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For many people who decide it's time to put alcohol addiction in the past, the most complicated and sometimes most unpleasant step of the journey to sobriety is detox and withdrawal. For some, alcohol withdrawal symptoms may be minor. However, for others, primarily those who struggle with a severe or long-term addiction, the process of cleansing your system of the effects of alcohol can be painful, scary, and difficult to accomplish without the help of professionals at an addiction rehab. In the most difficult or most severe cases, withdrawal from alcohol can be fatal.
Addiction treatment professionals at inpatient alcohol rehab centers may turn to specific medications as part of medically assisted therapy programs to reduce the intensity and severity of withdrawal symptoms. The goal of these medications is to help patients safely and successfully manage the difficulties of alcohol withdrawal so they can focus their attention on recovery instead of the discomfort of withdrawal symptoms. Benzodiazepine drugs are a class of medication frequently prescribed as part of medication-assisted therapy.
Benzodiazepines or benzos are drugs that work within the central nervous system to slow down the speed of communication between the brain and body1. Although some medications in the same drug class are naturally derived, meaning they come from ingredients in nature, benzodiazepines are manufactured or "man-made." Although the exact process (or mechanism of action) benzodiazepines use to help slow down communication while increasing the brain's production of chemicals is unknown, it is clear that these drugs are beneficial as part of comprehensive addiction treatment programs.
Using benzodiazepines as part of medically assisted therapy helps slow down the body by reducing blood pressure, slowing your heart, reducing the speed of emotional responses, and helping produce feelings of sedation and relaxation. This state of relaxation helps patients undergoing alcohol withdrawal in various ways but most notably by decreasing the pain and displeasure of withdrawal.
Depending on one's unique relationship with alcohol, the withdrawal process can produce a range of mild, moderate, and severe symptoms. For some, alcohol withdrawal or alcohol withdrawal syndrome can lead to potentially dangerous medical emergencies, including heart palpitations, seizures, and death. For others, unpleasant (but less dangerous) symptoms such as hallucinations, nightmares, vomiting, and body aches and pains may occur.
Medical providers at an inpatient rehab specializing in medically assisted alcohol detox may use benzodiazepines to help reduce the intensity and severity of alcohol withdrawal syndrome2. Depending on the drug, benzodiazepines could help control unpleasant withdrawal symptoms such as irritability, stomach upset, headaches, panic attacks, tremors, and difficulty sleeping, among others. The three benzodiazepines most commonly used to address the symptoms of alcohol withdrawal include Diazepam (Valium), Chlordiazepoxide (Librium), and Lorazepam (Ativan).
Diazepam3, better known as Valium, is a benzodiazepine frequently prescribed to help individuals struggling with anxiety, muscle spasms, or seizure disorders manage their symptoms. Diazepam is also often used as part of medication assisted therapy at an inpatient alcohol rehab. It helps by slowing down the speed of activity in the brain resulting in stress and anxiety reduction. Diazepam is considered a long-acting benzodiazepine, meaning the effects of the drug lasts for several hours, and the drug can still be detected in the system up to 100 hours after your last dose.
Chlordiazepoxide or Librium4 may be one of the oldest benzodiazepine drugs used in addiction treatment. First released to the market in the 1950s, Librium is primarily used to address symptoms related to anxiety disorders and alcohol withdrawal. However, like many other benzodiazepines, Librium is meant mainly to be a short-term course of treatment as long-term use can lead to significant dependency and addiction. The effects of Librium do not last as long as diazepam; therefore, some patients often find themselves taking larger and more frequent doses than prescribed to maintain the effects of the drug.
Lorazepam is marketed under the brand name Ativan5. Within the medical and mental health communities, Ativan is prescribed to treat a range of physical and mental health ailments. However, Ativan is highly addictive and carries a significant potential for abuse, even when used short-term and as directed. For this reason, it is rarely prescribed for periods longer than four months. Similar to diazepam, Ativan is a long-acting benzodiazepine, and its effects continue for many hours after use. Also, like diazepam, it can take up to 100 hours (approximately two days) for the drug to entirely leave your system. Despite its risks, Ativan has proven effective in helping to address painful and complicated symptoms of alcohol withdrawal syndrome.
Despite their benefits, benzodiazepines are drugs that patients should only use under the support and guidance of a trained medical or mental health professional. At an addiction treatment center specializing in medically assisted detox and withdrawal, trained and licensed medical professionals prescribed benzodiazepines to help patients manage their symptoms in safe and healthy ways. However, the choice to prescribe benzodiazepines depends on a variety of factors unique to the individual, including the severity of their addiction, the symptoms they experienced during detox, the treatment setting (inpatient versus outpatient rehab), and the individual's history with addiction in general.
Benzodiazepines used to manage alcohol withdrawal syndrome are prescribed in three ways2. The best method will depend on the individual and their treatment setting. Some types or modes of dosing are better suited for the inpatient environment, whereas others are well suited for both outpatient or inpatient treatment.
