Stopping benzodiazepines cold turkey can be dangerous. For people who’ve been taking them for months or years, sudden discontinuation can trigger seizures, panic attacks, hallucinations, or even life-threatening complications. Yet many patients are stuck on these medications long after they’re needed-often because no one ever showed them how to get off safely. The good news? benzodiazepine tapering works. When done right, it helps people regain control without the terror of withdrawal.
Why Tapering Matters More Than Ever
In 2022, over 30 million American adults used benzodiazepines like Xanax, Valium, or Klonopin. Nearly 1 in 6 used them long-term-meaning more than 120 days. That’s not just a number. It’s your neighbor, your parent, your coworker. Many started for anxiety or insomnia, then kept taking them because quitting felt impossible. The risks grow with time. Long-term use increases chances of falls in older adults, memory problems, car accidents, and even higher death rates in people with PTSD. The FDA warned in 2019: sudden withdrawal is harmful. Now, 28 states require doctors to create tapering plans for prescriptions longer than 90 days. The Department of Veterans Affairs cut long-term benzo use by nearly 24% between 2020 and 2023 by enforcing structured tapers. This isn’t optional anymore. It’s standard care.How Fast Should You Taper?
There’s no universal timeline. Your taper depends on how long you’ve been taking the drug, your dose, your age, and your mental and physical health. But here’s what the 2024 Joint Clinical Practice Guideline recommends based on real-world data:- If you’ve been taking benzos for 2-8 weeks: taper over at least 2 weeks
- For 8 weeks to 6 months: taper over at least 4 weeks
- For 6 months to a year: taper over at least 8 weeks
- For over a year: taper over 6 to 18 months
Which Benzodiazepine Are You Taking?
Not all benzos are the same. Short-acting ones like alprazolam (Xanax) and triazolam (Halcion) leave your system fast. That means withdrawal hits harder and sooner. Long-acting ones like diazepam (Valium) stick around longer, making withdrawal smoother. That’s why switching to diazepam is often the smartest move. Here’s the conversion:- 1 mg of alprazolam = 20 mg of diazepam
- 0.5 mg of lorazepam (Ativan) = 10 mg of diazepam
- 1 mg of clonazepam (Klonopin) = 10 mg of diazepam
Three Proven Tapering Methods
There are three main ways to taper, and each has its place:- Same medication taper: You slowly reduce your current benzo. Best for people on low doses or long-acting drugs like diazepam.
- Switch to diazepam: You transition from your current benzo to diazepam, then taper down. This is the gold standard for most people, especially those on short-acting drugs.
- Adjunct medications: Use non-addictive drugs to ease withdrawal symptoms. SSRIs for anxiety, melatonin or trazodone for sleep, or gabapentin for tremors and nerve discomfort. These aren’t replacements-they’re support tools.
Who Should Avoid Tapering?
Tapering isn’t for everyone. Some people need to stay on a low dose because alternatives haven’t worked. That’s okay. But you should consider tapering if:- You’re over 65 (benzos increase fall risk by 40%)
- You have a history of substance use disorder
- You’re taking multiple benzos or mixing them with opioids or stimulants
- You’ve been diagnosed with cognitive impairment or traumatic brain injury
- You have PTSD and are on benzos long-term (VA guidelines call this a high-risk practice)
What Happens During Withdrawal?
Withdrawal symptoms aren’t the same for everyone. Some feel mild anxiety. Others get severe insomnia, muscle spasms, or feel like they’re floating. Symptoms usually start 1-4 days after a dose reduction and peak within a week. They fade over days to weeks. Common signs:- Increased anxiety or panic attacks
- Insomnia or nightmares
- Tremors or muscle twitching
- Sensory changes (light sensitivity, ringing in ears)
- Heart palpitations or dizziness
- Nausea or vomiting
What Works Better Than Just Cutting Dose
Medication alone isn’t enough. Studies show that when people combine tapering with cognitive behavioral therapy (CBT), success rates jump from 42% to nearly 68%. CBT helps you learn new ways to handle anxiety, sleep problems, and stress without relying on pills. Other helpful supports:- Regular check-ins with your prescriber (every 1-2 weeks during taper)
- One pharmacy and one doctor only (to prevent accidental overuse)
- Time-limited prescriptions (e.g., only enough for 7-14 days at a time)
- Peer support from people who’ve done it before
- Apps that track symptoms and suggest adjustments (NIH is testing these now)
What to Do Before You Start
Don’t just cut your dose and hope for the best. Prepare first:- Get a full medical review-check for liver or kidney issues that affect drug processing
- Treat co-occurring conditions like depression or chronic pain
- Review your history: when did you start? Why? What happened when you tried to quit before?
- Build your support system: family, therapist, support group
- Write down your goals: better sleep? Clearer thinking? Less anxiety?
What to Avoid
Don’t:- Switch between different benzos on your own
- Use alcohol to “calm nerves” during withdrawal (it worsens symptoms)
- Try to taper while under major stress (divorce, job loss, illness)
- Stop because you feel “fine” after a few weeks-withdrawal can come back later
- Rely on online forums for dosing advice-every body reacts differently
What Comes After
Getting off benzos is just the first step. The real win is replacing them with healthier habits. Many people find relief through:- Regular exercise (even walking 30 minutes a day helps anxiety)
- Mindfulness and breathing techniques
- Structured sleep routines (no screens before bed, same wake-up time)
- Therapy for underlying trauma or chronic stress
- Non-addictive medications like SSRIs or buspirone
Can I taper off benzodiazepines on my own?
While some people do, it’s risky. Withdrawal can be dangerous, especially with short-acting benzos like Xanax. Seizures, psychosis, and severe anxiety are possible. Medical supervision reduces those risks significantly. Even if you feel fine, your body may be changing in ways you can’t feel. Always work with a doctor.
How long does benzo withdrawal last?
Acute withdrawal usually lasts 1-4 weeks after the last dose reduction. Some symptoms, like anxiety or sleep issues, can linger for months-this is called protracted withdrawal. It’s not a relapse. It’s your nervous system recalibrating. Most people improve steadily over 3-6 months with support and healthy habits.
Is it safe to taper if I’m older?
Yes-and it’s often critical. Older adults are at higher risk for falls, memory loss, and car accidents from benzos. The Beers Criteria lists benzodiazepines as potentially inappropriate for people over 65. Tapering under medical care reduces these risks. Slower tapers (over 6-12 months) are usually recommended for older patients.
What if my doctor won’t help me taper?
You have options. Ask for a referral to an addiction medicine specialist, psychiatrist, or geriatrician. The VA and many large health systems now have formal tapering programs. You can also contact the American Society of Addiction Medicine (ASAM) for provider directories. If your doctor refuses without explanation, seek a second opinion.
Will I ever feel normal again?
Yes. Many people report feeling clearer-headed, more energetic, and less anxious after months of being off benzos. The brain heals. It takes time-sometimes 6-12 months-but the brain regains its natural balance. You may have bad days, but they get fewer and farther between. Most people say the long-term freedom is worth the short-term discomfort.
Can I use marijuana or CBD to help with withdrawal?
Some people find CBD helps with anxiety or sleep during tapering, but research is limited. Marijuana can worsen anxiety or trigger panic in some. Neither is FDA-approved for benzo withdrawal. If you want to try them, talk to your doctor first. Don’t replace one dependency with another. Focus on proven methods: CBT, sleep hygiene, and medical supervision.
