1
What are benzodiazepines (benzos)?
Benzodiazepines (also called “benzos”) are a type of medicine called sedatives or hypnotics.
Benzodiazepines may be prescribed by your provider to help with anxiety or sleep problems
(insomnia). They work by calming different parts of the brain to cover up the symptoms of
anxiety or insomnia, but they do not solve the root cause of these problems.
You are taking a benzodiazepine if you are using any of the medications listed below:
• Alprazolam
(Xanax
®
)
• Clorazepate
(Tranxene-T
®
)
• Chlordiazepoxide
• Clobazam (Onfi
®
)
• Clonazepam
(Klonopin
®
)
• Diazepam
(Valium
®
)
• Estazolam
• Flurazepam
• Lorazepam
(Ativan
®
)
• Oxazepam
• Quazepam
(Doral
®
)
• Temazepam
(Restoril
®
)
• Triazolam
(Halcion
®
)
What are the side effects of benzodiazepines?
• Feeling drowsy or sleepy
• Headache
• Confusion
• Numb emotions
• Poor awareness of surroundings
• Muscle weakness
• Memory and concentration problems
• Tremor
• Problems with balance, swallowing, speaking,
and vision
These side effects can increase your risk of accidents at work, while driving or at home. It also
increases your risk of falling.
In general, how long should benzodiazepines be taken?
Benzodiazepines are only meant to be used generally for one week to one month to help with
anxiety and insomnia.
Last updated 05/2022
Patient Guide to Benzodiazepines
2
Can I become dependent on benzodiazepines?
Yes. Everyone will become dependent on benzodiazepines in as little as a few weeks of
regular use. Dependence can lead to addiction in some people.
What does drug dependence mean?
Drug dependence means your body craves the drug. People who have drug dependence will
experience uncomfortable symptoms if they do not take the drug. Anyone can become
dependent on benzodiazepines, just like anyone can become dependent on alcohol, certain
pain killers or street drugs.
What will get better when I stop taking benzodiazepines?
By trading benzodiazepines for other anxiety and stress reduction activities, talk therapy,
support groups, or a combination of all three, you will no longer experience the side effects of
the medications.
This means you will gain:
• More energy
• Improvements in memory and focus
• More awareness of what is happening around you
• More ability to participate in activities that interest you
• Reduced risk of falling and injuries from accidents
Will I feel bad when I start cutting back on my benzodiazepine dose?
No one feels 100% when they reduce their benzodiazepine doses. It is common to experience
some withdrawal side effects (see below) during tapering. Those people who have been on
these medicines for more than a month are more likely to experience the effects of
withdrawal.
The good news is withdrawal symptoms can be very tolerable when a taper plan is
individualized just for you and when you use relaxation activities, talk with a therapist and use
other coping strategies.
3
How do I stop taking benzodiazepines?
Slowly and with the help of a provider. Talk to your provider or pharmacist to create a dose
reduction plan. Dose reduction plans are also called “tapering.” Tapering involves working
with a provider to slowly reduce your medicine dosage over a long period (weeks, months or
even over a year).
It can also help to talk with a therapist, individual peer support providers or join a support
group with others who are learning new ways of coping with stress and anxiety without the
use of prescription medicine, drugs or alcohol. Please reach out to these supports if you feel
like extra support would help.
Are there other medications that can treat anxiety?
Yes. There are daily medicines that do not cause dependence. Talk to your provider about
this option.
What else should I know about stopping benzodiazepines?
• Trading benzodiazepines for cannabis, alcohol or other drugs will not reduce anxiety in
the long term, and it can also lead to drug dependence.
• It is very important to be honest with your provider about how comfortable you are with
each new dose reduction step. If you would rather wait to try the next dose reduction,
tell your provider.
Benzodiazepine withdrawal symptoms
• Anxiety, nervousness
• Muscle stiffness
• Weakness (“jelly legs”)
• Stomach pain or nausea
• Flu-like symptoms
• Vision problems
• Insomnia, nightmares or sleep
disturbances
• Dizziness
• Memory and concentration
problems
• May get easily upset
• Seeing or hearing things
(hallucinations)
• Tingling, numbness, unusual skin
sensations
• Feel like you are in a dream
4
How do I deal with my anxiety without benzodiazepines?
There are many things you can do to help yourself relax when you feel anxious, tense or
stressed. A good place to start is by doing the healthy activities that have helped you relax in
the past. You may find some of your favorite things to do – or new things to try – in the list
below.
This is not a complete list; you get to do what works best for you. If you choose to slowly stop
your benzodiazepine, you may need to try a number of different activities. Try these activities
more often or for a longer time to reduce the anxiety and feel more relaxed.
• Exercise (walking, running, biking,
hiking)
• Taking a warm bath
• Journaling
• Stretching (yoga or athletic
stretching)
• Listening to music
• Talking with friends
• Gardening
• Spending time with a pet
• Reading
• Making art (painting, drawing,
coloring, crafts)
• Deep breathing
• Progressive muscle relaxation
• Mindfulness/meditation
• Spiritual or religious practices of
your choice
• Other activities you like to do that
help you relax: ____________,
_____________, ______________
Other ways to help anxiety are:
• Drink less caffeine
• Avoid alcohol and other drugs
• Eat a healthy diet with less fast food
• Spend time outdoors!
5
Additional supports:
Peer support specialists.
• The David Romprey Warm Line offers peer support counseling at 1-800-698-
2392.
• Peer support specialists are also available in person through clinics and other
organizations.
Phone and text-based support lines like those found at Oregon’s Lines for Life
. Lines
for Life offers multiple phone and chat options based on your specific needs, including
the
Behavioral Health Support Line, which offers immediate access to screening,
counseling services and referral to available mental health and substance use
treatment.
• These lines are available 24/7 and are staffed by trained listeners who will offer
you support without judgement or pressure.
What do I do if my anxiety feels overwhelming?
Many people find talk therapy helps them learn ways to manage anxious thoughts and
feelings. One of the types of talk therapy that works well is called “CBT” or “cognitive
behavioral therapy.” This type of therapy helps you learn how to challenge your thinking about
the situations that make you anxious. Talk therapists gently guide you through this learning
process and, over time, the anxious thoughts and feelings don’t feel as powerful and don’t
lead to as much anxiety.
Other types of talk therapy are helpful, too! More important than the type of therapy offered by
a talk therapist is how comfortable you feel with them and if you feel like you are feeling better
from your time together.
6
Example benzodiazepine tapering schedule
This schedule is only an example. Work with your provider to come up with a plan that
works for you. It takes a long time to come off a benzodiazepine. It’s okay to take your time.
Your schedule may be shorter or longer than the example below.
Be sure to talk to your doctor or pharmacist before stopping your benzodiazepine. Together,
you can come up with a good plan!
Last updated 05/2022
WEEKS
TAPERING SCHEDULE
Monday
Tuesday
Wednesday
Friday
Saturday
Sunday
1-2
3-4
5-6
7-8
9-10
11-12
13-14
15-16
X
X X
X
17-18
X
X
X
X
X
X
You can get this document in other languages, large print, braille or a format you prefer.
Contact Oregon Prescription Drug Program, Amanda Parish at 503-383-8142 or email
amanda.b.parish@dhsoha.state.or.us.
We accept all relay calls or you can dial 711.
HEALTH POLICY AND
ANALYTICS
Office of Delivery
Systems Innovation
EXPLANATIONS
Full Dose Half Dose Quarter Dose
X No Dose