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Benzodiazepine Treatment & Rehab Explained

Table of Contents

Benzodiazepines are some of the most commonly prescribed medications in the UK, providing genuinely life-changing relief to a large number of Britons each year. However, these drugs are also known to pose a significant risk of abuse, and are also strongly habit-forming, with benzodiazepine addiction and dependence now affecting hundreds of thousands of people in this country alone.

Understanding Benzodiazepine Addiction and Rehab Treatment Options

Benzodiazepines are a class of drugs used primarily in the treatment of anxiety disorders, insomnia, seizures, agitation, muscle spasms, and alcohol (and other) withdrawal syndrome. Benzodiazepines increase the efficacy of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain and central nervous system (CNS), giving them sedative, hypnotic, anticonvulsant, anxiolytic and muscle-relaxant properties; however, the effects of benzodiazepines, especially at higher doses, can also include the manifestation of a euphoric “high” which, alongside their frequently pleasurable sedative effects, can make benzodiazepines sought-after by recreational users of intoxicating substances.

Benzodiazepines were discovered accidentally in the 1950s, but once their properties became apparent were brought to market as “minor tranquilisers”, intended as safer replacements for drugs in the barbiturates class (which, it had become clear, posed numerous dangers including the potential for addiction and the risk of fatal overdose). However, as different benzodiazepines were developed and marketed, their own associated risks emerged: though still considered safer and less problematic than barbiturates, benzodiazepines are now known also to be habit-forming, and to pose a risk of overdose.

Many different types and brands of benzodiazepines are available in the UK, both officially via prescription and illicitly. Although the effects and half-life of each particular drug may vary – certain benzodiazepines are only prescribed in the treatment of certain conditions, and some may be much longer-lasting than others – generally speaking they are the same in terms of the dangers they pose, including risks to physical and mental health. As a result, benzodiazepines are classed together under the Misuse of Drugs Act 1971, according to which they are categorised as class-C controlled substances, available to possess only with a valid prescription: unlawful possession and supply of benzodiazepines can result in sentences of up to five years’ imprisonment and an unlimited fine, and up to 14 years’ imprisonment and an unlimited fine, respectively.

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When provided medically, benzodiazepines are usually given in tablet or capsule form for oral consumption, but may also be administered via intravenous or intramuscular injection, sublingual patches, mouth spray, or rectally or vaginally. When used and abused recreationally, benzodiazepine tablets are sometimes ground up and snorted (insufflated), or even injected at significant risk to the user. These methods greatly increase the likelihood that a user will go on to develop an addiction – though it should be borne in mind that anyone using benzodiazepines over time, no matter the route of administration, is at risk of addiction and dependence.

Addiction of any kind is, effectively, a disorder of the brain’s reward centres (especially those found in parts of the brain known as the amygdala and the ventral tegmental area). A person engaging in a particular rewarding behaviour (such as taking benzodiazepines and experiencing their effects) over time may come to associate that behaviour with positive feelings and sensations thanks to the release of neurochemicals including dopamine (associated with feelings of pleasure and reward) which the behaviour prompts.

As time passes, the reward system adjusts to the frequency of exposure to the behaviour in question, making dopamine release more and more contingent upon the behaviour’s being engaged in – and the affected individual thus feels compelled to repeat the behaviour in order to achieve the desired positive sensations and emotions, and also to stave off the negative feelings which result from a dopamine deficiency when the behaviour is avoided. When a person feels an overwhelming compulsion to repeat the behaviour in question even though they may be aware of various negative consequences of doing so, the phenomenon is known as addiction.

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Addiction is related to, but distinct from, the phenomena of dependence and tolerance (with which it is nevertheless often confused). Tolerance occurs when someone taking a substance over time becomes used to certain levels of that substance in their system, and subsequently needs to take more and more of the substance to achieve the desired effects which they would originally have experienced at lower doses.

