Benzo Addiction: Symptoms and Treatment Options in Kentucky

Even though benzodiazepines are typically prescribed for short-term relief, misuse is common.^1,2,3 Many individuals take higher doses than prescribed, use the medication for a euphoric effect, or combine it with other substances to heighten its effects.³ Misuse includes using benzos without a personal prescription, taking the drug more frequently or in larger amounts than directed, and combining it with other substances, often resulting in significant risks like addiction, impaired judgment, and risky behaviors such as driving under the influence. Over time, tolerance builds, requiring higher doses for the same effects. Abruptly stopping can trigger severe withdrawal symptoms, often requiring medical detox for safe recovery.

Benzodiazepine abuse frequently leads to both physical and psychological symptoms, including drowsiness, blurred vision, poor judgment, and mood swings. Given the drug’s high potential for addiction and the risk of life-threatening withdrawal, medical supervision is strongly advised when discontinuing use.

As outlined by the DSM-5, sedative, hypnotic, or anxiolytic use disorders are identified by patterns of use that lead to serious interference with a person’s daily life and well-being. To diagnose this, at least two of the following signs generally appear within a year:⁴

• Taking the drug in larger amounts or for a longer time than initially planned
• Ongoing desire to cut down or quit, yet unable to do so despite attempts
• Spending significant time obtaining, using, or recovering from the drug’s effects
• Experiencing persistent urges or cravings to use
• Failing to fulfill duties at school, work, or home because of drug use
• Continuing to use despite harm to relationships or social life
• Dropping or reducing social, recreational, or work activities because of use
• Using in situations where it poses a risk to one’s safety
• Ignoring known physical or psychological issues caused or worsened by use
• Developing tolerance, meaning needing higher amounts to feel the same effects, though this doesn’t count if the drug is prescribed
• Experiencing withdrawal symptoms or using the drug to avoid these symptoms unless it’s prescribed to manage a condition

Benzodiazepine abuse typically occurs alongside other substances, with approximately 80 percent of cases involving polydrug use, often with opioids, as users combine drugs to enhance effects or mitigate withdrawal symptoms.² For example, studies show that up to 90 percent of methadone users also frequently use benzodiazepines, particularly high-potency types, to amplify the effects of methadone or to ease withdrawal when opioids aren’t available.² Alcohol abuse often coincides with benzodiazepine use as well; an estimated 3 to 41 percent of individuals with alcohol dependence have also used benzodiazepines to manage withdrawal symptoms or intensify intoxication.²

The primary source of benzodiazepines for those who misuse them is through medical prescriptions, some of which end up diverted to street sales, where they can sell for $5 to $10 per pill, especially in trade-name form, as they are easily identifiable and therefore in higher demand.² Short-acting benzodiazepines with high potency, like alprazolam and lorazepam, are particularly prone to abuse due to their rapid onset and intense effects.² Meanwhile, longer-acting benzodiazepines like clonazepam, despite being prescribed widely for psychiatric conditions, are also common on the street, whereas benzodiazepines with lower reinforcing effects, such as oxazepam and clorazepate, are less commonly abused.²

Tolerance to benzodiazepines generally develops with prolonged, consistent use. Many individuals prescribed these medications for anxiety find value in taking them on an as-needed basis, which can help limit dependency. However, extended use, high doses, or exceeding prescribed amounts often accelerate the onset of tolerance and may lead to physical dependence.² The rate at which tolerance develops varies significantly between individuals, influenced by factors such as body chemistry, dosage, and frequency of use.

Tolerance to benzodiazepines develops when the brain adapts to the drug, requiring larger amounts to achieve the same effect. As tolerance builds, physical dependence often follows, making it difficult to quit without experiencing withdrawal. Benzodiazepine withdrawal can be particularly severe, with symptoms such as seizures that may become life-threatening.

