August 28, 2025 – A brand new study, Long-term neurological consequences following benzodiazepine exposure: A scoping review, was published today in the journal PLOS ONE. It is the result of 2 ½ years of work and the largest review of its type to date. In 2024, a PLOS ONE study (aka "The BIND Paper") introduced the term “Benzodiazepine Induced Neurological Dysfunction (BIND),” and showed that this injury exists in a sub-population of individuals. To better characterize the likelihood of developing BIND, a team of researchers retrieved 14,097 publications, of which 11,446 were screened. After a thorough assessment, the researchers identified 46 eligible studies. Link to the Article: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0330277 Initial Findings In the 46 eligible studies, researchers found that some studies showed benefit from benzodiazepine discontinuation and nearly all of the studies identified an acute phase of withdrawal. That being said, they also found evidence of persistent neurological dysfunction. In fact, 61% of the studies provided signals that suggest a protracted withdrawal phase, although protracted withdrawal did not affect all persons Long-term neurological consequences following benzodiazepine exposure: A scoping review. Fig. 3. The core findings from each of the eligible studies is provided in three separate tables: those which provided notable signals of protracted symptoms (61%), those that showed benefits from discontinuation (30%), and studies which demonstrated no notable results (9%). While many patients benefit from discontinuation, others face persistent and sometimes disabling symptoms months or years later. Unfortunately, “few benzodiazepine studies looked for prolonged symptoms.” These symptoms appear “unpredictably and only in a subpopulation of patients,” and they were not systematically studied. Benzodiazepines are powerful agents, the use of which may lead to long-term neurologic dysfunction in some patients. The patient’s susceptibility, the extent, and reversibility of these neurologic changes is not known. There is an urgent need to answer those questions and limit long-term benzodiazepine use in accordance with the Hippocratic oath: first, do no harm. — Scoping Review, Discussion About the Research Team The "BZD Research Team" sponsored by the Alliance for Benzodiazepine Best Practices has been working together on various projects since 2020, when it began by publishing three consecutive papers on the Benzodiazepine Survey of 2018/2019. The third paper in that series was the BIND Paper, officially titled "Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey." It changed the landscape for how protracted benzodiazepine withdrawal is identified, and treated, and much of that work informed the research on this paper. In fact, five of the authors on that paper (Ritvo, Foster, Finlayson, Silvernail, and Martin) are still team members and authors on this scoping review. Scoping Review authors and their affiliations: University of Colorado School of Medicine Christi Piper Alexis D. Ritvo Kyla N. Shade Vanderbilt University Medical Center A. J. Reid Finlayson Peter R. Martin The School of Public Health at Yale University Jolene E. Bressi Ian J. Martin The Alliance for Benzodiazepine Best Practices Bernard Silvernail Uneven Life D E Foster Remembering Christy Unfortunately, during the work on this project, our research team suffered a huge loss. Dr. Christy Huff was the heart of the BZD Research Team. In addition to being the co-creator of the Benzo Survey of 2018/2019, lead author on its second paper, and a long time member of our team, she also was one of the first to conceive and help formulate the protocol for this scoping review. "Her work on behalf of benzodiazepine safety is well known, deserves praise, and will benefit many patients in years to come." Unfortunately, Dr. Huff passed away on March 5, 2024, due to complications from BIND. The team regrets that she can't be listed as one of its authors, but acknowledges that none of this would have been possible without her. "She was an uncompromising patient advocate, but, to us, she was also a dear friend and beloved colleague." — Scoping Review, Acknowledgments I had the pleasure of working with Christy in a variety of settings for about seven years, and she was a close friend. In her role as Medical Director for Benzodiazepine Information Coalition, in her research, and in her outreach to those suffering from benzodiazepine dependence and withdrawal, Christy never let you forget that she was a caring doctor, friend, and colleague. We miss her dearly. References Huff C, Finlayson AJR, Foster DE, Martin PR. "Enduring neurological sequelae of benzodiazepine use: an Internet survey." Therapeutic Advances in Psychopharmacology. 2023;13. doi:10.1177/20451253221145561. https://journals.sagepub.com/doi/10.1177/20451253221145561. Reid Finlayson AJ, Macoubrie J, Huff C, Foster DE, Martin PR. "Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey." Therapeutic Advances in Psychopharmacology. 2022;12. doi:10.1177/20451253221082386. https://journals.sagepub.com/doi/full/10.1177/20451253221082386. Ritvo AD, Foster DE, Huff C, Finlayson AJR, Silvernail B, et al. (2023) "Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey." PLOS ONE 18(6): e0285584. https://doi.org/10.1371/journal.pone.0285584. Shade KN, Ritvo AD, Silvernail B, Finlayson AJR, Bressi JE, Foster DE, Martin IJ, Piper C, Martin PR. (2025) Long-term neurological consequences following benzodiazepine exposure: A scoping review. PLOS ONE 20(8): e0330277. https://doi.org/10.1371/journal.pone.0330277.

Founded in 2020, the Benzodiazepine Action Work Group (BAWG) has rapidly become one of the most influential and active benzodiazepine advocacy groups in the nation, encompassing a unique blend of medical professionals, global support groups, and individuals with lived experience. Its co-chairs are Dr. Alexis Ritvo from the University of Colorado, Anschutz School of Medicine and D E Foster, founder of Easing Anxiety and host of the Benzo Free Podcast. BAWG is part of the Colorado Consortium for Prescription Drug Abuse Prevention and its mission is focused on increasing benzodiazepine safety through education, patient support, and informed prescribing and deprescribing practices. The workgroup's partner organizations include the Alliance for Benzodiazepine Best Practices, Benzodiazepine Information Coalition (BIC), Easing Anxiety, and the Schreiber Research Group. NOTE: The Benzodiazepine Action Work Group (BAWG) was disbanded in March of 2024. The website is no longer available, but some of its content can be found on the Consortium's Benzodiazepine Resources page.

A basic breathing technique to ease your daily stress. Feeling tense? Anxious? Frustrated? Angry? When we are feeling overwhelmed by the day’s events, the best practice is often just stepping back and taking a few deep breaths. In this video, we introduce a simple technique called diaphragmatic breathing, which can be remarkably effective in helping to ease the stress of a chaotic day. Video ID: EA006 Watch the Video Site Links VISIT US ONLINE — WEBSITE: https://www.easinganxiety.com — YOUTUBE: https://www.youtube.com/@easinganx PLEASE LET US KNOW WHAT YOU THINK — COMMENT: On this video in YouTube — COMMENT: On this blog post — EMAIL: feedback@easinganxiety.com Disclaimer All content provided on this YouTube channel is for general informational purposes only and should never be considered medical or health advice. The author of the content provided on this channel is not engaged in rendering medical, health, psychological, or any other kind of personal or professional services. Health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://easinganxiety.com/disclaimer. Credits VIDEO / IMAGE CREDITS All video and still image content not produced in-house or identified above was provided by… — FreeImages — https://www.freeimages.com — Pexels — https://www.pexels.com — Pixabay — https://www.pixabay.com MUSIC CREDITS Music provided by Storyblocks Audio — https://www.audioblocks.com EA Theme Song — NAME: “Welcome Home” — PERFORMED BY: Neil Cross — COMPOSED BY: Peter Godfrey (original title “Young Love”) Produced by Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2020 Denim Mountain Press – All Rights Reserved

Join D for a 40-minute video presentation on the research behind, the reality of, and recovery from benzodiazepine-induced neurological dysfunction (BIND), recorded live at Benzo Warrior Community (BWC) on November 12th, 2024. This is the first time D has been back at BWC since his 2022 presentation, "A New You: Life After Benzo Withdrawal." We had an amazing audience and the presentation was followed up by a 75-minute Q&A session (not recorded). Special thanks to Barbara Connolly for the gracious invitation to speak to this community, and for all the amazing work they do at BWC. Watch the Video... Visit us at "uneven" If you like this and other similar content, check out our brand new online community at "uneven." We just passed 100 members and have over 1,500 interactions each week. This new community is led by a group of individuals who have all struggled ourselves — so we get it. We understand that life is uneven, and that it might be a bit harder for some of us than it is for others. It's not fair, but that's the nature of life. But with help, with support, and with a solid community of friends behind you, you can thrive. Join now. The "uneven" community is completely free through the end of the year, so there's no better time to check us out than right now. Just visit our easy to remember URL: uneven.life. I hope to see you there, D