Dependence is similarly a consequence of the adjustment of a person’s system to the presence of a certain substance, though in the case of dependence the individual becomes reliant upon that presence in order to function normally; if the substance is withdrawn from the system suddenly (ie, if a benzodiazepine-dependent person stops taking benzodiazepines) various unpleasant and potentially dangerous symptoms may manifest (collectively known as withdrawal syndrome), until the affected person’s system can renormalise over time (achieve homeostasis).

In the case of benzodiazepines specifically, there is also an increase in dopamine levels caused directly by the drugs’ effects on the brain, which reinforces the mechanism by which addiction develops by exacerbating the impact of dopamine’s presence, and subsequent absence, when benzodiazepines are consumed and not consumed respectively.

Benzodiazepines are known both to be psychologically addictive and to possess a noteworthy physical dependence liability; indeed, withdrawal from benzodiazepine dependence usually gives rise to a number of unpleasant physical withdrawal symptoms, and sometimes to symptoms that can be extremely dangerous: along with alcohol and barbiturates, benzodiazepines are usually considered the most dangerous class of drugs in terms of the risks associated with withdrawal specifically.

As well as the direct risk of death from seizures, cardiorespiratory collapse and other symptoms, benzodiazepine withdrawal can also be dangerous in that it can cause profound depression and, occasionally, suicidal ideation: some users can be so debilitated and depressed by benzodiazepine withdrawal that they can resort to suicide in an attempt to escape the condition. Furthermore, previously benzodiazepine-tolerant individuals who go through a period of withdrawal but who subsequently relapse place themselves at a greatly enhanced risk of death from overdose: in relapse, they may consume doses of benzodiazepines to which they were previously tolerant but which may now be too great for their systems to handle safely and effectively.

Because of these various dangers, benzodiazepine addiction and dependence are considered very dangerous conditions, and it is imperative that if you are struggling with benzodiazepine dependence you do not attempt to go through detoxification and withdrawal independently without medical support and assistance: doing so could kill you. Always speak with your GP and/or an addiction specialist about safe treatment options for benzodiazepine dependence and addiction.

One silver lining to the proliferation of benzodiazepine abuse and addiction currently affecting the UK has been the emergence of various high-quality treatment centres, both public and private, which now operate across the country and which have significant experience in the treatment of benzodiazepine addiction. Numerous different approaches to treatment are deployed, but their aims are generally the same: to defeat the immediate pressures of dependence and to prepare the addict for a sober, abstinent and happy life after treatment.

Many treatment organisations offer residential rehabilitation (rehab) programmes; rehab is typically considered to be the most effective approach to treating addiction of any kind, and thousands of people now live healthy and successful lives having gone through addiction treatment in rehab.

What to Expect from Treatment

Every individual’s journey through addiction is unique, and so too is every process of recovery; while various commonalities exist across mainstream addiction treatment programmes, treatment itself needs to be highly personalised because of the many different requirements of individual addicts and because of the need to adapt treatment programmes to unforeseen developments, different paces of progress – as well as because every treatment facility may have its own operating philosophy and pressures.

However, though any one universal “roadmap” for addiction treatment may be impossible to compile, a rough guide to what to expect in rehab may be provided.

Addiction screening and assessment

Having entered rehab, the first part of your treatment will be a comprehensive physical and psychological assessment carried out by medical staff so they can get as full as possible a picture of your condition and of the severity and duration of your addiction. A holistic addiction treatment plan will be drawn up in response to this assessment, including a phased treatment structure and various targets; this will become the “framework” for your treatment during the rest of your stay in rehab.

Benzodiazepine detox

Detoxification (detox) is a vital aspect of addiction treatment as it cleanses your system of all substances of abuse (including benzodiazepines), defeating the immediate challenges posed by dependence and ensuring full abstinence and sobriety for subsequent phases of treatment (no treatment can hope to be successful if the client continues to wrestle with substance abuse and intoxication).

While there is no pharmaceutical “cure” for benzodiazepine addiction, some medications may be prescribed to alleviate certain problematic symptoms of withdrawal (in particular, depression and anxiety), some of which may be given right at the start of your stay in rehab depending on the outcome of your health assessment.

