalation, growing tolerance, and attempts to avoid adverse effects, ultimately leading to a case of complicated dependence.

Which benzodiazepine is most likely to cause dependence?

Medications with higher lipophilicity (ability to cross the blood-brain barrier) and shorter half-lives tend to have greater dependence potential. Valium shows the highest abuse liability in laboratory studies, with Xanax following closely behind.

According to a 2024 study, Xanax is the most prescribed benzodiazepine in the United States with 38% of prescriptions. It is associated with twice as many abuse-related emergency department visits as other benzodiazepines. Brett and Murnion indicate that, because of its high toxicity, overdose risk, and mortality rates, alprazolam (Xanax) was reclassified as a Schedule 8 drug in 2014. The combination of high potency, short half-life, and wide availability makes alprazolam one of the most likely benzodiazepines to cause dependence.

If you’re facing challenges with Xanax misuse, Ardu is here to offer the support you need. Our Xanax-oriented rehab services give you the tools to take control of your life and forge your own destiny.

What is the addiction rate for benzodiazepines?

The actual addiction rate for benzodiazepines is approximately 0.3% of the U.S. population (about 739,000 people), despite 2.2% reporting misuse. Votaw, et. al. reveal that, while many people are prescribed benzodiazepines, less than 2% escalate to high doses, and even fewer develop a diagnosable substance use disorder.

These rates increase significantly among certain populations:

  • The risk is much higher for people who combine benzodiazepines with alcohol or opioids.
  • Those with existing substance use disorders show higher rates of problematic use.
  • People in opioid treatment programs are particularly vulnerable, with studies showing up to 40-50% misuse rates in this population.

Votaw, et. al. also show a 139% increase in emergency room visits related to benzodiazepines, especially when combined with other substances. Treatment admissions specifically involving benzos and opioids together skyrocketed between 2000–2010.

Polysubstance abuse with benzos

Benzodiazepine abuse rarely occurs on its own. Most people combine benzos with other substances, primarily opioids and alcohol. When mixed with opioids, the combination becomes extremely dangerous because both drugs slow down breathing. 

The combination of benzos with other substances is known as polysubstance abuse. According to a 2016 study, polydrug abuse has led to a sharp rise in deaths, with benzos being involved in 31% of opioid-related fatalities by 2011. 

Australian researchers found that benzodiazepines are most often combined with opioid maintenance therapy (methadone or buprenorphine). More than half of methadone patients started benzo use after beginning treatment and 67% of buprenorphine patients used benzos concurrently. The study also notes that alcohol with benzodiazepine use is a significant concern because both substances bind to GABAA receptors and cause dangerous central nervous system depression.

People who mix benzos with other drugs tend to take much higher doses of benzodiazepines than those using them alone, further increasing the risk of overdose and death.

Is it difficult to get off benzodiazepines?

It is challenging to stop benzodiazepine use. Due to severe withdrawal symptoms and the high risk of relapse, quitting can also be dangerous. Abrupt benzodiazepine discontinuation can lead to life-threatening symptoms such as seizures and delirium tremens, which is why you need medical supervision.

Treatment for benzodiazepine dependence typically involves:

Recovery requires comprehensive care that addresses both physical dependence and psychological aspects of addiction. At Ardu, we take a comprehensive approach to treating benzodiazepine addiction in which we address the physical dependence and underlying mental health challenges.

Dual diagnosis services offered at Ardu

Dual diagnosis refers to the co-occurrence of SUD and mental health conditions. For example, benzodiazepine dependence often co-occurs alongside anxiety or depression. Treating both issues at the same time is important because mental health symptoms often fuel substance use, while substance use worsens those symptoms, creating a harmful cycle. 

Research shows that psychiatric symptoms and disorders, particularly anxiety and mood disorders, are consistently associated with both benzodiazepine misuse and a higher risk of developing a sedative/hypnotic/anxiolytic use disorder. A 2022 study reveals that benzo abuse has a strong association with comorbid psychiatric disorders, with approximately 40% of benzodiazepine abusers reporting a co-occurring mental health condition. This rate is much higher than in other substance abuse populations. 

Here’s what integrated approach to benzodiazepine addiction Ardu’s dual diagnosis treatment provides:

  • We use evidence-based medication-assisted treatment (MAT) to ease the physical symptoms of benzodiazepine withdrawal and reduce cravings. This stabilizes your mental health and physical well-being during recovery.
  • Our individual therapy focuses on uncovering how mental health issues contribute to your substance use, so you can develop coping mechanisms to address both the addiction and the root causes behind it.
  • Cognitive behavioral therapy (CBT) helps you identify harmful thought patterns that fuel both benzodiazepine addiction and co-occurring mental health conditions. By learning to challenge and change these thoughts, you gain better control over cravings and mental health symptoms.
  • Since benzodiazepines are often prescribed for anxiety and stress, our holistic therapies—such as yoga, mindfulness, and meditation—provide natural, healthy ways to manage stress and anxiety.