February 6, 2023 – The second paper on the Benzodiazepine Survey of 2018-2019 was published today in Therapeutic Advances in Psychopharmacology titled: “Enduring neurological sequelae of benzodiazepine use: and Internet survey.” This is the second in a series of three papers our team has been working on for almost four years now. The first paper was published on April 25, 2022 and was titled “Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey.” Our third paper was recently completed and we are in the process of its submission. One of the key findings of this second paper is the differentiation between acute withdrawal symptoms such as seizures, hallucinations, and body trembling which typically last for days or weeks, and the protracted symptoms such as anxiety, insomnia, cognitive difficulties, low energy, and others which can often last for months, even years. According to the paper’s conclusion, “Evidence tentatively suggests that early and late symptoms occurring following benzodiazepine use may be attributable to different mechanisms,” and that the latter may be due to neurotoxicity and/or neuroplastic changes in the brain. These findings are groundbreaking and also led us to a third and final paper from the survey, which will address the life consequences of these drugs and formerly introduce the term benzodiazepine-induced neurological dysfunction, or BIND. As I mentioned when we announced the first paper, I was very grateful to be one of the authors on this amazing team which includes Dr. Christy Huff, Director of Benzodiazepine Information Coalition and Drs. A. J. Reid Finlayson and Peter R. Martin of Vanderbilt University Medical Center. Special thanks also go out to Christy Huff, M. D. (BIC), and Jane McCoubrie, Ph.D. who originated the survey, and equally so to Bernie Silvernail and the Alliance for Benzodiazepine Best Practices for sponsoring the work and leading the charge to get these papers completed and published. Online Article: https://journals.sagepub.com/doi/full/10.1177/20451253221082386 PDF Version: https://journals.sagepub.com/doi/epub/10.1177/20451253221145561

April 26, 2022 – The first paper on the Benzodiazepine Survey of 2018-2019 was just published on April 25, 2022, titled: “Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey.” Our team has been working on this research for three years now, and finally, we have the first paper published in the journal “Therapeutic Advances in Psychopharmacology.” And this is just the first, many more are slated to follow. I was grateful and humbled to be part of this team and to have the ability to learn so much more about the processes and effects of benzodiazepines from such amazing people. The team behind this paper is some of the same people who are working on the definition and research behind the new term, BIND (Benzodiazepine-Induced Neurological Dysfunction). Special thanks should go out to the originators of the survey, Christy Huff, M. D. (BIC), and Jane McCoubrie, Ph.D. And equally so, to Bernie Silvernail and the Alliance for Benzodiazepine Best Practices for sponsoring the work and leading the charge to get these papers completed and published. Alistair J. Reid Finlayson, M.D. and Peter R. Martin, M.D. round out the author team and educate me on the medical side of benzos every week I have the privilege to meet with them. These doctors “get it,” and have seen the harm these drugs have caused first-hand. Thank you. And last, but by all means, not least, the individuals who took the survey deserve a huge thanks. You all shared your experiences with the survey team and made this survey count. Much like the podcast, you are the heart and soul of this survey. You rock!!! Talk soon, D 🙂 Online Article: https://journals.sagepub.com/doi/full/10.1177/20451253221082386 PDF Version: https://journals.sagepub.com/doi/pdf/10.1177/20451253221082386

Benzo usage, withdrawal, and BIND can be very confusing experiences. Along with tapering schedules, substance boundaries, and a variety of known and unknown symptoms, there is also a collection of both medical and non-medical terms that are often unknown to the average person. We hope this glossary may help clarify this issue and perhaps start to create a sense of clarity in this confusing time. We need your help We all make mistakes. And that definitely holds true for this website. Easing Anxiety is only as good as the time and effort put into it. We welcome any updates, corrections, or additions via our online feedback form. If you have references, please include them too. Thanks. A Acute Withdrawal Acute withdrawal occurs in the immediate period following drug discontinuation. It is a function of the rate of elimination of the benzodiazepine and its active metabolites. Symptoms that are more frequent during this stage can be severe, and even life-threatening, and include hallucinations, whole body tremors, and seizures. Thankfully, they are also often rt-lived and rare with a slow taper. Acute withdrawal lasts for approximately 10 days, but longer-acting benzodiazepines with longer half-lives may require up to 28 days to clear the body. Addiction Addiction—or compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal. — [NIDA, “Is There a Difference?”] Dependence and addiction can be totally unrelated. One can be dependent and addicted, dependent and not addicted, or addicted and not dependent. BIND is a result of dependence, and not addiction. The NIDA clarifies this further by stating: …physical dependence in and of itself does not constitute addiction, but it often accompanies addiction. — [NIDA, “Is There a Difference?”] Akathisia Akathisia is a common symptom during BIND. Simply put, akathisia is a disorder where the patient has a feeling of inner restlessness and the urgency to keep moving. It’s like being on high doses of caffeine all the time, even when you’re trying to sleep. You just want to get up and do something, like run a marathon or even climb the stairs. Anything to keep moving. Akathisia is a common side effect of earlier anti-psychotic drugs, and you guessed it, of benzos too. Amnesiac An amnesiac is a drug which provides loss of memory, typically recent memory, often used for medical procedures. Amnesiac is also the term used for a person who experiences loss of memory. Anti-Anxiety Medication The term “anti-anxiety medication” typically refers to benzos and benzo-like drugs. This includes three specific classes of drugs including benzodiazepines, nonbenzodiazepines (z-drugs), and thienodiazepines. Anticonvulsant An anticonvulsant is a drug used to help reduce the frequency and/or severity of seizures, fits, or convulsions. Anxiolytic Anxiolytic is a term used to describe any medication that provides, or is designed to provide, relief from anxiety. The Ashton Manual The Ashton Manual is widely considered the de facto standard for withdrawal from benzodiazepines, z-drugs, and other minor tranquilizers. Officially titled “Benzodiazepines: How They Work and How to Withdraw,” it was written by Prof. C. Heather Ashton who spent 12 years working with benzo recovery patients in her clinic. Learn more about Prof. Ashton and her manual here. B Benzodiazepine Withdrawal Syndrome (BWS) Benzodiazepine withdrawal syndrome (BWS) was a term given the collection of symptoms that occur in some people when they try to withdraw from long-term benzodiazepine use. The term BIND has replaced BWS in most circumstances. These symptoms can last months and even years. For those of us who took benzos per a doctor’s prescription, BWS is an iatrogenic illness — an illness caused by medical treatment. Benzo Belly Digestive distress during BIND is so prevalent that it even has its own name: “benzo belly.” Benzo belly is used to refer to the whole compilation of symptoms of the digestive tract that are the result of BIND. Some people have no problems at all with digestion during this time, while others have chronic discomfort and wind up on a very limited diet. Many of the symptoms are similar to those associated with irritable bowel syndrome, including nausea, vomiting, diarrhea, constipation, abdominal pain, flatulence, and heartburn. One of the most visible signs of benzo belly is the belly itself. Distention and inflammation of the gut is common in patients suffering from benzo belly and can be quite noticeable, as I mentioned earlier. Benzodiazepines Benzodiazepines are a class of psychoactive prescription drugs developed in the 1960s. Also called “anti-anxiety medications” or “minor tranquilizers,” benzos were developed to combat a variety of issues including panic attacks, anxiety, insomnia, muscle spasms, and seizures. Benzos The term “benzos” was originally derived from the word “benzodiazepine.” While it is still used as a slang term for benzodiazepines, and it can be used to also refer to other anti-anxiety drugs, such as nonbenzodiazepines (Z-drugs). BIND (Benzodiazepine-Induced Neurological Dysfunction) BIND defines the lingering neurological effects of sustained benzodiazepine exposure. Previously, this condition went by disparate terms such as Benzodiazepine Withdrawal Syndrome (BWS), Post-Acute Withdrawal Syndrome (PAWS), Protracted Withdrawal, Benzo Brain Injury, and many others. A new term (BIND) was proposed by the Benzodiazepine Nosology Group in 2022, and is now widely accepted within the benzo and medical communities. Formal Definition: Benzodiazepine-induced neurological dysfunction (BIND) is a constellation of functionally limiting neurologic symptoms (both physical and psychological) that are the consequence of neuroadaptation and/or neurotoxicity to benzodiazepine exposure. These symptoms may begin while taking or tapering benzodiazepines, and can persist for weeks, months, or even years after discontinuation. (Benzodiazepine Nosology Group) (Alliance, 2022) BZAI BZAI is an acronym which stands for Benzodiazepine-Affected Individuals. A BZAI is any person who has taken benzodiazepines and is, or has, adverse symptoms and/or life effects from their its use. This includes anyone dealing with benzodiazepine withdrawal or BIND. BZD BZD is an acronym for benzodiazepine(s) commonly used in medical literature and studies. BZRA BZRA is an acronym which stands for Benzodiazepine Receptor Agonist; BZRAs include benzodiazepines and nonbenzodiazepines (Z-drugs). C Cold Turkey (CT) Cold-turkey, or CT, refers to the sudden cessation of taking benzos after long-term use. Some patients have stopped taking their benzos abruptly, either independently or under doctors orders. CAUTION: Most medical experts