Behavioural therapy

If detox (whether with or without the help of medication) can be thought of as treating an addict’s body, therapy very much addresses problems of the mind. Therapy is the foundation of all addiction treatment, as it reveals and tackles the underlying psychological causes of substance abuse and addiction and allows addicts to learn about and remediate the negative thinking and behaviour which has led to the development of addiction.

A very wide range of therapy models and methodologies may be found in the treatment of addiction, but practicalities limit the variety of approaches which can be provided in any given treatment facility. If you believe you would benefit from any particular therapeutic approach, contact an addiction specialist to find out about treatment facilities where that approach is provided.

Addiction education

One aspect of addiction treatment which is often undervalued is addiction education. Understanding the true nature of substance abuse and addiction can have an extremely positive impact in terms of helping addicts to develop healthier, more reasonable and more positive outlooks on life, as well as a better comprehension of the damage their addiction has done to themselves and others – and will continue to do, unless they can successfully complete treatment and enter recovery.

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Many addicts – even those who have been wrestling with addiction for years – do not fully understand the effects of long-term substance abuse on their physical and mental health, their relationships, and their life prospects, and gaining that understanding can often be impossible from within the throes of addiction; treatment, and addiction education in particular, can enable the emergence of different perspectives which can help addicts view and analyse their actions in a very different and more productive light.

Follow up and aftercare (to avoid relapse)

An addict’s recovery is not complete when they walk out of rehab at the end of treatment; instead, recovery should be seen as a long-term (possibly lifelong) process requiring constant diligence and devotion if a return to addiction is to be avoided. In order to create the soundest possible footing for addicts moving into the recovery phase, high-quality rehabs usually provide up to a year’s free aftercare following the conclusion of a treatment programme. Aftercare can consist of various elements, typically including the creation of an appointment calendar so that treatment professionals can monitor progress and, if necessary, intervene; ongoing medicinal prescriptions; a commitment to participate in individual therapy and/or support group meetings; and more. Each aftercare programme is bespoke to each client and will reflect the specific gains that client has made during therapy and other parts of their treatment programme.

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Dual Diagnosis in Benzodiazepine Addiction Treatment and Rehab

When a substance use disorder occurs alongside one or more other mental health disorders, the condition is known as dual diagnosis. The relationship between substance abuse and mental health issues is quite profound: people suffering from poor mental health frequently self-medicate or seek escapism through the use of substances of abuse, whilst those substances can also cause mental health problems, either as a result of the direct impact of the substances in question upon the brain, or because of the deleterious impact of addiction upon life circumstances and general well-being.

Dual diagnosis is especially common in cases of benzodiazepine addiction, since benzodiazepines are commonly used in the treatment of some mental health problems, and their use frequently becomes abuse. Because dual diagnosis can make the treatment of addiction significantly more complex – as both the substance use disorder and any other mental health disorder need to be treated simultaneously, and their respective treatments could interfere with each other – specialist care is typically required.

Medication used for Benzodiazepine Addiction Treatment and Rehab

As yet, there is no pharmaceutical cure for benzodiazepine addiction. However, medication is used in the treatment of benzodiazepine addiction – in particular, during withdrawal, to alleviate (at least partially) the most problematic symptoms of withdrawal. For example, antidepressants may be prescribed to deal with depression (though which antidepressants specifically will depend on a doctor’s assessment, as some can interact dangerously with benzodiazepines) while anxiolytics can be prescribed to treat anxiety. If withdrawal symptoms arise which appear dangerous, other medications may be prescribed at a doctor’s discretion.

Pros and cons of using medication in benzodiazepine addiction treatment and rehab

Where possible, most doctors prefer to avoid prescribing medication, opting where practical for nonpharmaceutical treatment. Nevertheless, benzodiazepine withdrawal can be extremely problematic and very dangerous, requiring urgent pharmaceutical care – and even in less serious instances of withdrawal, medication can still make life much less distressing and uncomfortable for the addict.

