Research Explores the Experience of Benzodiazepine Withdrawal

A new study reveals many benzodiazepine users are misinformed about the risks of withdrawal and experience devastating consequences.

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In a new article published in Therapeutic Advances in Psychopharmacology, Alistair J. Reid Finlayson and his colleagues explore benzodiazepine use, tapering, and discontinuation.

The authors collected data using an internet survey of 1207 participants. The service users reported numerous adverse effects of using and discontinuing benzodiazepine (colloquially, benzos), including anxiety and uncontrollable anger. Between 80% and 90% of respondents said that these negative effects caused problems with work, social interactions, and freetime/hobbies. 76% of the respondents reported they had never been told that benzos should only be prescribed for short-term use or informed about the risk for physical dependence and harm.

The authors write:

“The trajectory of those who taper or discontinue benzodiazepines is unpredictable, and many patients experience a range of protracted and severe symptoms, even years after benzodiazepines were completely discontinued. Greater awareness is needed for both prescribers and patients about the potential for a difficult withdrawal from benzodiazepines.”

Research has linked long-term benzo use to cognitive impairment. People using benzos for greater than one year have shown deficits in working memory, processing speed, recent memory, visuoconstruction, and expressive language. These deficits may exist when people are actively using the drug, withdrawing from it, and for up to 3 and a half years after discontinued use.

Although benzos are indicated only for short-term use due to their potential for physical dependence and other adverse effects, most of the 100 million prescriptions written each year are for long-term use. This results in what some authors have called “iatrogenic dependence,” a harm caused by medical treatment and service provider incompetence.

Benzos’ potential for causing physical dependence is so pronounced that the Food and Drug Administration (FDA) in the United States issued a statement in 2020 warning of the potential for benzo harm and requiring an updated “boxed warning” about that potential.

The FDA was first presented with the problems surrounding benzos in 2010 when thousands of service users and concerned professionals signed a citizen’s petition to better inform the public of the dangers of benzos. Unfortunately, the FDA addressed the petition in 2015 with refusal and complete denial.

However, a 2020 study released by the FDA showed enough overwhelming evidence for benzos’ potential for harm that the regulatory agency was forced to change its position publicly. The FDA now acknowledges that physical dependence can result from taking benzos for just a few days even when taking benzos as prescribed, that stopping abruptly can be life-threatening, and that the prescription guidelines for benzos do not adequately appreciate their potential for harm.

The current research seeks to understand better the effects of benzo use, tapering, and discontinuation. Citing the FDA 2020 statement reversing their stance on the dangers of benzos and the “boxed warning” added to the drug, the authors assert that psychiatry has a tenuous grasp on the effects of benzos and benzo discontinuation. The current research is an effort to fill this gap in knowledge.

The authors developed a 19-question survey including questions about demographics, benzo use, symptoms, and outcomes. The survey was administered across several large websites related to benzo use, including Facebook and Reddit. The survey was anonymous with safeguards to ensure no more than one response per IP address.

One thousand two hundred seven people completed the survey and were included in the current analysis. The respondents were overwhelmingly female (71%), with many (55.9%) taking benzos together with other drugs, such as antidepressants or antipsychotics. 98.6% of the respondents reported having a current prescription for benzos. 68.4% reported that they took their benzo as prescribed, 22% said they took their benzo mainly as prescribed, and 8.7% reported they did not take the medication as prescribed.

63.2% of respondents had discontinued benzo use, 24.4% were tapering their doses down, and 11.3% were actively taking their full dose. The majority of respondents experienced adverse effects while using, tapering, and after discontinuing benzos, with some symptoms (low energy, anxiety, difficulty focusing, memory loss, etc.) persisting for years.

The majority of respondents (76.2%) reported that healthcare professionals “definitely did not” tell them that benzos should only be used for short periods (2-4 weeks according to the FDA) and that discontinuation may be difficult. An additional 5.6% reported that they were “probably not” warned about these dangers.

Use and withdrawal from benzos were associated with numerous adverse life events. More than half of respondents reported significant negative impacts on their marriage and other relationships (56.8%) and suicidal thoughts or attempts (54.4%) due to their use and discontinuation of these drugs. In addition, 46.8% reported being fired from a job or becoming unable to work. 40.9% experienced significantly increased medical costs.

Benzo withdrawal caused many problems for the respondents in their personal and professional lives. 49.1% reported “enormous” problems with their work-life due to benzo withdrawal, with an additional 19.3% reporting “severe” or worse benzo-related work issues. 48% had “enormous” problems with recreation and hobbies, with an additional 25.6% classifying their struggles as “severe” or worse.

