Benzodiazepines are used for the treatment of insomnia, anxiety, and prevention of seizures (convulsive attack) and muscle spasms. Benzodiazepines are sleep inducing in high doses, reduce anxiety in moderate doses, and are soothing medicine when taken in low doses. People who take high dose of benzodiazepines may appear drunk or relaxed. Benzodiazepines can be detected in specimen using Urine, Hair, and Saliva drug testing methods.
Urine Drug testing
Urine drug testing is one of the most convenient, easy, inexpensive, and reliable testing methods to find Benzodiazepines drug addiction. Urine drug test check for oxazepam specimen presence, a major metabolite of benzodiazepines. When concentration of the metabolite is present above the cut off levels, the test strip will display two red or pink bands, one each in Control region [C] and Test region [T], indicating a positive result. Positive screening results can be confirmed by sensitive methods like Gas Chromatography/Mass Spectrometry (GC/MS) test.
The Detection Period of benzodiazepines in urine is 3 days for prescribed use and 4 to 6 weeks for habitual use (for over one year). The screening tests cutoff concentration is 300 ng/mL and confirmation tests cutoff concentration is 200 ng/mL in urine.
Hair Drug Testing
A hair drug test for benzodiazepines uses a small sample of hair to recognize specified drug usage by the person being tested. Hair drug testing is most accurate form of testing over other measures of drug testing as it is performed in laboratory and very less affected by external factors. Hair drug test will not only identify drugs and its metabolites, but also can provide information on consumed quantity and even the drug abuse pattern. The hair drug testing can provide drug abuse history of up to 90 days. The detection period of benzodiazepines in hair is 90 days.
Saliva Drug Testing
Saliva or oral fluid-based drug tests are fast, reliable, convenient, and can detect whether the person has abused to drug in the last 5-10 minutes and unto last 72 hrs. Saliva or oral fluid based drug tests are widely accepted because of their convenience and the fact that they are less invasive, and very difficult to adulterate or contaminated. Donors have to give a sample by placing an absorbent collector in the mouth, or touching it on their tongue. Donors are not permitted to eat, drink, and brush teeth or floss (cleaning between teeth) before providing a sample. Simple on-site testing kits can detect the presence of benzodiazepines and show results in just five minutes. If results are positive, a GC/MS test should be done for confirmation.
Proper medication and treatment should be given to person, if confirmatory testing in any testing method reports positive result. Withdrawal symptoms of benzodiazepines are mainly anxiety-related and include convulsions, trembling, loss of appetite, and stomach problems. Abrupt stoppage of prescribed benzodiazepines can lead to these symptoms along with seizures and hyperactivity (attention deficit disorder).
Benzodiazepine Withdrawal and EFT- the Ideal Self-Management Tool
I’m an advanced Emotional Freedom Techniques (EFT) Practitioner as well as being a recovered involuntary benzodiazepine (benzo) addict. I came off benzos in 1988 and qualified in EFT in 2006. That’s quite an unusual combination. I wish EFT had been around when I was coming off. But now I’m qualified, it puts me in the unique position of being able to offer EFT tapping routines to people who are withdrawing from a place of personal experience. And that’s really good news because if there’s one thing you need when coming off benzos – it’s the advice and support of others who’ve been through it – ‘survivors’.
My own withdrawal in 1988
There wasn’t much information available when I came off, certainly nothing like there is now – internet sites, books and organisations. Professor Heather Ashton, world authority on benzo addiction and withdrawal, hadn’t set up her withdrawal clinic in Newcastle or written her manual (see below). I devised my own withdrawal programme, putting together a variety of complementary therapies and emotional /psychological support techniques. The result is ‘Safe Benzo Withdrawal’, my double CD set (see below) which contains advice and information based on my own experience. There is also a guided relaxation which I wrote specifically for benzo withdrawal. The data CD contains equivalence tables for switching to Diazepam (valium), a slower acting benzo.
Withdrawal Symptoms vary
Not everyone has a tough time coming off. We’re all different and there are many factors affecting the type of withdrawal i.e. dosage, type of medication, time you’ve been taking it etc. Rest assured. Many thousands of have now successfully come off and are living proof that it can be done. And now there’s a whole variety of withdrawal support resources available. (see below)
What is EFT?