Medication does come at a cost – which is, however, typically included in the overall rehab fee – and some medications potentially used in the treatment of benzodiazepine addiction can cause extremely undesirable side-effects. Because of this, it is imperative that you do not try to self-medicate if you are contemplating going through benzodiazepine withdrawal: always consult a doctor, and only ever take medicines which have been given to you according to a valid prescription by qualified doctor.

Medication replacement programmes for benzodiazepine addiction treatment

The treatment of some substance use disorders involves the use of replacement medications – i.e., substituting safer, legal medications for more problematic, more dangerous and often illegal drugs; this makes monitoring and managing intake significantly easier and makes life much less dangerous for the addict and treatment. In the case of benzodiazepine addiction, medication replacement programmes are not typically highly effective since benzodiazepines have very similar effects, though doctors may seek to replace a shorter-acting benzodiazepine with one with a longer half-life to reduce dosages and the frequency of abuse.

Duration of Benzodiazepine Addiction Rehabilitation

How long someone stays in rehab receiving treatment for benzodiazepine addiction depends on a variety of factors, including their personal circumstances, their physical and mental condition, the duration and intensity of their addiction, and how well they respond to treatment. Typically, a stay in rehab last between one and three months – however, both shorter and more intensive, and longer, programmes may be provided at certain facilities.

Benzodiazepine Addiction Treatment and Rehab Success Rate

It is difficult to give an accurate assessment of how successful or not rehabs are, as many addicts do not stay in touch with their treatment facilities long after the end of treatment, and thus do not report back on success or failure.

In 2012, the NHS’ National Treatment Agency for Substance Misuse published a report which estimated the success rates attained by the top-performing private addiction treatment facilities in Britain ranged between 60 and 80% (in terms of clients who have completed treatment and have remained abstinent five years later). At the other end of the scale, the worst performing facilities were unable to claim success rates of above 20%.

Twelve-Step Programme for Benzodiazepine Addiction Treatment and Rehab

One of the best-known methodologies in addiction treatment is the 12-step programme created by the founders of Alcoholics Anonymous (AA); many organisations, including Narcotics Anonymous (NA), now have 12-step programmes at their cores, and some rehabs also offer 12-step programmes – or preparatory courses intended to familiarise addicts with the 12-step model in advance of their participation in support group meetings and similar activity during recovery. However, some addicts do not feel that 12-step programmes are suitable for them, as such methodologies typically require addicts to concede that they need to place themselves in the hands of a higher power (such as God) which may not align with their personal beliefs.

Cognitive Behavioural Therapy for Benzodiazepine Addiction Treatment and Rehab

Cognitive behavioural therapy (CBT) is one of the most popular forms of addiction therapy in addiction treatment, and many addicts are already familiar to a certain extent with the methodology having seen it in film or on TV. CBT seeks to boost overall mental health, and address particular issues such as benzodiazepine addiction, by identifying and tackling negative thought processes and problematic behaviours, by increasing emotion regulation, and by aiding the development of coping strategies. Therapists give clients new skills such as information processing and work with them to create relapse prevention tools and techniques to take into life after treatment.

The Role of Counselling in Benzodiazepine Addiction Treatment and Rehab

Unlike much of the psychotherapy which may be provided during addiction treatment, counselling features the provision of useful advice on how to tackle specific problems such as those caused by substance abuse and addiction. Counselling is frequently given in rehab, but is also often an element of aftercare programmes and individual addicts’ ongoing recovery strategies: addiction counsellors can be found throughout the country. If you are struggling with an addiction, or have gone through treatment and would like supplementary support, contact an addiction specialist to talk about counsellors in your area.

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Individual vs Group Therapy

In rehab, therapy is typically provided in both one-to-one and group settings. Whereas individual therapy lets clients work closely with therapists to address their own particular problems, group therapy brings together a number of clients (typically between three and a dozen) who have similar experiences of the highs and lows of addiction in order that they can share those experiences, offer advice, provide new perspectives on troubling situations, and offer simple companionship to let each other know that they are not alone.