recommend a slow taper to withdraw. Stopping cold turkey, especially without medical supervision, can be very dangerous. It can even be fatal in extreme cases. Abrupt cessation of benzodiazepines may be very dangerous. — Prof. C. Heather Ashton, The Ashton Manual D Dependence Benzos can cause a person to become physically dependent on the drug. Here is a definition: [Physical dependence is when] the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal). — [NIDA, “Is There a Difference?”] There is a difference between addiction and dependence. One can be dependent and addicted, dependent and not addicted, or addicted and not dependent. The NIDA clarifies this further by stating: …physical dependence in and of itself does not constitute addiction, but it often accompanies addiction.” — [NIDA, “Is There a Difference?”] Depersonalization (DP) Depersonalization is a common symptom during BIND and is defined by the feeling of detachment from oneself as if someone is viewing themselves from outside of their body. This symptom is often experienced in conjunction with derealization. Derealization (DR) Derealization is a common symptom during BIND and is defined by the feeling of being disconnected from one’s surroundings, almost like living in a dream state. This symptom is often experienced in conjunction with depersonalization. Direct Taper If a person decides to discontinue taking benzos, it is recommend that he or she do so via a slow tapering process. There are three main methods for tapering: direct taper, substitution taper, or titration taper. The first and most straightforward method of tapering is a direct taper. This means that the person reduces the dosage of the benzodiazepine they’re currently on and they don’t substitute another benzo, like diazepam. This is the most popular method. They will still need a doctor to prescribe differing doses and perhaps a pill cutter to split pills. This method works best for benzos that are less potent or have a longer half-life. [Ashton, “The Ashton Manual”] Dopamine Similar to GABA and glutamate, dopamine is a neurotransmitter. The effect that dopamine has on the receiving neurons depends on its source, destination, type, and role. Dopamine is responsible for some emotions, desires, and motivation including the initiation of muscle movement. Dopamine is a neurotransmitter that helps control the brain’s reward and pleasure centers. — Psychology Today Dopamine is also a big player in addiction. All abused drugs including heroin, cocaine, alcohol, and benzos increase dopamine in one way or another. [NIDA, “Well-Known Mechanism”] Drug Enforcement Administration (DEA) The DEA is the governing body and law enforcement agency for prescription and non-prescription drugs in the United States. E Emotional Blunting Emotional blunting, also known as emotional anesthesia, is quite simply the inability to feel pleasure or pain. It’s like having no emotions. Benzos are tranquilizers, and they sedate emotional responses sometimes providing a general feeling of being emotionally numb. Former long-term benzodiazepine users often bitterly regret their lack of emotional responses to family members — children and spouses or partners — during the period when they were taking the drug. — Prof. C. Heather Ashton, The Ashton Manual F Formication A common symptom during benzo withdrawal, formication is a specific type of paresthesia. It is usually identified by the feeling of something crawling on the skin, like a spider or bug. G GABA Gamma-aminobutyric acid, or GABA, is a neurotransmitter. This natural brain chemical transmits messages from one neuron to another. Unlike glutamate, which carries an excitatory message, GABA’s message is inhibitory. Thus, when received, GABA signals the central nervous system to calm down. Benzos enhance the actions of GABA. Meaning, benzos increase the inhibitory effect of GABA on the neurons, therefore calming the brain and central nervous system.[Ashton, The Ashton Manual.] While this initial effect provides therapeutic benefits to the patient, eventually the body balances itself out in an effort to reach homeostasis. As the body adapts to a benzodiazepine, it down-regulates the gamma-Aminobutyric acid (GABA) receptors, decreasing their sensitivity. So, GABA has less of an effect. And since GABA is an inhibitory neurotransmitter, the calming effect of GABA is less effective. When a person discontinues taking benzodiazepines, all the physiological changes are exposed, which results in a rebound effect. The effect is generally the opposite of the initial effects of the drug. The homeostasis process kicks in again, but as before, this process takes time. Sometimes weeks, months, or even years. This is known as benzodiazepine withdrawal syndrome (BWS). Eventually, stability is reached again, and the withdrawal symptoms subside. The body returns to normal. Glutamate Glutamate is the most abundant neurotransmitter in the entire nervous system. It stimulates the neurons making them fire and helps brain development including learning and memory. Too much glutamate has been linked to Alzheimer’s disease, stroke, Parkinson’s disease, multiple sclerosis, and other diseases. Low levels of glutamate are often found in people with depression, schizophrenia, and autism. High concentrations of glutamate in the body can be toxic to nerve cells. If this happens over a prolonged period, it can cause damage, which is known as excitotoxicity. When it comes to brain communication, there are two opposing systems: glutamate and GABA. Glutamate stimulates, and GABA inhibits. Together they regulate the level of excitability in the brain. Think of glutamate as the gas pedal: it excites things into action. GABA, on the other hand, puts on the brakes. — Leigh, Jennifer, “Five (5) Facts About Benzodiazepine Withdrawal” H Half-Life Benzos differ substantially based on how long the drugs take to become metabolized and eliminated from the body. This amount of time is measured by half-life, which is the amount of time it takes for half of the initial dose to be left in the blood. Some drugs like triazolam (Halcion) have a half-life of only 2–5 hours, while others like diazepam (Valium) can take anywhere from 20–100 hours to reduce to half of the initial dose. The speed of elimination often comes into question when people ask about long-term symptoms. Can the drugs stay in the system longer even if they’re no longer found in the bloodstream, such as in brain tissue? This question is still to be determined. Hypnotic Hypnotic drugs are any medication that improves, or are designed to improve, the length or quality of sleep. I Interdose Withdrawal Experiencing withdrawal symptoms between doses of a benzo is called interdose withdrawal. This most commonly occurs in people who are on benzos with a shorter half-life, such as midazolam, oxazepam, and temazepam. It can also occur in people who take benzos periodically, such as before a stressful event like flying or public speaking. Once a person takes his/her next dose, the symptoms usually ease. J Jump Jump is a term commonly used to define the moment someone takes their last dose of benzos, usually at the end of their taper. Someone’s “jump day” may be very important to them since it identifies the day they are finally benzo-free, even though their symptoms may linger on for months, or even years. K Kindling Kindling is still somewhat of a mystery. Some people have gone back on benzos for some reason or another once they have become benzo-free. When they decide to withdraw again, it’s often harder than it was the first time. This is expected to be due to a process known as “kindling,” even though the mechanisms and other specifics are still open to speculation. M Myorelaxant Myorelaxant is a term used to describe medication that relaxes the skeletal muscles. N Nonbenzodiazepine (Z-drug) Nonbenzodiazepines, or z-drugs, are often prescribed as an alternative to benzodiazepines. The nickname “z-drugs” came from the name of drugs themselves; zolpidem, zopiclone, and zaleplon. Nonbenzodiazepines were released in the late 1980s as an alternative to benzodiazepines. They have entirely different chemical structures to benzodiazepines, and yet they have almost identical effects, and side effects. This includes tolerance and the potential for BIND, which is why they are included here and treated them the same as benzos. Some of the brand names of z-drugs are quite well known, such as Lunesta, Sonata, and Ambien. P Paresthesia A common symptom of BIND, paresthesia refers to the experience of strange sensations on or near the surface of the skin with no apparent physical cause. Common complaints include burning, tingling, pins and needles, numbness, or even electrical impulses. Potency Potency refers to the strength of the specific drug. The original benzodiazepines, like Librium and Valium, differ significantly from the current drugs, such as Xanax, Ativan, and Klonopin, based on potency. This variance can severely affect withdrawal. Protracted Withdrawal (Syndrome) Protracted Withdrawal goes by many names, depending on whom you ask. It’s known as protracted withdrawal syndrome (PWS), post-withdrawal, post-withdrawal syndrome, prolonged withdrawal syndrome, and persistent withdrawal syndrome. The current term that we use, is BIND. Only 10-15% of long-term benzo users will experience protracted withdrawal. Most will be symptom free well before this time. R Rescue Pill A rescue pill is a benzo pill to use in extreme cases during withdrawal or BIND when one’s symptoms and/or anxiety are more than they can handle. While it may provide a sense of security for the patient, it can also lead to updosing, if used. And, this can create more complications during the withdrawal process. Respiratory Depression Respiratory depression, also known as hypoventilation, is when breathing is too low or slow to provide adequate gas exchange, which increases the amount of carbon dioxide in the blood. It’s the opposite of hyperventilation, in which you breathe too fast and get too much oxygen in the blood. As humans, we need a balance of oxygen and