EFT is a healing tool developed by an American, Gary Craig. It’s a kind of emotional acupuncture based on ancient Chinese healing. About five thousand years ago the Chinese discovered the human body had energy channels, called meridians, through which the body’s essential energy or chi flows. Managing the flow of chi forms the basis of the Eastern healing practices, such as acupressure and acupuncture, which are now widely used in the West.
How does it work?
When we experience anything which distresses us, be it physical pain, emotional distress, anxiety, anger, fear etc, there is a disruption in the body’s energy field and the EFT tapping is designed to remove this disruption and restore a sense of calmness and equilibrium. These energy disruptions can be held unresolved in the body, for many years, and often tapping is addressing an event from childhood that continues to affect one’s present life.
How do you do it?
You tap with your fingertips on various points on the energy meridians around the face and body whilst focusing your thoughts on a distressing symptom or feeling you’re having and repeating an affirmation or positive self-healing phrase. (full instructions, see link below)
Why is EFT perfect for benzo withdrawal?
- It’s easy to learn and very simple to use. Concentration span can be very limited when you’re withdrawing, so a technique that’s quick and easy is important
- Use it anywhere, anytime. Benzo withdrawal symptoms, especially panic attacks, can be unpredictable. They might wake you at night, or come when you’re out somewhere. With EFT you don’t need another person, or any equipment – just your own fingertips and a minute or two of your own time.
- It’s a tailor made self-healing tool. You can design your own tapping routines to address whatever symptoms you’re experiencing.
- EFT is a self-management tool. This is about taking back power and responsibility for your own healing. Addiction, whether voluntary or involuntary (iatrogenic*), drains your self-empowerment. Using EFT can restore a sense of control over your life.
- It’s free. Just download the manual (see below). There’s no financial outlay. Of course, you have the choice of consulting a qualified EFT practitioner from time to time, to keep you on track and to gain some objectivity, and maybe learn some more advanced techniques – see my contact details below. But the basic routine taught in the manual consistently produces good results.
So there’s five excellent reasons to use EFT in your withdrawal and help you on your journey to recovery. Top three withdrawal tips are; Be safe – talk your GP. Be sensible – taper off very gradually at your own pace. Be supported – find or start a support group, either face to face or on the internet. I wish you all strength on your journey to recovery.
*iatrogenic = caused by the medical profession
Remember: never stop taking your medication suddenly. This can be dangerous. Consult your GP. The information in this article is not intended as a substitute for medical counselling.
Because there is a very strong problem of anxiety in our culture as well as insomnia, benzodiazepines are often used to treat these disorders. They also can be used in the context of medical surgeries as well as alcohol recovery. In the past the benzodiazepines prescribed included valium and librium. Now the more frequently prescribed medications are xanax and ativan to deal with anxiety. Other ones include dalmane and halcion. Addiction can be subtle and it’s important to not stop without doing so gradually. The benzo drugs are often abused due to the calming results they bring to people and eradication of anxiety.
Because the sedation effect, some people notice that their concentration isn’t as strong as it had been and feel they aren’t learning the way they’d want to. These need to be discussed with one’s physician. It’s important to be wary about mixing with partying beverages and even cough syrups. Also your judgment may be impaired and driving may not be recommended. I’ve seen some clients who say they feel slow or doped up. The medication needs to be re-adjusted. It is nice to have a sedating effect, but you still want to function at a high level.
Depending on the medication and dosage, withdrawal symptoms can include convulsions, stomach problems, trembling and appetite suppression. Don’t deceive yourself about these symptoms if you notice them. A physician’s or psychiatrist’s guidance is important to gradually come off the benzos, especially for the medications that leave the body quickly. Not all benzos leave at same rate.
Be honest yourself to examine if you have a strong dependency on the medication. Are you afraid if you weren’t going to take it? Do you plan your day around taking the meds? Don’t beat yourself up if you think you have an addiction but see a professional so you can discuss and form a plan for withdrawal. Certain disorders such as panic problems and other phobias may require continuous need for benzodiazepines to maintain stability and again this needs to be determined by a physician or psychiatrist.
