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Frequently Asked Questions
| Q |
If benzodiazepine withdrawal is so difficult, why don’t I just stay on my pills? |
| A |
When benzodiazepines are used for sleep they lose their effectiveness after 2 weeks and if used for anxiety, after a few months. You would be taking a drug with little or no therapeutic value.
The more drugs a person takes, the greater the chance of drug interactions. This is particularly relevant for older people, who may be taking a number of medications for different conditions.
Not everyone experiences a difficult withdrawal from benzodiazepines - it varies greatly from person to person. Many people dependent on benzodiazepines experience withdrawal symptoms while they are still taking the pills. They have nothing to lose and everything to gain by slowly coming off the pills. |
| Q |
Do some people have to take benzodiazepines long term for medical reasons? |
| A |
There are some rare medical situations where a person and their doctor might decide that the benefits of taking benzodiazepines long term outweigh the risks associated with the use of these drugs. The risk of dependency would be minimised by taking the benzodiazepines infrequently if this is possible. |
| Q |
I have been off all benzodiazepines for six months, yet still feel really unwell. Could I still have withdrawal after all this time? |
| A |
Benzodiazepine withdrawal can last for a long time if a person has been taking the drugs for a number of years. |
| Q |
Are there any other medications I can take to relieve the benzodiazepine withdrawal symptoms? |
| A |
Basically, no other drugs will stop the withdrawal symptoms. Adjunctive drugs can be used for specific withdrawal symptoms, such as pain relievers, anti-depressants or anti-nausea agents. (Flumazenil is a drug which reverses the effects of benzodiazepines, however its use is only by intravenous injection in a hospital situation to reverse the effects of benzodiazepine overdose.) |
| Q |
Can I stop the benzodiazepines straight away? |
| A |
It is dangerous to come off the benzodiazepines suddenly (cold turkey). There can be the risk of having a withdrawal fit. Usually people are so overwhelmed by withdrawal symptoms they start taking benzodiazepines again, consequently feeling a failure and with an unnecessarily bad experience of withdrawal. Some people say that they haven’t got the patience to cut down slowly. If this is the case, it is safest to go into a residential Drug Withdrawal Unit to come off, where medical supervision is available. |
| Q |
How long will withdrawal last? |
| A |
The $64 dollar question! The length of withdrawal varies from person to person and is difficult to predict. As a general rule, the longer the person has been taking the benzodiazepines, the more likely it is that they will experience a long withdrawal period. Withdrawal symptoms can last for weeks or months and, for a small but significant number of people who have been taking benzodiazepines for quite a long time, years. |
| Q |
I feel really incredibly sick after starting to cut down my pills - can this really be withdrawal from one little pill? |
| A |
The intensity and severity of the benzodiazepine withdrawal often takes people by surprise. It has often been stated that the withdrawal is worse than heroin withdrawal – and this by people who know! Not everyone will experience severe withdrawal but it can be very painful and protracted. |
| Q |
I have been getting my scripts regularly from the same practitioner and have never been warned of the risk of dependency. Why wasn’t I told? |
| A |
According to the benzodiazepine prescribing guidelines from the RACGP(Royal Australian College of General Practitioners), all patients who are started on benzodiazepines should be warned of the risks and advised of safe and appropriate use. It may be that because the benzodiazepines are relatively well tolerated initially that the risks are underestimated by some GP’s. Medicines Information is usually included in the package in Australia and this should state the risk of dependency with long term use. |
| Q |
I am only taking a very small dose of benzodiazepine every day – could I be dependent on this small amount? |
| A |
The development of dependency is not related to the amount taken, but rather the regularity with which it is taken. Taking even a small amount every day for longer than a few weeks or months can mean you will have withdrawal symptoms when you cut down or stop. Not everyone develops tolerance to benzodiazepines(needing more to have the same effect) and this has often meant the dependency is not recognised. |
| Q |
What is safe and appropriate use of the benzodiazepines? |
| A |
The benzodiazepines are safe to use occasionally or intermittently; or every day for no more than a few weeks at a time. The benzodiazepines are useful drugs for a number of medical procedures and as an anaesthetic. The drugs can also be useful for severe anxiety while the person seeks longer term assistance, or short term in a crisis. (Use of the benzodiazepines in a crisis can be controversial because of the effects of the drugs on emotions and memory. Many people prescribed them following the death of a family member or friend, for example, have felt cheated if they have not been able to remember the details of the funeral.) |
| Q |
I am still having quite bad symptoms 3 months after my last benzodiazepine dose. I have been told by my doctor that the drug would be out of my system by now and I therefore couldn’t still be having withdrawal. Is this true? |
| A |
Drug withdrawal is not related to the amount of drug circulating in the blood stream. The symptoms are as a result of the changes in the brain cells in response to the presence of the drug, and the resultant changes in brain chemistry when the drug is no longer present. In the case of the benzodiazepines, the drugs have a “dampening down” effect, and when removed, the excitatory brain activity is over active. |
| Q |
Can I ever use benzodiazepines again without becoming dependent? |
| A |
If you use benzodiazepines according to the “safe use” principles, that is, intermittently or for no more than a few weeks, there is no reason you should become dependent on them. |
| Q |
I have recently come off benzodiazepines after using them for a number of years. I need to have an operation and am scared that if I am given benzodiazepines I will “kick-start” the withdrawal symptoms again. What can I do? |
| A |
There is no reason why one or two doses of benzodiazepine following a previous dependency and withdrawal period should initiate withdrawal, as withdrawal is caused by the adaptation of brain cells to the presence of a drug. The brain cells will not change in response to one or two doses. |
| Q |
How can I cope with my sleep problems if I don’t use benzodiazepines? |
| A |
Benzodiazepines do not really help sleep problems that have existed for any length of time. The benzodiazepines do not treat the cause of the sleep problem, and long term use of benzodiazepines actually worsens the quality of sleep.
See The Better Sleep Booklet in Resources for information on achieving a restful night’s sleep. |
| Q |
How can I cope with my anxiety if I don’t use benzodiazepines? |
| A |
Benzodiazepines relieve the symptoms of anxiety only and do not change the causes or improve your ability to cope with anxiety. For long standing anxiety, specific counselling therapies such as Cognitive Behavioural Therapy (CBT) work extremely well and do not have the risk of dependency. | | |
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