New Benzodiazepine Tapering Guideline Emphasizes Patient-Centered Approach

Timelines for tapering may vary significantly among patients. A multidisciplinary group led by the American Society of Addiction Medicine (ASAM) undertook the development of the Guideline in response to growing concerns about the risks of long-term benzodiazepine use, a class of medications prescribed for anxiety, sleep disorders, and other indications. Our state-specific resource guides offer a comprehensive overview of drug and alcohol addiction treatment options available in your area. Withfacilities locatedin Florida, Ohio, Maryland, Colorado, New Jersey, and Washington, The Recovery Village offers different programs to help treat benzodiazepine addiction and get you on the path to a drug-free life. The experienced medicalstaff at The Recovery Villageoffers patients the resources needed for an effective detoxification process. It is best to do a benzodiazepinedetox under medical supervisionand in the care of addiction professionals with established safety protocols.

Benzodiazepine withdrawal can also lead to disturbances in mental function that persist for several months or years after onset of symptoms (referred to as post-acute-withdrawal syndrome in this form). Ultimately, benzodiazepine withdrawal is a challenging process, that needs support and professional guidance. Our addiction treatment programme can help you to get to the bottom of your addictive behaviours, develop coping mechanisms for the future and help you to achieve a life free from benzodiazepine dependence. Our medical detox service offers a controlled environment, where you can safely withdraw from substances such as benzodiazepines.

The Time is Now!

• Benzodiazepines are a group of drugs called nervous system depressants.
• Enduring, self-paced, on-demand microlearning videos that highlight key takeaways from the guideline in interactive question-and-answer formats.
• Depending on which benzodiazepine you are currently taking, your doctor may want to switch you to a different one before your taper begins.
• Rockville, MD (June 17, 2025) – The new Joint Clinical Practice Guideline on Benzodiazepine Tapering, published today in the Journal of General Internal Medicine (JGIM), offers evidence-informed strategies to help clinicians and patients safely taper benzodiazepine medications while minimizing withdrawal and other symptoms.
• We publish material that is researched, cited, edited and reviewed by licensed medical professionals.

Benzo withdrawals can be severe, and life threatening complications can occur. In most cases of benzo withdrawal, suddenly stopping the medication is not recommended, as it can be dangerous. The main cause of the symptoms of benzo withdrawal is the sudden reduction of dopamine in the brain.

New Benzodiazepine Tapering Guideline Emphasizes Patient-Centered Approach

In addition, over half of the survey respondents said benzodiazepines’ side effects or withdrawal symptoms caused them to consider suicide. Once you stop taking benzodiazepines, rebound symptoms may last up to 3 weeks after your last dose. Read on to learn more about benzodiazepine withdrawal, including the signs, how long it lasts, and how to get support with tapering off safely. If you stop taking them “cold turkey,” or all at once, you may experience severe, even life threatening, withdrawal symptoms. If you want to stop taking benzodiazepines after consistent long-term use, your doctor can help you gradually taper off your medication. Benzo withdrawal can be a stressful process, but it is often necessary for people trying to get themselves off benzodiazepine drugs.

Benzodiazepine Withdrawal & Detox Options

There is no known cure for protracted benzodiazepine withdrawal syndrome except time, however, the medication flumazenil was found to be more effective than placebo in reducing feelings of hostility and aggression in patients who had been free of benzodiazepines for 4–266 weeks. Benzodiazepine withdrawal syndrome (BZD withdrawal) is the cluster of signs and symptoms that may emerge when a person who has been taking benzodiazepines as prescribed develops a physical dependence on them and then reduces the dose or stops taking them without a safe taper schedule. This stage usually lasts for a few weeks, but some people might experience these withdrawal symptoms for longer. A medically assisted drug detox programme will help to ensure that the withdrawal process is as safe as possible, minimising the risk of severe withdrawal symptoms and complications. If you stop taking benzodiazepine medication, you might experience withdrawal symptoms. Rockville, MD (June 17, 2025) – The new Joint Clinical Practice Guideline on Benzodiazepine Tapering, published today in the Journal of General Internal Medicine (JGIM), offers evidence-informed strategies to help clinicians and patients safely taper benzodiazepine medications while minimizing withdrawal and other symptoms.

Benzodiazepine Withdrawal Warnings

Receive updates from ASAM regarding CME, online education, and events on a variety of addiction-related topics. As requested, FDA officers provided nonbinding feedback and technical support to the guideline panel and methodological team. A free, quick-reference digital tool to provide healthcare providers with instant access to current guidelines in a clear concise format.

Addiction Treatment

• Tapering the drug by slowly reducing the prescription strength may help make withdrawal symptoms much easier to manage.
• The neuroadaptive processes involved in tolerance, dependence, and withdrawal mechanisms implicate both the GABAergic and the glutamatergic systems.
• Some symptoms may appear without warning and can be a significant source of distress.
• If you have any concerns or questions about your medication, it’s crucial that you speak to a healthcare professional, who will be able to offer advice and support.
• These can include things like lingering anxiety and irritability, and difficulty sleeping.