While not everyone will experience difficulties tapering off a benzodiazepine (tranquilliser), many are subject to adverse and bizarre symptoms which can prove traumatic. The following tips will help anyone preparing to taper or already in the process of withdrawing.
Cold turkey:
If you are currently taking a benzodiazepine, please do not discontinue the drug abruptly as this is dangerous and can cause seizures, withdrawal psychosis and protracted withdrawal. It is best to withdraw at a comfortable pace determined by you, under the supervision of your doctor and using a tapering schedule such as those outlined in the Ashton Manual.
Unique experiences:
It is best to not anticipate a difficult withdrawal as each individual’s experience is unique and not everyone is subject to severe and protracted symptoms. Focusing mainly on negative accounts and anticipating the worst may intensify your anxiety and hinder recovery.
Support system:
Having a reliable support base of at least a few family members or friends to provide emotional and practical support will make a big difference. Don’t hesitate to ask for help if you need it. If you are isolated, try getting online forum support from those who can relate to your experience. Even speaking to a helpline worker is better than trying to cope on your own; sharing your concerns can be therapeutic.
Affirmations/Positive Self-talk:
This is a powerful strategy for coping with worrying thoughts. Instead of focusing on the symptoms and intensifying your anxiety, you can use positive affirmations such as ‘I am grateful for my healing’ or ‘Every day in every way I am getting better and better’ to create a positive shift in energy. Try to stay in awareness and when you notice the negative self-talk just tell yourself to ‘stop’ (without judgment) and switch to a positive affirmation.
Breathing:
Finding at least one breathing technique that works positively for you is key. An easy way to create a rhythm is by focusing on your breath as you take air in and breathe out slowly. There are many highly recommended techniques including diaphragmatic breathing and the 4-7-8. To do the 4-7-8: breathe in to the count of 4, hold for 7 counts and exhale to the count of 8; it should feel unforced and natural.
Self-nurturing:
This is a time to be self-indulgent so do not feel guilty if all you feel like doing is curling up on the couch with a good book or movie. Enjoy distracting yourself with online games, keep mentally stimulated with puzzles, watch funny You Tube clips, try watercolour painting, listen to uplifting music and do all the leisurely activities that you had no time for when life was busy. Avoid stressful situations, emotionally draining people and remember it is okay to say ‘no’. Those who genuinely care will understand and once you are well again you will be able to commit and give more of yourself.
Dietary modifications:
During withdrawal the nervous system can be in a constant state of hyper-excitability. Some find it necessary to monitor and modify their diets to minimise gastric disturbances and other symptoms. Having small, frequent, simple, low glycaemic meals, avoiding caffeine, alcohol, sugar/sweeteners, mono sodium glutamate (MSG) and processed ready-meals are all reported to help. It is also important to stay hydrated by drinking adequate amounts of water throughout the day.
Alcohol:
Alcohol works on the same receptors in the brain as benzos (GABA). Having even a minuscule amount during withdrawal is known to exacerbate symptoms as it interferes with receptors’ up-regulation or healing. If you are having unpleasant symptoms and are still consuming alcohol, try omitting it for a while and see if your condition improves.
Exercise:
Implementing a vigorous exercise routine can sometimes worsen symptoms so a gentle routine with gradual increase is advisable. Conversely, exercise well tolerated can be very beneficial during withdrawal; your body will let you know your limits. Even a short walk in fresh air or a simple yoga routine to keep the energy flowing should make a positive difference.
Complementary therapies:
The reported benefits of massages, osteopathy, chiropractic care, reflexology and other complementary therapies during withdrawal are conflicting. In cases of extreme sensitivity they can cause symptom flare-ups and it is good to be aware of this. Should you have an unwanted reaction, a gentle approach could be an option until you are well enough to enjoy deeper stimulation.
Supplements:
Vitamins and other supplements cause negative reactions in some people while others have found that they seem to help. It is a matter of observing and excluding: if you are having a problematic withdrawal while taking supplements, you could try omitting them to see if your symptoms improve.
