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Benzodiazepines, commonly referred to as ‘Benzos’, are prescription-only medications that can be used to treat alcohol withdrawal symptoms.
There are numerous benzodiazepines available for alcohol withdrawal treatment, but they all differ in their potency, the onset of action and duration of effects. Not all are suitable for detoxification.
In this article, we examine the different benzodiazepines available on prescription, their usage and risks and which ones are used in alcohol recovery and the treatment of alcohol use disorders (AUDs)
The most commonly used medication for alcohol detox, benzodiazepines, comes in two main types: Chlordiazepoxide (Librium) and Diazepam (Valium). Both are licensed for the treatment of dependence and are the first line of recommended medical treatment by NICE The National Institute for Health and Care Excellence.
Other benzodiazepines may be used when clinically more appropriate, but it is rare. Both Librium and diazepam have the most effective pharmacological properties concurrent with withdrawal.
The onset of effects, duration of effects and potency of Librium and Diazepam ensure a safe and comfortable detox when medically managed.
If, for medical or personal reasons, you cannot use benzodiazepines for alcohol withdrawal, a different medication may be used as a suitable alternative.
Alternative medications for alcohol withdrawal treatment include Gabapentinoids, Carbamazepine and Clomethiazole.
Alternative medications for alcohol withdrawal carry additional risks and side effects, and they are only ever prescribed within residential settings because of this.
Benzodiazepines are the most common medication used to treat alcohol withdrawal. They work by reducing the symptoms to a safe and manageable level.
Alcohol withdrawal symptoms include:
Alcohol use impacts neurotransmitters within the brain, and the CNS – Central Nervous System go into overdrive, creating several dangerous physical and psychological symptoms. The use of benzodiazepines in alcohol withdrawal is useful for two reasons. Firstly, it is a sedative to soothe your overstimulated system.
Secondly, Benzodiazepines work by increasing the effect of GABA, or gamma-aminobutyric acid, which is a neurotransmitter that sends calming messages to the brain and body. This, in turn, reduces the overactivity of the brain and reduces the symptoms associated with alcohol withdrawal.
Before undergoing a full medical detox or a medically assisted detox, you will have been comprehensively assessed by a doctor or psychiatrist familiar with addiction and the detoxification process. This is essential to ensure that the correct medication, dosage and duration of treatment is prescribed.
If you start using benzodiazepines in alcohol withdrawal, all alcohol use must immediately cease.
Choosing to undergo a detox within one of our treatment centres, you will undergo a full medical detox facilitated by qualified professionals. You will also receive 24/7 monitoring and care throughout the detoxification process. Clinically, this has been proven to be the safest way to detox.
Detoxing using benzos can be a very individual experience. Generally, most people find it a very comfortable way of stopping. You are likely to feel quite drowsy and calm and unable to think clearly and maybe unsteady on your feet. This is why professional treatment is essential to ensure your safety.
During treatment, only light, supportive therapies should be undertaken. Comprehensive treatment should commence immediately after the detox has been completed and the brain fog has lifted. This is when you are most vulnerable to relapse and when therapeutic interventions are of optimum benefit.
Detoxing using medication is not something you should attempt at home alone. There are many risks associated with self-administering a detox for alcohol withdrawal.
The main danger associated with using benzodiazepines to stop alcohol withdrawal is drinking whilst taking the medication. This can very easily lead to overdose, dependence and a dual addiction that is often fatal.
Despite the risks associated with self-medicating, many in desperation turn to the dark web or street dealers to obtain their own medication supply.
If you or a loved one are even considering this as a possibility, please call and speak to our team member at Rehab Guide before making an informed decision.
A detox should ideally be carried out within a CQC registered rehab, where nursing and medical care are on hand 24/7.
Of course, residential rehab isn’t an option for everyone, and it is possible to get a prescription for alcohol detox medication and stay at home. Regarding benzodiazepines, UK doctors in the NHS don’t always offer this for various reasons, including government policies and restrictions. It is possible to get a private prescription for a home detox if you feel this is the best option for you or a loved one. A detox doctor will need to give a consultation on the phone or in person before prescribing benzodiazepines for alcohol withdrawal.
It is crucial to understand that benzodiazepines do not actually treat addiction, and they only deal with the physical aspect of dependence by enabling a safe alcohol withdrawal – when taken exactly as prescribed.
Once a detox has been safely accomplished, a comprehensive rehabilitation programme is vital to treating the underlying causes of addiction and healing and rewiring the brain.
Without intensive rehabilitation using evidence-based treatment methods, a person suffering from addiction, dependence, or alcoholism will be highly susceptible to relapse.
Benzodiazepines are a group of Class C controlled drugs that belong to a family classed as ‘minor tranquillizers’.
There is a vast range of benzodiazepines available on prescription. They are used to treat various conditions experienced during alcohol withdrawal, including seizures, anxiety, panic disorder, sleep disorders and muscle spasms.
They can be administered orally in tablet or liquid form, sublingually under the tongue, intravenously, or by injection.
Short-term use usually provides safe and effective treatment. However, long-term use often leads to tolerance and dependence,
Different benzodiazepines have different uses. Each medication varies in its potency, effects and duration.
Commonly prescribed benzodiazepines include:
| Abuse and misuse can lead to addiction, overdose, coma, respiratory arrest and death. Benzodiazepines are especially dangerous when mixed with other depressant drugs, such as alcohol or opiates. |
Some of the stronger benzodiazepines are used only within a hospital setting for sedation during minor operative procedures or as a premed for calming a patient before surgery. They should be used with extreme caution. For example, Klonopin and Xanax are 20 times stronger than valium (Diazepam).
As well as treating alcohol withdrawal, benzodiazepines can be used to treat both mental health and physical pain conditions involving muscle spasms and seizures. They are also considered highly addictive, have a moderate to high abuse potential, and prolonged use leads to tolerance and dependence.
Thankfully, following a review, there are now tighter guidelines for prescribing and monitoring patients new to treatment. However, this does not help the numerous people who are already dependent on one of these drugs. It has also done little to deter people from abusing them or turning to the internet to purchase their own.
If you plan to undergo alcohol treatment, you could be concerned about any side effects you may experience.
Each different benzodiazepine will have additional side effects and risks, but some side effects are common to all.
Common physical side effects of benzodiazepines include:
Common psychological side effects of benzodiazepines include:
Here at Rehab Guide, we pride ourselves on delivering the latest cutting-edge, highly bespoke, evidence-based addiction treatment.
Our drug detox and alcohol rehabs are staffed by multidisciplinary teams of highly skilled professionals, most of whom are in recovery themselves. We understand addiction as we have been there. We also understand how to effectively treat it in all of the many forms it presents.
From the first time you speak to us, you are guaranteed complete discretion, professionalism and compassion. We will also support your family and loved ones throughout your treatment process.
If you have a problem with alcohol and want help to safely and successfully stop, call and speak to our team of friendly addiction experts today.
References:
Goldberg, Raymond (2009). Drugs Across the Spectrum. Cengage Learning. p. 195. ISBN 9781111782009.
Ncbi.nlm.nih.gov – Benzodiazepine Pharmacology and Central Nervous System–Mediated Effects
National Institue for Health and Care Excellence – NICE – Treatment summary for alcohol dependence https://bnf.nice.org.uk/treatment-summary/alcohol-dependence.html
NHS addictive prescription drug review findings:
Prescribed medicines report https://www.gov.uk/government/publications/prescribed-medicines-review-report