carbon dioxide, and when we get out of balance, bad things can happen. When benzos are combined with street drugs, such as cocaine, heroin, or others, this respiratory depression can become fatal. S Substitution Taper If a person decides to discontinue taking benzos, it is recommend that he or she do so via a slow tapering process. There are three main methods for tapering: direct taper, substitution taper, or titration taper. A substitution taper includes switching, over time, from the patient’s current benzo to another benzo that is better for tapering. The choice for substitution is usually diazepam (Valium). Diazepam has a long half-life and is less potent, making it a good substitute for a slow tapering schedule. Diazepam substitution will take more planning and coordination with one’s doctor and may extend their tapering time to include switching between benzos, but it has been a very effective method for people who take more potent benzos. [Ashton, “The Ashton Manual”] T Taper Most experts agree that quitting benzos suddenly (cold turkey) is ill-advised, dangerous, and can be fatal in extreme cases. A slow reduction in dosage, or taper, is normally recommended and can last months or even years. Tapering can incorporate substitution, titration, or just a direct reduction in dosage depending on the needs of the patient. Please see The Ashton Manual for more information on tapering. Any reduction in dosage should only be done under the direct supervision of a licensed physician. Thienodiazepines Thienodiazepines, like z-drugs, also have a very similar effect as benzodiazepines. They interact with the same receptor sites as benzos and as a result, have similar side effects. Bentazepam, brotizolam, clotiazepam, and etizolam are some of the common thienodiazepines. Some of their brand names include Clozan, Rize, Etilaam, and Pasaden. Titration Taper If a person decides to discontinue taking benzos, it is recommend that he or she do so via a slow tapering process. There are three main methods for tapering: direct taper, substitution taper, or titration taper. Titration means mixing benzos with milk or water to create a liquid form of the drug, allowing the user to better control his or her dosage. This allows for very small and accurate doses. It also allows the patient to stay on one medication while tapering at a slow, controlled rate. [Ashton, “The Ashton Manual”] Tolerance When a person is in tolerance it means that their body responds less and less to the effects of the drug requiring more and more to get the same benefit. This can be tied with an increase in side effects and even symptoms like those experienced during BIND. This is called “relative withdrawal.” Your body thinks it’s withdrawing since it needs more and it’s not getting more. When drugs such as heroin are used repeatedly over time, tolerance may develop. Tolerance occurs when the person no longer responds to the drug in the way that person initially responded. — [NIDA, “Definition of Tolerance.”] Tolerance Withdrawal After taking benzos for several weeks, a patient’s body will start to adapt, and the drug can stop being as effective. Their body has reached stasis and has adjusted to the drug’s effects. Therefore, their body craves more of the drug to provide the same benefits, which causes them to increase their dose. If their body doesn’t get more of the drug, then it can go into tolerance withdrawal, meaning that their body has reached tolerance of the medication and craves more. BIND symptoms can also be present during tolerance. Many of the symptoms during this phase can be similar to those experienced during and after actual withdrawal of the drug. X Y Z Waves & Windows Waves & Windows are terms used during BIND referring to the cyclical nature of symptoms. A wave is when you experience intense symptoms during BIND for a period of time. This can be days, weeks, or even months. Windows are the opposite. A window is when you feel good and most, or all, your symptoms have subsided. You start to feel normal again. Most people with BIND go through waves and windows at some point in their recovery. It may feel much like a roller coaster. Symptoms get better, then they get worse, then they get better, etc. There are even times when some symptoms get worse while other symptoms get better. Z-drugs See “nonbenzodiazepines.” References This list of references for the Glossary of Terms is not comprehensive and represents some of the more frequently referenced materials. Ashton, C. Heather. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). 2002. Accessed April 13, 2016. http://www.benzo.org.uk/manual/. Foster, D E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, Colorado: Denim Mountain Press, 2018. https://easinganxiety.com/book. Leigh, Jennifer, “Five (5) Facts About Benzodiazepine Withdrawal (You Need to Know),” Additionblog.org, August 16, 2015, accessed March 6, 2017, http://prescription-drug.addictionblog.org/five-5-facts-about-benzodiazepine-withdrawal-you-need-to-know. National Institute on Drug Abuse (NIDA). “Is There a Difference Between Physical Dependence and Addiction?” Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Updated January 2018. Accessed April 8, 2018. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence. National Institute on Drug Abuse (NIDA). “Well-Known Mechanism Underlies Benzodiazepines’ Addictive Properties.” NIDA Notes, April 19, 2012. Accessed August 10, 2017. https://www.drugabuse.gov/news-events/nida-notes/2012/04/well-known-mechanism-underlies-benzodiazepines-addictive-properties. “What is Dopamine?,” Psychology Today, accessed August 10, 2017, https://www.psychologytoday.com/us/basics/dopamine. Wikipedia (varied). For Information Purposes Only – Not Medical Advice All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. Please read our site disclaimer for more information.

Prof. C. Heather Ashton wrote what many medical professionals — and even more patients — consider the “bible” for benzo withdrawal (BIND). If you are considering tapering from a benzodiazepine, please work with your doctor and read this manual. Where to Find It BENZODIAZEPINE INFORMATION COALITION (BIC) Overview / Table of Contents PDF Version Kindle Version Nook Version BENZO.ORG.UK (Original Source) Online Manual About the Manual Benzodiazepine withdrawal (BIND) is ripe with unending questions. Most without answers. But one question has been answered: What is the single best resource for benzo withdrawal? It’s simple. The Ashton Manual. The Ashton Manual is officially titled Benzodiazepines: How They Work and How to Withdraw and was written by Prof. C. Heather Ashton DM, FRCP. The original manual can be found on the website benzo.org.uk/manual. Benzodiazepine Information Coalition (BIC) provides PDF, Kindle, and Nook versions of the manual at benzoinfo.com/ashtonmanual. All are free to the public. Prof. Ashton’s manual has guided thousands of patients to success during BIND. No other resource has helped more people through this challenging experience. Full of medical facts and valuable information, Prof. Ashton finds a way to let us know that she believes we can succeed and motivates us to do just that. About Professor Ashton Many people in the benzo community will tell you that Prof. Ashton has helped more people taper from benzodiazepines than all the other people combined. And they would be right. Chrystal Heather Ashton DM has held such distinguished titles as Fellow of the Royal College of Physicians, London (FRCP), National Health Service Consultant in Clinical Psychopharmacology, National Health Service Consultant in Psychiatry, and Emeritus Professor of Clinical Psychopharmacology at the University of Newcastle upon Tyne, England. Prof. Ashton worked at the University of Newcastle upon Tyne since 1965 as a researcher, clinician, lecturer, senior lecturer, reader, professor, and emeritus professor. She published approximately 250 papers in professional journals and books on psychotropic drugs and gave evidence to various government committees on tobacco smoking, cannabis, and benzodiazepines, and lectured on benzodiazepines in various countries. Retirement When Professor Ashton closed her clinic in 1994 to retire, there was no one to take it over to continue her work. In 1995, she submitted a research proposal to the medical research council in the U.K. to “investigate the link between long-term benzodiazepine use and permanent brain damage.” Her proposal was rejected. [Lakhani, “Drugs Linked to Brain Damage.”] In Memoriam Prof. Ashton sadly passed away on September 15, 2019. We created a Tribute Page to share how much she meant to us in the benzo community. Visit our tribute page to read what she meant to so many people… or even add your own. Prof. Ashton’s Experience with Benzo Withdrawal In 1982, Professor Ashton established the first benzodiazepine withdrawal clinic within the British NHS and ran the clinic for 12 years. She studied the histories of over 300 patients and closely followed their progress. For twelve years I ran a benzodiazepine withdrawal clinic for people wanting to come off their tranquillisers and sleeping pills. Much of what I know about this subject was taught to me by those brave and long-suffering men and women… It is interesting that the patients themselves, and not the medical profession, were the first to realise that long-term use of benzodiazepines can cause problems. — Prof. Ashton References Ashton, C. Heather. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). 2002. Accessed April 13, 2016. http://www.benzo.org.uk/manual/. Foster, D E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, Colorado: Denim Mountain Press, 2018. https://easinganxiety.com/book. Lakhani, Nina, “Drugs Linked to Brain Damage 30 Years Ago,” Independent, November 7, 2010, accessed March 4, 2017, https://www.independent.co.uk/life-style/health-and-families/health-news/drugs-linked-to-brain-damage-30-years-ago-2127504.html. For Information Purposes Only – Not Medical Advice All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. Please read our site disclaimer for more information.