We go beyond addiction treatment to help you rebuild emotional resilience and regain control over your life.

Contact Ardu Recovery Center, and start your journey toward healing today.

Ardu’s detox services

Detox is the critical first step in the treatment of benzo addictions. We understand the risk factors associated with prolonged abuse of benzodiazepines, so our detox services focus on minimizing the risk of dependence and addressing both the physical and psychological effects of withdrawal. 

Many of our detox services, such as medication management and holistic therapies, also overlap with our dual diagnosis treatment, for comprehensive care for addiction and co-occurring mental health conditions. To support your mental health during this challenging process, we also employ: 

  • Tapering protocols to gradually reduce benzodiazepine use and prevent severe withdrawal symptoms.
  • Nutritional counseling to support your body’s recovery and replenish essential nutrients lost during benzodiazepine use.
  • Holistic detox services where we focus on the whole person by integrating physical, emotional, and mental wellness practices to support a balanced recovery process.
  • Experiential therapy to help you process emotions and trauma and foster emotional growth and self-awareness during detox through art, music, or adventure-based experiences.
  • Alternative therapies where we employ innovative treatments such as float spa and vibroacoustic therapy to calm the nervous system and reduce withdrawal symptoms.

Our goal is to guide you through a safe, supportive detox and set the foundation for long-term recovery.

Ardu’s rehab services

Ardu offers the nation’s best drug and alcohol rehab services with a comprehensive, compassionate approach to benzodiazepine use recovery. Our expert medical team, personalized care, and focus on long-term success provide unparalleled support at every stage. 

Here’s what you can expect:

  • Our residential program provides a structured, supportive environment crucial for early recovery. You’ll receive round-the-clock care, participate in intensive therapy sessions, and engage in holistic activities. This immersive experience allows you to focus entirely on your recovery, free from outside triggers and distractions.
  • For those who have completed inpatient treatment or require a less intensive approach, our outpatient program offers flexibility without compromising on care. You’ll attend regular therapy sessions and receive ongoing support while maintaining your daily responsibilities, so you can practice recovery skills in real-world situations.
  • Addiction affects not just the individual, but the entire family system. Our family therapy sessions promote understanding, improve communication, and help rebuild relationships strained by benzodiazepine or other forms of addictive behaviors. We provide education and support to help your loved ones participate in your recovery journey.

Whether starting your journey or transitioning from detox, Ardu provides the tools to overcome benzo addiction and reclaim your life. Reach out to us today to learn more about our personalized treatment options and let us help you build a brighter tomorrow.

Drew Redd

Drew Redd is the executive director of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Benzodiazepine addiction FAQ

What is the most common withdrawal symptom with benzodiazepines?

The most common withdrawal symptom of benzodiazepines is anxiety, which often becomes more severe once the drug is stopped. Other frequent symptoms include insomnia, tremors, and in extreme cases, suicidal ideations. 

These symptoms are a result of the body’s physical dependence on the drug, which alters brain chemistry over time. Withdrawal can also cause respiratory depression and seizures, which is why anyone discontinuing benzodiazepine use must do so under the supervision of medical professionals to avoid life-threatening complications.

How can I overcome benzodiazepine dependence?

Overcoming benzodiazepine dependence requires a carefully managed approach, ideally under the supervision of medical professionals. The first step is typically a tapering schedule, gradually reducing the dose to minimize withdrawal symptoms such as anxiety, tremors, and suicidal ideations. This process may also involve medication-assisted treatment to manage physical symptoms and cravings.

Cognitive-behavioral therapy (CBT) addresses the underlying mental health issues that often contribute to dependence, particularly in patients with a history of substance abuse. Long-term recovery requires a comprehensive plan that includes medical detox and ongoing therapy.

Are SSRIs safer than benzos?

In general, SSRIs (Selective Serotonin Reuptake Inhibitors) are safer than benzodiazepines for the treatment of anxiety and depression, especially for long-term use. Benzodiazepines are effective in the short term, but they carry a high risk of physical dependence and withdrawal symptoms. According to health care professionals, there’s a lower abuse potential of benzodiazepines than SSRIs, so they are prescribed for chronic conditions with fewer side effects. SSRIs can still cause issues such as insomnia and sexual dysfunction, but their safety profile is better suited for extended use in clinical practice.

What is the daily limit for benzodiazepines?

The daily limit for benzodiazepines varies based on the specific medication and the patient’s condition. For example, diazepam is typically prescribed in doses of 2 to 10 mg, up to four times a day. Exceeding this limit can increase the risk of physical dependence, respiratory depression, and other serious benzodiazepine side effects. Always follow the prescribed dosage carefully, especially if you have a history of substance abuse. 