Choosing a Treatment Centre for Benzodiazepine Addiction Treatment and Rehab

if you are considering seeking treatment for your addiction, it is understandable that you may feel quite daunted by the prospect of picking a treatment facility: after all, there is no reason why you should have any expertise in this area. However, it is crucial that you make the right choice, as what treatment facility you attend may have profound implications for the eventual success or otherwise of your treatment. Put together a wish list of what you want to get out of your treatment, and contact an addiction specialist to discuss this list and what might be realistic, and to find out about the best treatment facilities in your search area.

Inpatient Benzodiazepine Addiction Treatment Programme

Some rehabs offer benzodiazepine addiction treatment on both an inpatient and outpatient basis. The stereotypical idea of “rehab” is usually the inpatient residential option, which sees addicts removed from their normal environments in which they have slid into addiction, and placed in a residential environment – usually for between 30 and 90 days – where they can receive treatment according to a bespoke addiction treatment plan.

Advantages of inpatient benzodiazepine addiction treatment and rehab centres

The advantages of inpatient treatment are numerous: 24/7 medical support available on-site; therapy, prescription and other appointments all provided in the facility; a safe, confidential, pleasant, substance-free setting in which addicts can focus on recovery; other facilities on site such as gyms; and the support and help of a ready-made peer group which understands the nature of addiction.

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Outpatient Benzodiazepine Addiction Treatment Programme

Outpatient treatment can be valuable for people who feel unable to take the time out from family or professional obligations which residential inpatient treatment would entail. In an outpatient treatment programme, some appointments – therapy, health assessments et cetera – are carried out at the facility, but other elements of the treatment plan need to be carried out independently. While outpatient treatment can be successful, in some cases it is problematic as it does not remove addicts from their daily environment of substance abuse and addiction.

Short-Term vs. Long-Term Treatment

Numerous factors will determine how long you need to stay in treatment for your benzodiazepine addiction. If you are contemplating treatment, speak with a doctor and/or an addiction specialist about how long your treatment programme is likely to be.

All-Age Rehabs vs. Specific Age Group Rehabs

Some addicts may need to be treated in age-specific facilities: for example, it may not be appropriate for particularly young addicts to receive treatment in the same facility as certain problematic adult clients, while elderly patients may need facilities set up specifically to cater for their needs. If an especially young or elderly person near you is suffering from benzodiazepine addiction, contact an addiction specialist to talk about age-specific rehabs.

Gender-Specific vs. Mixed Gender Programmes

Some addicts prefer to be treated in single-gender rehabs – and indeed depending on the particulars of the case doctors may recommend this. Ask an addiction specialist about the pros and cons of gender-specific and mixed-gender treatment facilities.

Treatment Near Home vs. Different City or County

Some addicts prefer to receive treatment in facilities near their homes, as they may feel comforted by the proximity to loved ones. Others, however, wish to put as much distance as possible between themselves and their environments of substance abuse and addiction. Talk with an addiction specialist about any issues you may have regarding the location of the treatment you are contemplating.

Benzodiazepine Addiction Rehabs and Confidentiality

Confidentiality is a vital aspect of any rehab operation: clients need to feel safe that the outside world will not become aware of their condition or treatment. If confidentiality is especially important to you, and you seek reassurance, ask for a full outline of confidentiality policies any rehab at which you are considering receiving treatment.

Questions to Ask Treatment Centres

If you are investigating particular treatment facilities and options, consider asking staff at those facilities the following questions:

  • Is the facility fully licensed and accredited?
  • What success rates can be demonstrated by the facility?
  • What payment terms are available?
  • What therapy methodologies are deployed?
  • Will I be able to receive visitors?
  • How long does treatment last?
  • What medical care is available on site?
  • What aftercare is provided?