Benzodiazepine-Induced Neurological Dysfunction (BIND) affects more than just the patients suffering from it. Although not in the same way or to the same extent, family members and friends — I’ll call caregivers — are impacted by it as well. As a caregiver, you may find yourself unexpectedly comforting your loved one, dealing with personality changes, talking through symptoms and ways to mitigate them, altering routines, and canceling plans. Along the way, you and the person going through BIND may feel the effects of isolation, loss of normalcy, and perhaps lack of income if he or she is unable to work. I can tell you that patience, understanding, reassurance, and flexibility are all keys to helping someone go through the difficult journey of recovery. Although I can’t speak with any clinical expertise, I have learned some valuable lessons along the way that may be of help to those suffering from withdrawal symptoms and their friends and family members watching from the sidelines. by Shana Foster (from the book Benzo Free) You Are Not Alone When I researched this, I came across some excellent resources, some of which I share below. But I did notice one thing which was consistent among most of them. Since they are usually written by the benzo patient, most of the articles focus on what you can do to help them. I’m a patient myself, and I understand this point-of-view quite well. But what about you? Please know, we do understand that this is hard for you too. And as I said in the tips below, we appreciate you, even if we don’t always say it. The good news in all of this is that you are not alone. Far from it. Resources to support the caregiver may be hard to find, but they are there, and we have collected some of them for you to make things easier. We’ve also provided 10 Tips for the Caregiver which gives some key points to keep in mind during this difficult time. We realize that this page is not anywhere near complete, and it will continue to grow as we collect more resources. And you can help. If you know of a resource which is not listed below, please tell us about it on our feedback page. Thanks, D 🙂 D E Foster Easing Anxiety Founder 10 Tips for the Caregiver 1) Believe the Symptoms Are Real This is the number one thing you can do for your loved one going through benzo withdrawal. Most physical, emotional, and psychological symptoms of benzo withdrawal are invisible to others. For those on the outside, it’s easy to doubt whether the symptoms are real, imagined, or invented to solicit sympathy or get out of doing an unpleasant activity. This can be terribly frustrating to those suffering from it. It’s bad enough to go through benzo withdrawal, but then for others to question its existence makes it much worse. The single best thing you can do for those going through BIND is to provide assurance that you believe them. 2) Create a Calm Environment Since benzos are an anti-anxiety medication, it makes sense that people may experience heightened — even extreme — anxiety as they withdraw from the drug. At the same time, they may be managing a myriad of painful and debilitating physical symptoms, which only adds to their anxiety. That’s even more reason they need to surround themselves with calming influences. And you can help with that. Start with the obvious, like creating a quiet haven that can be mostly free of interruptions. Allow this to be a special place where the patient can escape for a while. Declutter your home so there are fewer obstacles that can cause frustration. Turn on relaxing music. Watch light-hearted movies. Go for nature walks. Listen more. Talk less. Lighten the schedule. Plan ahead to avoid last-minute rushes. Just don’t make the place so comfy that he or she won’t want to come out of it. When the symptoms subside, you may want to balance the isolation with some social experiences. We’ll cover that shortly. 3) Limit your Isolation It’s understandable that benzo withdrawal (BIND) symptoms can force the biggest of extroverts into hiding. Will they feel up to socializing? What if their symptoms kick in during dinner? Will friends and family understand? Won’t it be embarrassing to have to leave the show half-way into the second act? These fears are quite real and make it so tempting to stay home alone. But, it’s good to interact with others and maintain relationships when they can. And, if for no other reason, it’s good for them to think about something else besides their own symptoms for a while. Encourage your loved one to socialize with friends and family when they can. Don’t push them, especially if it’s a bad symptom day. Keeping some semblance of a social life is important, but only if it’s beneficial for you and your patient. If it’s better to stay home, invite friends to come over. If the patient needs to excuse him or herself for a few minutes to lay down, your friends will understand. This is as important for you as it for the one for which you are caring. Be careful of becoming too isolated. 4) Prepare for Potential Personality Changes — Both Good and Bad Unfortunately, a common symptom of benzo withdrawal can be personality changes. The person you once knew, once counted on, is now different. Most of the time the changes are minor, but they can be significant enough to affect a relationship, whether it be that of a spouse, partner, parent, child, sibling, friend, or colleague. Knowing that this change may happen, can go a long way towards dealing with it when it does. Try not to be judgmental during this time and understand the cause of this change. Often, they may return to the person they were prior to the drugs after withdrawal. And, even if they don’t, sometimes the changes are positive ones. Many people who have successfully withdrawn from benzos are more compassionate, better listeners, and less focused on trivial matters or material possessions. Try and be understanding the best you can, and support them with these changes. 5) Budget for Potential Financial Changes Some people go through BIND without missing work. For others, the symptoms are too intense to concentrate, and they need to step away from their jobs for a while. BIND symptoms are seemingly unpredictable and non-linear — symptoms don’t necessarily clear up and go away entirely, like when you recover from the common cold. They seem to appear, disappear, and come back again later — a pattern known as waves and windows. So, even if your loved one is managing his or her symptoms effectively today, that doesn’t necessarily mean that he or she won’t need to miss work when the next wave of symptoms comes around. Either way, it’s good to be prepared. If the patient can’t work, the loss of a regular income can have a big impact on finances. It might help to reduce unnecessary costs and save money during the smoother sailing times in case rough waters lie ahead. If there’s any financial upside to BWS, it might be that your loved one spends less than usual because he or she doesn’t feel up to going out as often. Then again, more frequent doctor visits might cancel that gain. 6) Let Your Friends and Family Members Know What's Happening Unfortunately, BIND is still relatively unknown to the general public. And since it’s virtually invisible to others and can last for so long, it’s easy to misunderstand the person going through it, doubt the condition is real, or even forget their symptoms exist. So, as long as the patient agrees, it’s good to let your trusted friends and family members know what’s happening and remind them of it periodically. This isn’t like strep throat that goes away after a couple of weeks. When your friends and family are in the know, they tend to be much more understanding when you can’t attend an event or cancel or change plans at the last minute. It’s important for them to know that sometimes the physical or emotional symptoms of benzo withdrawal make it difficult or impossible for the patient to leave the house and/or be around other people. 7) Remember, It's the Condition, Not the Person Remember the person behind the symptoms. This isn’t them — it’s their condition that’s causing them to be more emphatic, anxious, angry, irritable, complaining, forgetful, irritated, or withdrawn. When you think of it that way, it helps you to find the compassion you need to be around them. This journey isn’t easy for the caregiver. It’s even harder for the patient. 8) Find Gratitude It helps to remember that some others have much greater challenges and manage to not only get through the day but in some cases thrive. Despite the circumstances, somebody always has it worse than you in the world. Together with your loved one, you can be grateful that you both can feed yourselves, walk through the grocery store, smell and taste the warm bread, and see the fresh buds on the crabapple tree outside the window. Practice looking for the positive each day. Even if it’s just 10 seconds between symptoms, every little bit helps. 9) We Appreciate You!!! — Even If We Don't Say It People in benzo withdrawal are overwhelmed with themselves. It’s not intentional, it’s just a fact. So many symptoms, so many negative thoughts, so many struggles, so many fears and irritations that on some days, it’s near impossible to know what’s going on around us. It’s important to remember that we appreciate you. We really do. Even if you don’t hear it enough. We know this is hard for you too, and you also didn’t sign up for this. We are grateful for all of your love, your time, your understanding, and we know we need you now more than ever.. 10) And Most of All, Take Care of Yourself As a caregiver, it’s easy to get sucked into the overwhelming vortex of symptoms, anxiety, and sense of helplessness that accompanies benzo withdrawal. It’s important to keep yourself in a healthy state of mind. After all, how effective can you be as a caregiver if you’re frazzled, depressed, and bitter? Here are three things that can help maintain or regain some sanity: Balance comfort with “me time.” BIND can be overwhelming for the person going through it. When symptoms are at their worst, it’s easy to devote your entire day to comforting the patient. But, work, laundry, dishes, taking your daughter to a birthday party, picking up your son from practice, etc. still must be done. And, you need to take time for yourself amid it all. Sometimes, your loved one might appreciate your presence 24/7, while other times he or she might prefer to be alone. Either way, it’s good to give the patient time and space to work through symptoms on his or her own. Find a balance that works for both of you. Go for a change of scenery. Cabin fever can set up quickly when you and your loved one spend all your time at home. It’s understandable — when you don’t feel good, there’s no place better than home. But after a while, it’s healthy to experience new sites, smells, and sounds. Start small, like a trip to the grocery store or walk around the neighborhood. On better days, try strolling around the mall or going out to eat. It’s amazing how getting away from the routine can help lift both of your spirits. You Need Socialization Too As we said above, your need for socialization is important too. It’s tempting to stay home with the patient instead of venturing out with friends and family members throughout the withdrawal process. After several months, you might find that your own relationships with others feel more distant. It’s important to maintain your own support system for times when you need a shoulder to cry on, distraction, or advice. Remember, benzo withdrawal (BIND) can take a long time in some cases, but it is temporary. Life does get better when it starts to ease. It can be incredibly hard to have patience during this difficult time, and it’s important to find your own support system to ride out the storm. Take care of yourself and remember we truly appreciate all that you do. With love, Shana and D 🙂 Key Resources for the Caregiver Articles How to support a loved one with benzo withdrawal syndrome by Jennifer Leigh What We Wish Family And Friends Knew About Benzo Withdrawal by Jennifer Leigh Videos How to Talk to Loved Ones about Benzos by D E Foster for BIC Tips for Loved Ones: From a Benzo Survivor by Jocelyn Pedersen Podcast Episodes Conversation with a Caregiver (The Benzo Free Podcast) The Dinner Party: Caregivers, Relationships, and Living with BIND (The Benzo Free Podcast) Suicide Prevention Easing Anxiety's Suicide Prevention Resources Suicide Prevention from the CDC QPR Training for Suicide Prevention References Ashton, C. Heather. “The Bridge Project, Bradford: Speech by Professor C Heather Ashton, DM FRCP: Annual Meeting, December 2011.” Benzo.org.uk. Accessed January 27, 2017. https://www.benzo.org.uk/chabradford.htm. Foster, D E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, Colorado: Denim Mountain Press, 2018. https://easinganxiety.com/book. For Information Purposes Only – Not Medical Advice All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. Please read our site disclaimer for more information.