More than half of respondents also reported “severe” or worse problems with social interactions, their ability to take care of their home, and their relationships with their spouse and family. 47.3% reported severe or worse problems with their ability to walk and drive.

Many of the respondents left comments on the survey that the authors sorted into several common complaints. For example, many patients remarked on the difficulty of withdrawing from benzos. One participant wrote:

“If I could think of the one worst possible thing you could do to a person, it would be benzo withdrawal. Beats cancer and Alzheimer’s combined. If I could make it go away by chopping my arms and legs off, I would!”

Many respondents experienced poor treatment by medical professionals, with some saying their doctors outright lied to them by saying overdose and dependence were impossible on benzos. According to the participants’ comments, options to discontinue or taper benzo use were also limited.

The authors conclude:

“This survey is an initial step to better recognition of the risks of benzodiazepine therapy and the awareness that withdrawal symptoms may be more varied, more severe, and more prolonged than are presented in the literature or product labeling. Benzodiazepine withdrawal symptoms are more common than most clinicians realize.”

 

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Reid Finlayson, A. J., Macoubrie, J., Huff, C., Foster, D., & Martin, P. R. (2022). Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey. Therapeutic Advances in Psychopharmacology, 12, 204512532210823. https://doi.org/10.1177/20451253221082386 (Link)

6 COMMENTS

  1. “Another limitation of our survey is that it recruited respondents from social media and online sources that deal with benzodiazepine use and withdrawal. Respondents were self-selected, forming a convenience sample that may not repre-sent the population of benzodiazepine users as a whole because visitors may have sought sites such as these specifically because they have experienced problems. Moreover, those who use the Internet for health information tend to be younger,22 and those who join online support groups for medical conditions tend to be in generally worse health.23 Our results thus may not be generalizable to the population of all people taking benzodiazepines”

    In other words? Absolute junk science. We’d be savaging the study design if it was used to describe SSRI efficacy, and rightly so.

    This publication also seems like an outline for pro-pharma groups that have a vested interest in promoting ‘novel’ new ‘antidepressants’ and slamming older and safer– though still problematic– medications. (I didn’t read the articles, I need to keep my blood pressure down, just looked at their headlines.)

    Also: “The study was granted an exemption from requiring written informed consent from respondents.”

    Also: “The Alliance for Benzodiazepine Best Practices has paid for the services of a medical writer and associated article publication costs.”

    Check out the “alliance.” Does it seem like a legitimate advocacy organization for patients?

    Can’t be sure, but I have my doubts.

    • Yes, it looks like a fishy group, of which there are many.
      I just know that, after long-term antidepressant and benzo use – prescribed by a psychiatrist who told me I would “always” have depression – getting off was close to hell. But – in the end – it was all worth it, as now I know that, whatever my reactions to life happen to me, they are genuinely mine, unfiltered through the lens of a pharmaceutical haze.

  2. I have the most fun with my angels, or they do me. They are like older siblings who send a junior, such as myself, out to buy cigarettes. Buy this metaphor I mean I am so enamoured with them that I do as I am told. Without question. So sometimes they send me off on a wild goose chase to chat to someone about something topical. I tell the angel I cannot say that. Then they tell me it will be fine because the person really likes me immensely.
    This has me bowled over in astonishment. So I then eagerly agree to go speak to whomever it is they want me to. But over the years, on numerous occasions, it later turned out that the person could not tolerate me. They really found me beneath their contempt. Yet the angels sent me specifically to that person. Again and again. I would get sad at never getting a warm response from the person, given that I was told by the angels that the person thought me charming. Eventually the angels would do a reveal and declare that person thought me deranged. Surprisingly I often fell about laughing at such a prank. But I never lost my faith that the angels were just spreading peace and harmony to others.

    Am I meant to mention benzos? I have used them years ago.

    I sometimes feel that everyone has two guides or angels in their life. They are just like their staff in a school yard, making sure their person does not keel over or get up to mischief of a damaging sort.

    BUT….
    because your freedom of choice is so holy then your choices are to be revered even by angels. Even your stupid choices come first. Angels are not allowed to overly influence you or live your life for you. But I find it funny in comments sections when I get tetchy about reading someone’s political statement and want to reduce it to rubble and want to be “right about my views”, but I pause and wonder if my fellow commenter has two angels who want to yell at me…
    “Please do not utter what you are about type to since our person is having a really rough day”.
    To which my angels may answer those angels with…
    “Well our person here is determined to say it and we cannot stop her but she will learn through saying it that being “right” is not satisfying”.

    I have grown accustomed to regarding life in this way, about my impact, not on the person I read of, but on the way my actions might impact their two angels who in their background and are trying to hold that person together in a round about way.