What can I use when I run out of Xanax?

Running out of Xanax (alprazolam) can be dangerous, especially if you’ve been using it regularly. Sudden discontinuation may lead to severe withdrawal symptoms, including anxiety, seizures, and even suicidal ideations. Contact a medical professional immediately for guidance if you’re on a regular schedule for Xanax.

In some cases, they may prescribe a longer-acting benzodiazepine such as diazepam to manage withdrawal symptoms. Beta-blockers can alleviate physical symptoms such as rapid heartbeat or trembling. Do not substitute or stop medications without professional advice.

What is a benzo belly?

Benzo belly refers to the bloating, abdominal discomfort, and digestive issues that can occur during benzodiazepine withdrawal. This condition arises as the body adapts to functioning without the drug, which can affect digestion and lead to prolonged discomfort. 

According to clinical practice, benzo belly is part of the broader withdrawal syndrome that may persist for weeks or even months after discontinuing benzodiazepines. Patients may also experience vivid dreams, fatigue, and other physical symptoms. Managing benzo belly often requires dietary adjustments, hydration, and sometimes medications prescribed by health care professionals to ease the process.

How long does it take to develop a physical dependence on benzodiazepines?

Physical dependence on benzodiazepines can develop within just a few weeks of regular use, depending on the dosage and the specific drug involved. Using benzodiazepines for more than two to four weeks significantly increases the risk of dependence.

Long-term benzodiazepine users are more likely to experience acute withdrawal symptoms such as anxiety, insomnia, and suicidal ideations when they stop the drug. For patients with a history of substance abuse, the risk of developing dependence is even higher, necessitating close supervision and a structured tapering plan to prevent complications.

Which is the most heavily abused drug?

Among prescription medications, benzodiazepines are among the most frequently abused drugs, often in combination with alcohol or opioids. According to the National Institute on Drug Abuse, the abuse of benzodiazepines with alcohol is particularly dangerous because it increases the risk of respiratory depression and drug overdose deaths. 

The widespread prescription for benzodiazepines makes them highly accessible, contributing to their frequent misuse. Individuals with a history of substance abuse are especially vulnerable to developing dependence.

Can you take diazepam for years?

While diazepam is sometimes prescribed for short-term relief of anxiety or muscle spasms, taking it for years is not recommended due to its high risk of dependence. Long-term use can lead to tolerance, meaning higher doses are required to achieve the same effect, which increases the risk of serious side effects like respiratory depression and cognitive impairment. 

Long-term use of benzodiazepines like diazepam should be avoided unless closely supervised because stopping the drug after prolonged use can lead to severe withdrawal symptoms, including suicidal ideations.

Resources

Votaw VR, Geyer R, Rieselbach MM, McHugh RK. The epidemiology of benzodiazepine misuse: A systematic review. Drug Alcohol Depend. 2019 Jul 1;200:95-114. doi: 10.1016/j.drugalcdep.2019.02.033. Epub 2019 May 7. PMID: 31121495; PMCID: PMC6639084.

Junkes, L., Mendlowicz, M. V., Shader, R., & Nardi, A. E. (2024). Leo Sternbach and the benzodiazepines 60 years on: A revolutionary treatment for anxiety disorders. Pharmacological Research, 207, 107310. https://doi.org/10.1016/j.phrs.2024.107310

Brett J, Murnion B. Management of benzodiazepine misuse and dependence. Aust Prescr. 2015 Oct;38(5):152-5. doi: 10.18773/austprescr.2015.055. Epub 2015 Oct 1. PMID: 26648651; PMCID: PMC4657308.

Votaw VR, Geyer R, Rieselbach MM, McHugh RK. The epidemiology of benzodiazepine misuse: A systematic review. Drug Alcohol Depend. 2019 Jul 1;200:95-114. doi: 10.1016/j.drugalcdep.2019.02.033. Epub 2019 May 7. PMID: 31121495; PMCID: PMC6639084.

Schmitz A. Benzodiazepine use, misuse, and abuse: A review. Ment Health Clin. 2016 May 6;6(3):120-126. doi: 10.9740/mhc.2016.05.120. PMID: 29955458; PMCID: PMC6007645.

Zamboni, L., Portoghese, I., Congiu, A., Zandonai, T., Casari, R., Fusina, F., Bertoldi, A., & Lugoboni, F. (2022). Polysubstance Use Patterns Among High Dose Benzodiazepine Users: A Latent Class Analysis and Differences Between Male and Female Use. Frontiers in Psychiatry, 13, 811130. https://doi.org/10.3389/fpsyt.2022.811130

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