In 2022, the Benzodiazepine Action Work Group (BAWG) published three PDF documents that have become staples for practitioners and patients alike in regards to benzodiazepine prescribing, deprescribing (tapering), and peer support. Dozens of medical experts and community leaders were involved in their development including members of Easing Anxiety, the Alliance for Benzodiazepine Best Practices, Benzodiazepine Information Coalition, and the Schreiber Research Group. These guidances are provided for free and can be accessed on BAWG's website or via the links below: Benzodiazepine Prescribing Guidance This document includes BZRA (benzodiazepines / Z-drugs) prescribing recommendations geared towards medical professionals. View PDF Here: https://corxconsortium.org/wp-content/uploads/Benzo-Prescribing.pdf Benzodiazepine Deprescribing Guidance This document provides guidance for both practitioners and patients regarding deprescribing (tapering) from benzodiazepines and Z-drugs. View PDF Here: https://corxconsortium.org/wp-content/uploads/Benzo-Deprescribing.pdf Benzodiazepine Peer Support Guidance This document provides guidance for individuals involved with both formal and informal peer support in the benzo community. For training, view our Peer Support Training Page. View PDF Here: https://corxconsortium.org/wp-content/uploads/Benzo-Peer-Support.pdf Benzodiazepine Action Work Group (BAWG) The mission of the Benzodiazepine Action Work Group (BAWG) is to increase benzodiazepine safety through education, patient support, and informed prescribing and deprescribing practices. BAWG is part of the Colorado Consortium for Prescription Drug Abuse Prevention and is co-chaired by Alexis Ritvo, MD, MPH (CU Anschutz Medical Center, the Alliance) and D E Foster (Easing Anxiety, the Benzo Free Podcast). DISCLAIMER The recommendations in these documents are evidence-based and/or amplified by collective clinical experience. They are not comprehensive and should not replace clinical judgement informed by individual circumstances. Other sources provide detailed background information and rationale for these recommendations. Never stop or reduce dosage of a benzodiazepine, Z-drug, or any other prescribed medication unless under the direct supervision of a licensed physician. These documents are created and maintained by the Benzodiazepine Action Work Group (BAWG) at the Colorado Consortium for Prescription Drug Abuse Prevention. Easing Anxiety is providing links to these documents for informational purposes only. View Easing Anxiety's complete disclaimer at https://easinganxiety.com/disclaimer.

What are the basics about anti-anxiety drugs? What are they for? Where did they come from? How do they work? How many people take them? What are the side effects during use? Definition of Benzos The term “benzos” is short for benzodiazepines, a class of anti-anxiety medication also known as minor tranquilizers, sedatives, BZDs, BZRAs, and others. These drugs are typically prescribed for anxiety disorders, panic attacks, insomnia, muscle spasms, and seizures. Nonbenzodiazepines (Z-drugs) is another class of sedatives which can have similar effects to benzodiazepines and can also be referred to as “benzos.” Common Types of Benzos Benzodiazepines Nonbenzodiazepines (Z-drugs) alprazolam (Xanax) clonazepam (Klonopin) diazepam (Valium) lorazepam (Ativan) temazepam (Restoril) eszopiclone (Lunesta) zaleplon (Sonata) zolpidem (Ambien) zopiclone (Zimovane) To view a complete list of benzos, visit our “Types of Benzos” page. Treatment Uses Benzos have a variety of therapeutic actions but can be broken down into five primary categories that Prof. Ashton described in her manual. These include: anxiolytic (relief from anxiety) hypnotic (improving sleep) myorelaxant (muscle relaxation) anticonvulsant (relief from convulsions) amnesiac (loss of memory, single-use for medical procedures) The immediate effects of most benzodiazepines can make a person feel relaxed and sometimes sleepy. Even a mild sense of euphoria. Many studies show that occasional, short-term use of benzodiazepines is effective for specific purposes including surgical procedures, alcohol withdrawal, and seizures. Are They Dangerous? While somewhat effective treating the above conditions, benzos can cause physical dependence when taken long-term. In October 2020, the U.S. Food and Drug Administration (FDA) issued a Black Box Warning to address “serious risks of abuse, addiction, physical dependence, and withdrawal reactions.” Withdrawal can include a laundry list of moderate to severe symptoms, which not only can be painful and debilitating, but can also last for months, even years. Benzos are also a leading cause of overdose death when combined with opioids and other narcotics. Brief History Benzodiazepines were originally developed by Leo Sternbach at Hoffman-La Roche in New Jersey. On February 24, 1960, the FDA approved the first benzo medication named chlordiazepoxide with the brand name of Librium. It was soon followed by diazepam, which many people know as Valium. Valium was the top-selling drug in the U.S. for 13 years, between 1969 and 1982. As benzos became increasingly popular, a backlash also gained momentum in the ’80s. Long-term benzo users were suffering from severe withdrawal symptoms, and the media picked up their stories. In 1987, a new class of anti-depressants called Selective Serotonin Reuptake Inhibitors (SSRIs) entered the market, and the Prozac era took hold pushing benzos to the sidelines. In 1981, pharmaceutical manufacturer Upjohn (now part of Pfizer) released alprazolam, and they marketed it under the catchy name of Xanax. While still a benzodiazepine, Xanax represented this new group of benzos that are even more potent than the ones in the 70s. Xanax is 20 times more potent than Valium. By 1986, Xanax had overtaken Librium, Valium, and Prozac to become the best-selling drug in history. And by 2013, prescriptions for benzos in the U.S. climbed to 5.6% of the population. The market demand for general anxiety medications was valued at $3.2 billion in 2014 and is expected to rise to $3.7 billion by the end of 2020. Benzos were back and with a vengeance. How Do Benzos Work? Long story short, we don’t really know. Research has provided some answers, but even after 50+ years there are still unanswered questions. The neurotransmitters glutamate and GABA appear to be the primary mechanisms of action. So let’s take a look at those here. Think of glutamate as the gas pedal: it excites things into action. GABA, on the other hand, puts on the brakes. — Jennifer Leigh, Addictionblog.org Glutamate is the most abundant neurotransmitter in the entire nervous system. It stimulates the neurons making them fire and helps brain development including learning and memory. GABA, gamma-aminobutyric acid, is the primary inhibitory neurotransmitter in the brain. GABA produces a general calming effect on your central nervous system by settling down nerve cells that get over-excited. When your neurons get over-excited, you get anxious. The more GABA, the calmer you feel. GABA receptors are the part of the neuron that can receive GABA neurotransmitters. So, only neurons with GABA receptors can be influenced by the calming effect of GABA, and if those receptors ever become damaged, then the nerve cells may not receive the calming message. Benzos enhance the actions of GABA. Meaning, benzos increase the inhibitory effect of GABA on the neurons, therefore calming the brain and central nervous system. For this reason, benzodiazepines have been found useful in treating anxiety, insomnia, muscle spasms, epilepsy, alcohol detoxification, and is helpful in certain medical procedures. Unfortunately, this process also has a tendency to down-regulate the GABA receptors over time which is one of the primary factors causing dependence. We will discuss more on this in Basics of BIND.. GABA does seem to get all the press when it comes to benzos, but it’s not the complete picture. …benzodiazepine actions are by no means confined to a particular neurotransmitter or brain pathway. — Prof. Ashton Prof. Aston’s paper titled “Protracted Withdrawal Syndromes from Benzodiazepines,” published in 1991, is a great resource here. In that paper, she notes that GABA inhibits both the nervous activity in the brain and the release of excitatory neurotransmitters such as acetylcholine, noradrenaline, dopamine, and serotonin. The clinical effects of benzos are most likely a result of a combination of these reactions. Benzo Usage According to IMS Health, 36 million people in the U.S. were taking anti-anxiety drugs in 2013. For benzodiazepines alone, according to the American Journal of Public Health, 13.5 million adults filled prescriptions in 2013. Here are how the numbers break down (IMS Health)… Total number of people in the U.S… Taking psychiatric drugs: 79 million Taking antidepressants: 41 million Taking anti-anxiety drugs: 36 million Taking ADHD drugs: 10 million Taking antipsychotics: 7 million Total number of people in the U.S. taking anti-anxiety medication who are… 5 years old or younger: 727,304 6–12 years of age: 790,149 13–17 years of age: 650,273 18–24 years of age: 1,660,953 25–44 years of age: 8,944,200 45–64 years of age: 14,439,465 65+ years of age: 9,691,791 It is estimated that at least five million people in the U.S. and U.K. alone are on benzos long-term and have the potential for withdrawal complications. References Ashton, C. Heather. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). 2002. Accessed April 13, 2016. http://www.benzo.org.uk/manual/. Ashton, C. Heather. “The Bridge Project, Bradford: Speech by Professor C Heather Ashton, DM FRCP: Annual Meeting, December 2011.” Benzo.org.uk. Accessed January 27, 2017. https://www.benzo.org.uk/chabradford.htm. Ashton, C. Heather. “Protracted Withdrawal Syndromes from Benzodiazepines.” Journal of Substance Abuse Treatment 8 (1991): 19-28. https://www.benzo.org.uk/ashpws.htm. Bachhuber, Marcus A., Sean Hennessy, Chinazo O. Cunningham and Joanna L. Starrels. “Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996-2013.” American Journal of Public Health (AJPH) (April 2016). Accessed April 7, 2018. doi:10.2105/AJPH.2016.303061. Byrne, A. “Benzodiazepines: The End of a Dream.” Australian Family Physician 23(8)(Aug 1994):1584-5. Accessed April 17, 2018. https://www.ncbi.nlm.nih.gov/pubmed/7980158. Commonwealth of Pennsylvania. Prescribing Guidelines for Pennsylvania: Safe Prescribing Benzodiazepines for Acute Treatment of Anxiety & Insomnia. Updated May 15, 2017. Accessed April 7, 2018. http://www.health.pa.gov/My%20Health/Diseases%20and%20Conditions/M-P/opioids/Documents/PA%20Guidelines%20on%20Benzo%20Prescribing.pdf. Edwards, Elaine, “Bad Side-Effects of Drugs Such as Valium A ‘Medical Disaster’,” Irish Times, October 10, 2016, Accessed October 10, 2016, https://www.irishtimes.com/news/health/bad-side-effects-of-drugs-such-as-valium-a-medical-disaster-1.2824495. Foster, D E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, Colorado: Denim Mountain Press, 2018. https://easinganxiety.com/book. “Global General Anxiety Disorder Market Worth USD 3,775 Million and CAGR 2.4% by 2021,” Zion Market Research, November 18, 2016, Accessed November 19, 2016, http://www.medgadget.com/2016/11/global-general-anxiety-disorder-market-worth-usd-3775-million-and-cagr-2-4-by-2021.html. IMS Health. Vector One: National (VONA) and Total Patient Tracker (TPT) Database (2013). Extracted April 2014. Quoted in CCHR International. “Total Number of People Taking Psychiatric Drugs in the United States.” Accessed April 3, 2018. https://www.cchrint.org/psychiatric-drugs/people-taking-psychiatric-drugs/. Wikipedia, “Leo Sternbach.” For Information Purposes Only – Not Medical Advice All information presented on uneven is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. Please read our site disclaimer for more information.