When symptom triggered regimen dosing is used, benzodiazepine drugs are provided according to withdrawal symptoms based on withdrawal rating skills. The severity and intensity of symptoms are rated on a fixed schedule, and medications are administered based on the severity of symptoms experienced. Symptom triggered regimen is preferred for most cases of alcohol withdrawal syndrome because patients receive less medication overall, and their treatment duration is inevitably shorter.
Fix tapering dosing involves medication administration at scheduled intervals regardless of the patient's symptom severity at the time. This method of medication administration is best suited for outpatient addiction treatment settings where frequent and comprehensive monitoring is difficult or impossible. Additionally, fixed tapering dosing may be preferred in an inpatient setting where patients' assessments of the severity of their symptoms cannot be accurately relied upon.
Loading dose regimens use the benefits of long-acting benzodiazepines to help manage and reduce the potential for medical complications related to specific withdrawal symptoms such as seizures and delirium.
Medically assisted alcohol withdrawal treatment provides significant benefits to individuals looking to get sober and successfully overcome the challenges of alcohol use disorders. Research has shown that completing an addiction treatment program is a critical first step on the road to lasting sobriety. However, it is not uncommon for people who enter an inpatient addiction treatment facility to struggle through the early stages of detox. This can lead to challenges finishing the detox process and inevitably difficulties successfully completing an entire course of addiction treatment. Choosing an alcohol rehab that specializes in medically assisted detox and medically assisted therapy can help ensure the greatest opportunities for safely and successfully achieving and maintaining lasting sobriety.
Benzodiazepines as part of alcohol use treatment, provide medical and addiction treatment providers with a broad range of potential treatment options. There are many types of benzodiazepines, with the three listed above being the most commonly seen as part of addiction treatment programs. The benefit of having a broad range of treatment options is that it allows treatment providers to choose the best course of treatment for each individual seeking help to address their symptoms. This level of flexibility will enable providers to continue to provide individualized comprehensive treatment designed to address each patient's unique treatment needs and goals.
Additionally, benzodiazepines as part of a medically assisted therapy program help reduce the intensity and severity of acute and persistent alcohol withdrawal symptoms. They are especially beneficial and help address potentially severe medical symptoms such as seizures and unpleasant withdrawal symptoms such as body aches and pains. Using benzodiazepines as part of an alcohol use treatment program allows patients the opportunity to safely and successfully withdraw from alcohol by helping them manage the most intense and unpleasant symptoms in a safe and supported therapeutic environment. When used as directed for short-term therapeutic programs, benzodiazepines can help you manage the withdrawal symptoms while focusing on putting the physical and psychological effects of alcohol addiction in the past.
Despite the benefits of benzoxepines as part of a medically assisted treatment program, there are drawbacks of using benzodiazepines as well. Different benzodiazepines produce different side effects depending on the individual and their unique detox process. Symptoms can range from mild to severe, and some of the side effects of benzodiazepine use also mirror those of alcohol withdrawal syndrome. This close relationship can make it difficult for patients and their treatment providers to determine the root cause of side effects and symptoms.
It is also essential to remember that although benzodiazepines are prescribed to help people overcome addiction, they are addictive medications as well. Even when used as prescribed, benzodiazepines have a high potential for dependency and addiction. Because benzodiazepines carry an elevated risk for dependence and addiction, they are classified as controlled substances which means they can only be obtained by prescription from a licensed medical provider. It is essential to follow their dosing recommendations and only take them for as long as they were prescribed as part of your treatment program. These drugs are only meant to be used for short-term symptom management, and long-term use increases your risk for dependency and addiction. Additionally, it is essential to taper off or reduce your dose as prescribed by your treatment professional. Suddenly stopping benzodiazepine drugs can lead to severe, potentially fatal withdrawal symptoms.
Benzodiazepines are a first line medication used in medically assisted detox and treatment programs. However, it is vital to note that despite their benefits, the use of benzodiazepines is not without risk. Therefore, it is vital to talk to your addiction treatment provider about the benefits and the risks of benzodiazepines to determine if their use as part of your individualized treatment program can help you meet your treatment needs and goals.
Detox from alcohol can produce a wide range of symptoms ranging from mild to potentially life-threatening. The symptoms you experience when looking to get and stay sober from alcohol will vary depending on factors related to your addiction. If you have struggled with a long-term addiction to alcohol or your drinking is severe, your withdrawal symptoms may also be notably more difficult to manage than someone with a mild alcohol use disorder. That said, participating in a medically assisted therapy program where benzodiazepines are used to help manage and reduce the intensity of your symptoms may be beneficial in helping you safely and successfully overcome alcohol once and for all. Again, the highly skilled treatment team at an inpatient alcohol rehab can help you decide how benzodiazepine's fit into your treatment program.
There are many treatment programs in the United States and likely many close to you. However, not all rehabs provide the same level of care or the same treatment models. Therefore, some rehabs may not offer medically assisted therapy or medically assisted detox. It is important to find a program where the therapy models, types of treatment, and level of care are suitable to help you safely overcome addiction. If you have started researching programs online, you may have noticed there are many available, and the research process can quickly become complex and confusing.