Sleep:
When sleep is disrupted during withdrawal it can take time for a normal pattern to be resumed. If you have already eliminated the usual culprits such as caffeine, alcohol, uncomfortable room temperature, television in room, late news/mental stimulation, loud noises, bright lights etc., you could try sleep CDs, breathing exercises and other relaxation techniques. However, during acute withdrawal you may find that nothing works. Non-resistance will minimise your anxiety and deep relaxation and rest may be the only options. Eventually you will sleep for a few hours at a time and this will increase until you end up having a full, sound night’s sleep of a much better quality than when you were on the drug.
Acceptance:
The most important withdrawal coping tool is acceptance of the symptoms. If you can assume the role of ‘detached observer’ and acknowledge that the symptoms are temporary and a necessary path to recovery, then you may not feel inclined to fight them. The more you resist, the more power you give to the symptoms, and they will end up having a much stronger than necessary influence on your experience. Acceptance is the easiest way.
Someone needs to make it very clear — to kids and adults of all ages — that benzodiazepines mixed with other drugs or alcohol kills a lot of people every year. In fact, if you’re regularly mixing benzos with other drugs or alcohol, you’re probably lucky if you only become dependent and need to get off them.
This week in Tampa, FL, a young adult found his 42-year-old father dead in his bedroom, his face and ears partially eaten off by the family’s three pit bull puppies. A family friend said the deceased had spent the evening drinking heavily, and had then taken Xanax, one of the worst of the benzo’s, before going to sleep. Authorities haven’t yet determined if the man was still alive when the dogs got at him, but chances are he wasn’t. After drinking excessive alcohol and taking Xanax, both of which are central nervous system (CNS) depressants, it’s too late for drug detox, and one’s chances of survival can be slim to none without emergency medical aid.
Meanwhile, up in Brooksville, FL, just north of Tampa, a 17-year-old boy was arrested for trying to sell Xanax pills to another kid at the local high school. The wanna-be pusher was arrested and taken to jail. It wasn’t reported where he got the more than two dozen Xanax pills, but data from law enforcement and drug detox and rehab providers indicates a lot of prescription drugs are swiped from parents and relatives. It’s also becoming all too easy for kids to get prescriptions from doctors by faking symptoms — they see it in movies and on TV all the time — and more and more kids are getting dependent on benzos and winding up in drug detox centers themselves. Drug detox for kids as young as 12 is becoming more prevalent across the US.
Xanax is one of the most abused benzodiazepines around, frequently associated with recreational polydrug mishaps. Judging from statistics, the danger message is not being delivered strongly enough that two or more CNS depressants have cumulative effects, and can shut down your breathing and your heart. Just think Heath Ledger, Anna Nicole Smith or even Elvis Presley, who died with 14 drugs in his system.
CNS depressants include benzos, opiates such as heroin, morphine and methadone, and prescription painkillers such as Vicodin, Percocet or OxyContin. Dependencies and addictions to all these kinds of drugs are routinely treated at drug detox centers across the country.
Alcohol is also a CNS depressant and should never be mixed with benzos. Cocaine, normally associated with “speeding up” rather than slowing down one’s system, has frequently figured in lethal drug toxicities when mixed with Xanax or other benzos.
Benzos are just plain dangerous drugs. Dependency is extremely common, especially when taken for extended periods of time, but can occur in a surprisingly short time, too. You know you’re dependent if you get withdrawal symptoms when you stop taking it. Withdrawal from Xanax can cause agitation, panic attacks, severe anxiety, muscle cramps, and seizures which can be life-threatening. Medical drug detox is an absolute must for anyone who has become dependent on benzos.
The bottom line is, when Xanax or any benzodiazepine is prescribed, the doctor or the pharmacist should make absolutely sure that the person understands all the dangers. Of course, in a perfect world, no one would be taking these drugs at all. But as long as we live in an imperfect world, someone needs to sit everyone down, especially high school kids, and give them the straight facts about the dangers of benzodiazepines so they really get it once and for all. No kid should have to grow up knowing they contributed to someone’s trip to an emergency ward, or worse, the morgue. They shouldn’t have to live with the responsibility of anyone needing a drug detox program, either.