However, a prolonged and severe withdrawal syndrome can cause profound disability, which may lead to breakdown of relationships, loss of employment, financial difficulties, as well as more serious adverse effects such as hospitalization and suicide. Management of benzodiazepine dependence involves considering the person’s age, comorbidity and the pharmacological pathways of benzodiazepines. Some people may not fully stabilize between dose reductions, even when the rate of reduction is slowed. According to the British National Formulary, it is better to withdraw too slowly rather than too quickly from benzodiazepines.

General Health

When you are physically dependent on a drug, it means your body can’t operate normally without it. Benzodiazepines are among the most commonly prescribed medications in the United States. Benzodiazepines are a group of central nervous system depressants used to treat anxiety, insomnia, and seizures. This is an important function in the elderly, especially if they drive a car due to the increased risk of road traffic accidents in benzodiazepine users. Further improvements were noted at the 52-week follow-up, indicating ongoing improvements with benzodiazepine abstinence.

If you or someone you know is planning to come off benzodiazepines, it’s crucial that you seek medical guidance and support. When you stop taking benzodiazepines, or reduce the amount you’re taking, your brain may struggle to readjust to functioning without the drug. While these medications can be effective in managing symptoms, if you abuse these substances or use them over a prolonged period of time, this can lead to physical dependence and the need for withdrawal. ASAM is dedicated to increasing access and improving the quality of addiction treatment, educating physicians and the public, supporting research and prevention, and promoting the appropriate role of physicians in the care of patients with addiction. A panel of individuals with lived experience provided input on the Guideline, where they underscored the need for clinicians to understand how to best support patients and slow tapers. The Guideline notes that individuals who have been using benzodiazepines for years may need to slowly taper for a year or more.

People who have been through acute withdrawal often say that this phase is the most difficult. Symptoms generally last 5–28 days, though some may last for several months. There are three possible phases for benzo withdrawals, each with an estimated timeline. Withdrawal symptoms may vary from person to person, although there are some common symptoms. However, going through any withdrawal during pregnancy also has its risks. Inpatient treatment can be costly, depending on the facility.

Management

While withdrawal symptoms might be distressing, it’s important to remember that with the proper medical supervision, you’ll be able to take steps towards a healthier future. Once your body is free from the drug, you’ll be able to enter evidence-based benzodiazepine addiction treatment, if this is the best next step for you. We’ll help you to manage any unpleasant withdrawal symptoms by using appropriately prescribed medication. At Priory, we can provide expert benzodiazepine withdrawal treatment, helping to safely remove these Benzodiazepine withdrawal substances from your body and take steps to address your physical and psychological dependence.

ASAM Criteria

The authors also warned of the similarities in pharmacology and mechanism of action of the newer nonbenzodiazepine Z-drugs. At 24 weeks, significant improvements were found, including accuracy of information processing improved, but a decline was seen in those who remained on benzodiazepines. The authors concluded benzodiazepines were not effective in the long term for sleep problems except in suppressing withdrawal-related rebound insomnia.

A neonatal withdrawal syndrome, sometimes severe, can occur when the mother had taken benzodiazepines, especially during the third trimester. A clinical trial of patients taking the benzodiazepine alprazolam for as short as eight weeks triggered protracted symptoms of memory deficits which were still present up to eight weeks after cessation of alprazolam. Their recommendation is that, for most patients dependent on benzodiazipines and for whom the risks of continuing benzodiazipine use outweighs the benefits, the initial pace of the taper should generally include dose reductions of 5 to 10% every 2–4 weeks. It can be too difficult to withdraw from short- or intermediate-acting benzodiazepines because of the intensity of the rebound symptoms felt between doses. There is no standard approach to managing benzodiazepine withdrawal.With sufficient motivation and the proper approach, almost anyone can successfully withdraw from benzodiazepines. The psychological interventions studied were relaxation training, cognitive-behavioral treatment of insomnia, and self-monitoring of consumption and symptoms, goal-setting, management of withdrawal and coping with anxiety.

But when you start removing benzodiazepines from your system, suddenly your clogged neurons become an open freeway with no traffic lanes. When benzodiazepines attach to your neurons, they invite a bunch of chloride ions inside. These drugs mimic the effects of a neurotransmitter called gamma aminobutyric acid (GABA). Among respondents whose symptoms lasted months or years, over half said caffeine or alcohol worsened their PAWS symptoms. Benzodiazepine-related PAWS can last around 6 to 12 months, although some symptoms can last for years. Dependence and withdrawal can happen to anyone, even if you take your medication exactly as instructed.

The American Society of Addiction Medicine (ASAM), in collaboration with ten other American medical associations, issued a joint statement regarding benzodiazipine tapering in June 2025. Long half-life benzodiazepines like diazepam or chlordiazepoxide are preferred to minimize rebound effects and are available in low dose forms. Pre-existing disorder or other causes typically do not improve, whereas symptoms of protracted withdrawal gradually improve over the ensuing months. Withdrawal symptoms occur during dose reduction and may include insomnia, anxiety, distress, weight loss, dizziness, night sweats, shaking, muscle twitches, aphasia, panic attacks, depression, numbness, dissociation, paranoia, indigestion, diarrhea, and photophobia.