Treating benzo addiction requires a comprehensive, individualized approach to address both physical dependence and underlying psychological factors. It often involves a combination of medical intervention, behavioral therapies, and long-term support. Below are some of the available options for addiction recovery and rehabilitation:

Medical Detox

Medical detox is the initial phase of treatment, focusing on safely managing withdrawal symptoms as benzo leaves the body. Conducted in a supervised medical setting, detox involves medical monitoring and the use of medications to ease discomfort, prevent complications, and stabilize the individual physically and mentally. Detox not only addresses the immediate physical effects of withdrawal but also prepares individuals for the next steps in treatment, establishing a strong foundation for ongoing recovery.

Inpatient Treatment

Inpatient treatment provides a highly structured, 24/7 supportive environment, making it one of the most intensive care options for benzo addiction. Individuals live at the facility, usually for 30-90 days, engaging in daily individual therapy, group sessions, and holistic treatments like yoga, meditation, or art therapy. The immersive nature of inpatient care helps individuals focus entirely on recovery, away from triggers and stressors. This option is ideal for those with severe addiction or co-occurring mental health disorders, as it combines medical supervision with comprehensive therapeutic interventions.

Partial Hospitalization Program (PHP)

A partial hospitalization program offers intensive support while allowing individuals to return home each night, providing a balance between structure and flexibility. PHPs typically involve full-day sessions, 5-7 days a week, including medical monitoring, individual counseling, group therapy, relapse prevention, and skill-building activities. PHPs are suitable for those who have completed detox or inpatient treatment but still require substantial support to manage cravings and maintain stability. The program fosters accountability and helps individuals transition to less-intensive care while continuing to build recovery skills.

Intensive Outpatient Program (IOP)

An intensive outpatient program offers significant support while allowing individuals to maintain daily responsibilities like work, school, or family obligations. IOPs generally require attendance several times a week for therapy sessions, group counseling, and educational workshops. IOPs emphasize relapse prevention, coping strategies, and personal accountability, making them ideal for those transitioning from inpatient or PHP. This level of care allows individuals to apply recovery skills in real-time while still receiving structured support, bridging the gap between more intensive care and independent living.

Standard Outpatient Treatment Program (OP)

Standard outpatient treatment is the least intensive level of care, involving weekly or bi-weekly therapy sessions. It often serves as a step-down from more intensive programs or as a primary option for those with mild addiction and a strong support system. Standard outpatient treatment focuses on ongoing therapy, relapse prevention, and regular check-ins with counselors. It allows individuals to continue recovery while managing daily life. This approach promotes long-term stability by providing consistent support and resources, helping individuals maintain sobriety in the face of everyday challenges.

Medication-Assisted Treatment (MAT)

Medication-assisted treatment combines FDA-approved medications with therapy to treat both the physical and psychological aspects of benzo addiction. Medications like buprenorphine, naltrexone, and alternative doses of benzo are used to reduce cravings, manage withdrawal, and block the euphoric effects of opioids. These medications work best when integrated with behavioral therapies such as Cognitive Behavioral Therapy (CBT), individual counseling, and support groups. MAT is suitable for various stages of treatment, from detox through outpatient care, and is particularly effective for those with a high level of physical dependence. MAT aims to stabilize individuals, making recovery safer and more sustainable by reducing the risk of relapse while supporting broader therapeutic efforts.

Aftercare Planning

Aftercare is a crucial component of long-term recovery, offering support after formal treatment ends. It may include ongoing therapy, 12-step meetings, sober living environments, alumni programs, or life skills training. Aftercare helps individuals maintain sobriety, manage potential triggers, and continue personal growth, ultimately reducing the risk of relapse. Tailored to each individual’s needs, aftercare fosters accountability and community support, helping individuals stay engaged in recovery and build a fulfilling, substance-free life.

Support Groups

Support groups also play a valuable role in the recovery process. They provide a community of individuals who are experiencing the same struggles. They offer a space for sharing experiences and coping strategies. They also provide a sense of belonging and understanding. Narcotics Anonymous and SMART Recovery are examples of such groups.