Benzodiazepine Addiction Rehab and Treatment Statistics

  • In 2016, over 400 people died in England and Wales as a result of benzodiazepine abuse.
  • The most frequently prescribed benzodiazepine in the UK is diazepam – which is often better known by the brand name Valium.
  • Over 12 million benzodiazepine prescriptions were written in the UK in 2015 – at a cost to the NHS of more than £50 million.
  • More than a quarter of a million Britons have currently been taking benzodiazepines for longer than advised by a doctor.
  • Benzodiazepines were first discovered by accident in 1955 by Dr Leo Sternbach.

Benzodiazepine Addiction Treatment & Health Insurance

Private addiction treatment does come at a cost – but many addicts in rehab have their treatment covered by private health insurance. However, not all health insurance policies cover every kind of treatment. If you are unsure as to what your policy does and does not cover, contact your insurer and asked them to provide in writing a full list of what is and is not covered. You may also wish to speak with an addiction specialist about using health insurance to pay for addiction treatment.

Get Help Today

If you are struggling with a benzodiazepine addiction, it is easy to feel that you have lost your grip on your life, and that there is no hope ahead of you. However, it is vital that you do not despair: high-quality addiction treatment facilities now operate throughout the UK, many with very significant expertise in the treatment of benzodiazepine addiction specifically. Such facilities can give you the help you need to take back control and to enjoy a life free of benzodiazepine abuse and addiction, and all the risks – including very significant dangers to physical and mental health – that they entail.

Speak with your GP and/or an addiction specialist today to discuss the various treatment options which may be available to you, and how to set out on the path to recovery. Make that call today: it could be your first step on the road back to a happy, healthy and successful life free of benzodiazepine abuse, and full of all the great things that you can still enjoy once you overcome your addiction.

Sources

https://en.wikipedia.org/wiki/Benzodiazepine

https://bjgp.org/content/67/662/e609

https://www.ncbi.nlm.nih.gov/pubmed/1362661

https://www.psychologytoday.com/gb/blog/demystifying-psychiatry/201505/how-many-people-take-benzodiazepines

FAQs

How long does inpatient benzodiazepines rehabilitation take?
How long you will need to stay in treatment depends on numerous factors including your personal condition and the duration and severity of your addiction. Typically, a stay in rehab lasts between 30 and 90 days – though shorter, and longer, treatment programmes are often available.
How effective are benzodiazepines treatments?
It is impossible to say for sure how effective any addiction treatment may be: so many different things affect any individual’s chance of a full recovery. Roughly speaking, the best private addiction treatment facilities in the UK achieve a success rate of between 60% and 80% in terms of people who have been through treatment and remain abstinent five years after the end of the treatment plan.
What factors determine whether I go for inpatient or outpatient benzo rehab?
Whether inpatient or outpatient treatment is better for you will depend on many different things, including your personal ability to engage in treatment whilst remaining in your home environment where you have succumbed to substance abuse and addiction. Speak with an addiction specialist about the pros and cons of inpatient and outpatient treatment as they relate to your particular condition – and ask the staff at any facility you may be considering attending for evidence of success rates for both inpatient and outpatient rehab.
How dangerous is it if benzodiazepine addiction goes untreated?
An addiction to benzodiazepines is extremely dangerous. Firstly, the abuse of benzodiazepines has a wide range of very significant physical and mental health risks, including long-term neurological damage and various conditions which could be fatal if left untreated. Benzodiazepine abuse can also lead to death by overdose. Moreover, benzodiazepine withdrawal itself can be fatal – and while withdrawal can be monitored and managed in rehab (and potentially assisted with medication) withdrawing independently could result in your death. Don’t forget, withdrawal can also be enforced – for example, if a benzodiazepine-dependent individual is suddenly unable to obtain benzodiazepines – so if you are struggling with a benzodiazepine addiction you may be engaged in a long-term game of Russian roulette.
How much does treatment cost?
The cost of treatment for benzodiazepine addiction can range very significantly from one facility to another – and from one treatment programme to another, even in the same facility. Very roughly speaking, rehab costs between £4,000 and £15,000 per month: speak with an addiction specialist about more precise pricing, including fees at any rehab you are particularly interested in attending.

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