Benzodiazepine-induced neurological dysfunction (BIND) can come with a barrage of expected, unexpected, and even sometimes bizarre physical and psychological symptoms. Neuroadaptation and neurotoxicity has caused the central nervous system to become hypersensitive and over-reactive to everyday stimuli, leaving these symptoms in its wake. The following is a list of possible side effects reported by individuals who have experienced difficulties during benzodiazepine withdrawal. We have categorized these symptoms into 14 categories. Seven are psychological symptoms including anxiety symptoms, behavioral symptoms, cognitive symptoms, excitability symptoms, perception symptoms, sleeping symptoms, and social symptoms. And the other seven are physical symptoms including abdominal/gastrointestinal symptoms, symptoms of the eyes, ears, nose & mouth, symptoms of the head & neck, symptoms of the heart & lungs, muscular symptoms, nerve sensations, and immune & endocrine symptoms. We did a 14-part series on the Benzo Withdrawal focused on the various categories of withdrawal symptoms. Here is the introduction below. The remainder of the episodes can be found in their respective symptom categories following. Benzo Free Podcast: Episode 8 An Introduction to Benzo Withdrawal Symptoms CAUTION This list is a general resource. Just like the list of possible side effects on a medication label, nobody will get all, or even most, of the symptoms listed. In fact, many discontinue benzodiazepines with little or no difficulty at all. For those who do have symptoms, it can be helpful to know that they might be caused by benzos, and that they will fade over time. If you are easily triggered by this type of content, you might want to refrain from reading. Psychological Symptoms Anxiety Symptoms Generalized Anxiety – People with Generalized Anxiety Disorder (GAD) often experience chronic, consistent worry about a variety of issues and concerns. This is the most common form of anxiety. Hypochondria – Hypochondria is also known as hypochondriasis, illness anxiety disorder, or somatic symptoms disorder and it’s often identified by constant worrying about one’s own health. This is perhaps the most frightening type of anxiety during BIND due to the continuous barrage of physical aches, pains, sensations, and perceptions that give an obsessive mind plenty of ammunition. Panic Attacks – Prof. Ashton states: “Panic attacks may appear for the first time during withdrawal, although some patients have long experience with this distressing symptom.” Ashton also reminds patients that these rarely last longer than half-an-hour and are never fatal.[Ashton, The Ashton Manual.] Paranoid Thoughts – Normal anxious thoughts are often confused as paranoia. Clinical paranoia is identified as experiencing consistent, ongoing suspicions that are unfair and unrealistic. Paranoid thoughts, like jealousy, conspiracy theories, and the feeling that others are out to get you, can be elevated during withdrawal. Phobias – The list of identified and named phobias numbers in the hundreds. Many are familiar with the more common ones, such as acrophobia, agoraphobia, and claustrophobia. In benzo withdrawal, preexisting phobias can escalate, and new phobias can emerge. Benzo Free Podcast: Episode 9 Anxiety: The Beast of Benzo Withdrawal Behavioral Symptoms Anger/Irritability/Aggression – During sustained benzodiazepine use, our calming mechanism can become damaged, which can make it more difficult for us to control our feelings of anger, aggression, and rage. This experience is sometimes referred to as “benzo rage.” This lack of control can lead to physical violence and abuse. Depression/Suicidal Thoughts – Depression is quite common during withdrawal and BIND. While it may not be a direct effect of the benzos, the suffering many endure could in of itself cause the onset of moderate to severe depressive episodes. Depression can lead to suicidal thoughts during withdrawal, and these thoughts need to be taken seriously and managed with therapy, medication, and support, as needed. If you are having suicidal thoughts, please seek help. Obsessions – Obsessive traits, such as OCD, may be increased during withdrawal. It’s important to remember the cause of this increase and know that they will usually decrease as we start to heal. Benzo Free Podcast: Episode 13 Benzo Bad Guys: Anger, Aggression, Depression and Obsession Benzo Free Podcast: Episode 67 Anger and Irritability in Benzo Withdrawal Cognitive Symptoms Cognitive/Memory Dysfunction – Poor memory and cognitive dysfunction are two common and very distressing side effects of BIND. Unfortunately, these can be some of the last symptoms to fully recover. Intrusive Memories – Another very uncomfortable cognitive side effect can be intrusive memories. These can be traumatic events from someone’s past or even a vivid memory of another person they haven’t seen or thought about for years. One theory is that this is linked to dreaming. Since benzos affect REM and SWS sleep and often prevent dreaming during their use, this could be a sign of healing, and that normal dreaming is starting to return. Benzo Free Podcast: Episode 17 Benzo Brain: Cognitive Dysfunction and Memory Loss in Withdrawal Benzo Free Podcast: Episode 73 Benzo Brain: Cognitive Symptoms in Withdrawal Excitability Symptoms Akathisia – Simply put, akathisia is a disorder where the patient has a feeling of inner restlessness and the urgency to keep moving. It’s like being on high doses of caffeine all the time, even when you’re trying to sleep. Jumpiness – Jumpiness, or reactive movements, are also common in withdrawal and BIND. The patient’s body is very sensitive to a variety of stimuli, thus the body has a tendency to over-respond. Restless Legs – Restless leg symptoms are also common and often happen in tandem with akathisia. Benzo Free Podcast: Episode 23 Perpetual Motion Madness: Excitability Symptoms of Benzo Withdrawal Perception Symptoms Depersonalization/Derealization – Both of these disorders are related to feeling detached from reality. Depersonalization is feeling detached from yourself as if you’re viewing yourself from outside your body. Derealization is feeling disconnected from your surroundings, almost like you’re living in a dreamlike state. Vertigo and lightheadedness are also common with derealization. Some experts believe that it’s a defense mechanism that helps the body cope with excessive suffering by detaching from the experience. Hallucinations – Hallucinations are perhaps the most terrifying of all possible symptoms. They’re more common in acute withdrawal and are rare in BIND. Treatment usually involves helping the patient recognize that the hallucination is unreal, which aids in alleviating the fear. Misperceptions / Perceptual Distortions – Incorrect understanding or abnormal interpretations of experiences can be a symptoms of BIND in some people. Benzo Free Podcast: Episode 28 The Loss of Reality: Perception Symptoms of Benzo Withdrawal Sleeping Symptoms Insomnia – Insomnia is one of the most common complaints during BIND. Since benzos are frequently used as a treatment for insomnia, it makes sense that withdrawal from the drug could affect a person’s ability to sleep. The sleep that people experience while taking benzos is not a typical, healthy type of sleep. Benzos inhibit both REM (rapid eye movement) sleep and SWS (slow wave sleep), so the patient doesn’t get the deep sleep that his/her body really needs. Nightmares – During tapering, withdrawal. and BIND, many patients experience very vivid dreams and nightmares. This may be a sign of recovery. The dream process was subdued during benzo use and now is starting to return to its normal functioning. The nightmares usually subside in a couple of months once the body adjusts to normal REM sleep.[Ashton, The Ashton Manual.] Benzo Free Podcast: Episode 32 The Restless Pursuit of Rest: Insomnia in Benzo Withdrawal Social Symptoms General Social Anxiety – General social anxiety is a widespread problem for people on benzos. Many started taking the drug because of this issue, and others developed it during the process. It can be very frightening and extremely limiting. Specific Social Anxiety – Some also develop social anxiety only in specific environments or situations. Benzo Free Podcast: Episode 36 Interminable Isolation: Social Symptoms in Benzo Withdrawal Benzo Free Podcast: Episode 64 Surviving Isolation: Benzo Withdrawal in Chaotic Times Physical Symptoms Abdominal / Gastrointestinal Symptoms Abdominal Pain – Pain in the abdominal area is quite common during withdrawal. The cause is not always known, but most of the time it appears to be related to the gastrointestinal tract. It can range from a mild nuisance to severe pain and seems to be influenced by diet, anxiety, and the randomness of BIND’s waves and windows. Appetite/Weight Change – Ashton has stated that considerable weight loss (8–10 lbs. or more) can occur during BIND.