    This has had a good effect on me, sensing this. I am not so shouty these days. But it would have been better had I got to that state without any notion of angels but simply because I myself could see “the other” needed held together.

    I don’t know where my angels will send me for cigarettes next, but I hope it is a place with people of sincerity as I have come to know here. I have learned a lot about my flaws here, my lack of patience, my meanness, my arguementativeness. It is easy to talk about the heart when I don’t have one.

    I am leaving… in a humble appreciation of peoples willingness to meet me in the raw and with deep feeling and intelligence.

    (The angels are saying “skip that bit”……to which I shove their jocular pranking away).

  3. No matter what alleged “study” they attempt to do or maybe concoct on “benzo withdrawal” these so-called researchers conveniently forget that most “patients” are prescribed more than just the “benzos.” Usually, the “patient” is also receiving an anti-depressant, even a neuroleptic, or perhaps a drug like lithium, also. Two of the psychiatrists I had prescribed me “benzos” first klonopin and then a new psychiatrist abruptly changed it to Xanax because in their opinion “benzos” would counter the side effects of the “neuroleptics” of which I was first prescribed Risperdal, then switched to abilify and when I had the side effect from ability of being unable to swallow, I was switched back to Risperdal. One more point is that during this time I was prescribed other drugs while taking the drugs I just listed, but I have little to no memory of each and every drug prescribed me. I know this is a long way around to get to the point that the people who constructed this study seem to have no realization of what’s actually going on in the “psych drug world.” Thank you

  4. All week my angels have been nudging my coffee drinking elbow by uttering the words…

    “Lex Talionis”.

    I had to look that up as it is in Latin. Although I did my degree in Divinity I took the non Latin learning runway of scholarship. Ever the truant.

    Today I read that “Lex Talionis” means the concept of justice that refers to an eye for an eye, a tooth for a tooth.
    What is meant by this saying is not…
    “Someone just hit me therefore I have a right to slam them into a wall”.
    It is not a divine “thumbs up” for revenge.

    What the phrase means is justice ought to be ONLY an eye, if an eye was affected, or ONLY a tooth if a tooth was affected.

    Justice ought to be proportionate. Blame should not be a massive mile long net. A dragnet from a trawler ship dragging in every crustacean and accusation of wrong that has ever occurred in the lifetime of the plaintiff. It ought to not be a laborious “hauling in”, as proof of every misdemeanor that has ever occurred to someone in a lifetime. Blameworthy stuff that was possibly done unknowingly by a cast of hundreds.

    In this Era of Bullying one of the techniques a bully may use is mimicking victim talk. But confusing bullies can also get spiffing in lambasting some poor victim’s actual “victim talk” as if it is “illogical” or as if the victim is a “Liar”.

    But mostly when a bully performs “victim talk” it involves heavy emphasis on relentless blaming. A bully may blame a great many people because no bully is happy deep down. No one who is woodenly out of touch with their lively feelings is ever joyful or calm. Because a bully cannot access the calm and caring that comes from living in acceptance of emotions. A bully uncalmly decides that an eye for an eye is not good enough. They want it ALL. They want the punishment to be of the order that whole world crouches quivering and quaking in sorry apology. But even after that, the bully wants those people, hundeds, thousands of individuals, people that the bully may not even have met, to change. So soon all the “others” are to change who they are and how they speak and how they dress and when they eat and sleep.

    This is not “Lex Talionis”.

    A world that does not do proportionate justice is a nightmare world. Vengeance is not healing. It is merely an extention of the thrashing activity of the injury.

    Injuries need calm to heal them. Calm comes from accepting every feeling. Even the feeling of loss, once accepted fully instills calm.

    From calm can arise the striving for the gracious balance restorer of proportionate justice and compensation.

    In a furious world with a metaphorically smashed fingertip it wants more than “lex talionis”. It wants judgement to be a total annihilation of another desperate human being. Amber takes a moment to form in an apocalyptic conflagration and thousands of years to appreciate the pure, clearness of.

  5. As appealing as it is to pile on ANY article describing benzos as the extremely dangerous & ubiquitous class of drugs they are, I gotta agree with another Commenter who views this ‘study’ with suspicion.
    Over 90 million users and a 1207 sample of self-responding reporters (THEIR descriptor) from social….nah, there are more legitimate studies that underscore the horrors of these pills.

    My battle-tested radar was pricked. I completely trust my ‘gut’; a decade of carefully documented (mine AND their’s) records, memories of the body & soul hell that activate when tapped, & the relentless Trojan horse messaging by the enemy-psychiatry…& their owners-pharma.
    Nope.

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