[Ashton, The Ashton Manual] Since benzos can increase appetite, this might be a rebound effect. Gastric distress might also be a cause since many people are forced to adapt their diet to manage symptoms. Constipation – Constipation can occur during BIND and is often aggravated by over-breathing. Natural laxatives can help with this condition. Distension/Inflammation – One of the most surprising and frightening symptoms of BIND can be abdominal distension. Both men and women have experienced significant and sometimes painful distension, to the point of appearing to be in a late-stage of pregnancy. This is usually experienced in conjunction with digestive difficulties, which causes inflammation. It’s not a permanent condition, and changes in diet can help manage it. Gastritis/Diarrhea/Nausea/Vomiting – Due to the effect that BIND has on the overall digestive system, other symptoms, such as diarrhea, nausea, and vomiting may not be a surprise. Symptoms common with irritable bowel syndrome, gastritis, acid reflux, and other digestive difficulties are also quite prevalent. Groin Pain – The upper abdomen is not the only location to experience pain during BIND. The groin area can be affected too. Inflammation of the gut can affect the lower abdomen and groin. Factors that also come into play include chronic muscle tightness and injury. Menstrual Difficulties – Benzos and BIND can play havoc with a woman’s menstrual cycle, including heavier bleeding, irregular periods, cessation of periods, bleeding between cycles, and increased breast pain. Women do need to be cautious of anemia and other complications during this time if their cycles become too frequent. Pelvic Floor Dysfunction – Pelvic floor dysfunction has been a common diagnosis in women for some time and is rapidly becoming more common in men as well. It can be aggravated by, or even first appear, during BIND. Due to effects that the removal of benzodiazepines have on the tightness of our muscles and on inflammation in the abdomen, this is not unforeseen. Urinary Difficulties – Increased urinary frequency can be common with BIND. Urgency, leaking, and even inability to urinate are also prevalent. Benzo Free Podcast: Episode 11 Benzo Belly: Our Gut in Withdrawal Benzo Free Podcast: Episode 49 The Pelvic Problem: Benzo Symptoms of the Pelvis and Lower Abdomen Benzo Free Podcast: Episode 60 Benzo Belly: Our Gut in Withdrawal (Take 2) Symptoms of the Eyes, Ears, Nose & Mouth Blurred/Double Vision – Some people suffer from vision problems during BIND. Discontinuation can affect the eye muscles, which can lead to distorted vision or even eyelid spasms. Difficulty Swallowing – This can be quite distressing and may even feel like a choking sensation at times. The best course of action is to eat slowly, take small bites, and chew your food thoroughly. Dry Mouth/Metallic Taste – People can experience dry mouth during BIND. It’s usually a mild issue but can lead to other problems of the mouth. A metallic taste is also typical. Oral Thrush – Oral thrush (Oropharyngeal Candidiasis) happens when candida yeast spreads into the mouth. It can appear as white spots inside the mouth, but often the area infected just becomes red and sore. Avoiding foods with gluten, sugar, and some dairy products can help. If this issue is severe, a doctor can prescribe an antifungal medication. Sore/Dry Eyes – Some people complain of dry eyes during BIND, often in conjunction with dry sinus and mucous membranes. Sound & Light Sensitivity – It’s not uncommon for people in BIND to say they have an extreme sensitivity to sounds and light. Their nervous systems have become hyper-excited and can overreact to regular everyday stimulation. Some people have been forced to isolate themselves in their homes to avoid this sensation. Tinnitus – Tinnitus is very common in BIND. Constant or periodic ringing or noise in the ears can range from a mild annoyance to very distressing. There are other possible causes of tinnitus, so if it’s severe, it may be wise to visit a specialist to get checked out. Unusual Smell – The olfactory senses can also be affected by BIND. Some people speak of a burned smell. Most of the time there are no external causes for these sensations. Some people even have smells return with the reconnection to lost memories. Benzo Free Podcast: Episode 16 Benzo Withdrawal Symptoms of the Eyes, Ears, Nose, and Mouth Symptoms of the Head & Neck Balance Issues – The cerebellum, which controls your motor stability and maintains equilibrium, is full of GABA receptors and is heavily affected by benzos. When damaged, it can affect one’s ability to maintain balance. This is often the cause of falls in the elderly. Dizziness/Lightheadedness/Vertigo – Along with anticholinergics and antihistamines, benzodiazepines are commonly used as vestibular suppressants and are often taken by people who suffer from motion sickness, motion sensitivity, and vertigo. When the drugs are removed, the vestibular system reacts and can cause dizziness and lightheadedness during recovery. Headaches / Migraines – Headaches are another common complaint during BIND and are often combined with pressure in the forehead and temples. Some complain that it feels like there is a tight band around their head. Migraines can also be triggered during this time. Neck Pain – Neck pain often occurs in conjunction with headaches and sometimes chest pain. This is most likely due to muscle tightness in the area, which is aggravated by stress and the reduction of the benzodiazepines — benzos are excellent muscle relaxants. Slurred Speech – Dysarthria is the medical term for difficulty speaking, which is indicated by slow or slurred speech. It’s often a result of neurological injury, which can include benzodiazepine dependence, withdrawal, and BIND. This can be exacerbated by alcohol and lack of sleep. Throat Tightening – In addition to difficulty swallowing, some people also feel like their throat is tightening or swollen. This is a common symptom of excessive anxiety, so it’s no surprise that it also appears during BIND. Relaxation exercises can help ease the tension in the neck. Benzo Free Podcast: Episode 20 Unsteady, Unintelligible, and Unyielding: Head and Neck Symptoms of Benzo Withdrawal Symptoms of the Heart & Lungs Breathing Difficulties – Breathing difficulties are common including hyperventilation (over-breathing) and hypoventilation (depressed breathing). Benzos can suppress respiration and have a track record of affecting breathing patterns. When mixed with opiates, they can cease breathing altogether causing death. If you feel you have significant breathing issues during withdrawal, please speak with your doctor immediately. Flushing/Sweating/Skin Conditions – Flushing, excessive sweating, burning of the skin, heat rashes, and related skin conditions are part of the benzodiazepine hall-of-crazy-symptoms. They can be quite irritating and occasionally painful, but they’re rarely dangerous. Heart Palpitations – Heart palpitations are another one of the scary symptoms that often send people to the emergency room. These are also common in panic attacks and heightened states of anxiety but are usually benign. Beta blockers help some people during withdrawal if the palpitations are severe. Consult with your doctor if you feel these are needed. Benzo Free Podcast: Episode 24 Cardiopulmonary Consternation: Heart and Lung Symptoms of Benzo Withdrawal Muscular Symptoms Possible muscular symptoms can include aches, convulsions, fatigue, jerks, pains, pulls, spasms, sprains, stiffness, tears, tics, tremors, twitches, and overall weakness. Benzos are very effective muscle relaxants. By the time the drugs are removed from one’s system the muscles have been chemically relaxed for months or even years, and now they need to figure out how to behave in this new drug-free environment. The removal of a long-term muscle relaxant, in addition to damage to the nerves that signal the muscles, can create a painful cascade effect with some bizarre results. While limited exercise is generally beneficial during BIND, caution needs to be maintained to avoid injury. Benzo Free Podcast: Episode 29 Tight, Tense, and Twitching: Muscular Symptoms in Benzo Withdrawal Nerve Sensations In addition to akathisia, burning sensation of the skin, muscle tics, tremors, and spasms as defined in previous categories, nerve sensations can also include the following: Paresthesia – Paresthesia refers to strange sensations on or near the surface of the skin with no apparent physical cause. Common complaints include burning, tingling, pins and needles, numbness, or even electrical impulses. Formication – Formication is a unique type of paresthesia usually identified by the feeling of something crawling on the skin, like a spider or bug. Benzo Free Podcast: Episode 33 Sights, Sounds, and Sensitivities: Nerve Sensations of Benzo Withdrawal Immune & Endocrine Symptoms Immune System – Some people seem to get more infections during BIND. Since most are under more stress during withdrawal, and knowing that chronic stress can lower the immune system’s ability to fight off germs, this makes sense. Depression also can be a cause of diminished immunity. Another factor is that people going through BIND tend to live a less healthy lifestyle. Endocrine System – As for the endocrine system, we know that benzos have an effect, but there is little information on this topic from related studies. Some women complain about menstrual difficulties, but these are common in the general population too, so it’s hard to determine a cause and effect. Both male and female patients have occasionally complained about breast swelling and engorgement during withdrawal. The good news is that most endocrine system issues do improve once withdrawal is complete. Benzo Free Podcast: Episode 43 Immune and Endocrine Symptoms of Benzo Withdrawal References Ashton, C. Heather. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). 2002. Accessed April 13, 2016. http://www.benzo.org.uk/manual/. “Benzodiazepine Withdrawal Symptoms.” BenzoBuddies. Accessed April 23, 2017. http://www.benzobuddies.org/benzodiazepine-information/withdrawal-symptoms. Foster, D E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, Colorado: Denim Mountain Press, 2018. https://easinganxiety.com/book. Wikipedia (varied). For Information Purposes Only – Not Medical Advice All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. Please read our site disclaimer for more information.