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Why Are Benzodiazepines Used for Alcohol Withdrawal?

  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Modified:
  • Reading Time: 8 minutes
  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Last Update:
  • Reading Time: 8 minutes

Learn how benzos are effectively used for managing alcohol withdrawal symptoms during detox.

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According to the National Center for Drug Abuse Statistics, about 141 thousand Americans die from alcohol effects in an average year. Additionally, 385 Americans die every day from alcohol causes, 10% of deaths occur between the age of 15 and 49, and men are three times more likely to die from alcohol abuse than women.

The ability of benzodiazepines to highly inhibit neurotransmissions in the brain makes them ideal for treating you if you are suffering from alcohol withdrawal.

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More About Benzos

Understanding Benzos

What are Benzodiazepines?

According to the DEA, benzodiazepines are classified as schedule III drugs, forming a class of drugs such as Xanax and Valium with potential misuse and abuse. These medications help treat anxiety, muscle spasms, and panic disorder, but when abused, they become lethal.

Benzodiazepines (Benzos) are anxiolytic (tranquilizers) classes of drugs that belong to a larger group of substances classified as central nervous system (CNS) depressants. Benzos work by increasing the inhibition of neurotransmissions in the brain.

For years now, benzodiazepines have been the primary drugs for treating alcohol. These sedative drugs ease withdrawal symptoms and prevent delirium tremens and seizures. Some examples of benzos include diazepam (Valium), lorazepam (Ativan), chlordiazepoxide (Librium), etc.

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Navigating Alcohol Withdrawal

What is Alcohol Withdrawal Syndrome (AWS)?

When you use alcohol excessively and abruptly stop or reduce the amount you drink, you develop side effects called alcohol withdrawal syndrome. These symptoms may include anxiety, trembling, insomnia, and other mental and physical side effects. This is because alcohol falls under depressants that affect the central nervous system and sedate your brain.

Exposing yourself to long-term alcohol use changes your brain structure to cater to the impacts of alcohol. Your brain does so by producing abnormally high levels of norepinephrine or serotonin.

The abnormally high levels may change your vital signs, like blood pressure and heart rate, thus putting you at risk of a stroke, heart attack, and even death. However, 1 in 20 people experience the most severe form of alcohol withdrawal, called delirium tremens (DTs). In a DTs state, your brain fails to readjust when it lacks alcohol, creating temporary confusion and dangerous changes in your breathing and blood circulation.

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Alcohol and Benzos Impact on Brain Function

How Does Alcohol Affect Your Brain?

Your brain consists of numerous nerve cells and neurons organized in patterns that relay your thoughts, emotions, behaviors, movements, and sensations. A complex system of nerves connects your brain to the rest of your body so that communication can happen in a blink of an eye.

According to the Substance Abuse and Mental Health Services (SAMHSA), 4.8 million Americans misused benzodiazepines, while 28.3 million had prescription benzodiazepines in 2019.

Alcohol and other addictive drugs, including opioids, and cocaine, produce a delightful addition of the neurotransmitter dopamine in a region of the brain called the basal ganglia; This area is tasked with controlling reward and your ability to learn based on a rewarding system. Therefore, you feel the need to drink more alcohol.

How Benzodiazepines Affect Your Brain

Benzos work directly with neurotransmitters in your brain, affecting the communication between the nerves of your brain. One of the most important neurotransmitters of benzos is GABA (gamma-aminobutyric acid).

Benzodiazepines trigger GABA- the relaxing neurotransmitters in your brain that slow down neuronal functions. By activating GABA, benzodiazepines oppose anxiety and help you feel calm.

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Using Benzos to Manage Alcohol Withdrawal

How Are Benzos Used to Treat Alcohol Withdrawal Symptoms?

You may have realized that you are suffering from Alcohol Use Disorder (AUD); the feeling and need to stop may lead you to decide to stop drinking immediately. When you stop without seeking professional help, the move can be very detrimental to your health.

Benzodiazepines (Benzos) are the ideal pharmacological medications to treat acute alcohol withdrawal. Treatment with benzos can be administered to you as an outpatient if you are experiencing mild to moderate withdrawal. Still, for a more severe form of alcohol withdrawal, you may need to be hospitalized in a medical facility for a more comprehensive treatment plan.

Benzos prevent and treat symptoms of alcohol withdrawal and counter other mental health issues that co-occur with alcohol dependencies, such as anxiety disorders and insomnia. It is common to receive benzos at the beginning of your treatment regime, i.e., during medically aided detox. You can only use benzos for short-term treatment since they are highly addictive.

The differences in the GABA receptor complex and GABA neurotransmission in your brain influence the reinforcement and intoxication side effects of alcohol and benzodiazepines.

Chronic modulation of the GABA(A)-benzodiazepine receptor complex plays a significant role in CNS dysregulation during alcohol abstinence. Withdrawal symptoms originate partly from a reduced GABAergic inhibitory function and an increase in glutamatergic excitatory function.

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The Role of Benzodiazepines in Alcohol Withdrawal

Why Benzos Treat Alcohol Withdrawal

Both alcohol and benzodiazepines have an anti-anxiety effect on your brain. The ability of Benzodiazepines to mimic the effects of alcohol in your brain makes them ideal for treating alcohol withdrawal symptoms. Its effect kicks in very fast and lasts longer in your brain, effectively treating alcohol withdrawal.

This allows benzodiazepines to essentially replace the effects of alcohol in your brain and prevent you from experiencing withdrawal symptoms. The recovery process is usually prolonged and may prove difficult. However, slowly weaning off the medication can still curb withdrawal symptoms.

Be observant and careful when using benzos to treat alcohol withdrawal since they are highly addictive. You may not notice if you are developing a dependency on benzos.

In alcohol addiction treatment facilities, your withdrawal symptoms could be treated with long-acting benzodiazepines such as diazepam (Valium) and chlordiazepoxide (Librium) or short-acting oxazepam and lorazepam (Ativan).

The most common treatment plan for alcohol withdrawal entails 3 days of long-acting benzodiazepines on a structured schedule. The severity of your condition may lead to further medication.

The two most commonly prescribed long-acting benzos are chlordiazepoxide and diazepam, which you can be given orally or intravenously. You may preferably take Librium due to its high anticonvulsant ability or Valium in case you have overdosed on alcohol, as it is safer to use for that purpose.

You may need to observe the intervals between administering the drug and when it takes effect to avoid a benzo overdose.

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Consulting a Medical Professional for Benzodiazepine Use in Alcohol Treatment

Benzodiazepines have been used to treat both alcoholism and alcohol withdrawal symptoms effectively. Knowing what kind of benzodiazepine you may require is the best approach to avoid issues like addiction. Consult a medical professional before commencing any medicine. Always stick to your doctor’s instructions.

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Written By:

Geoffrey Andaria

Geoffrey Andaria mental health writer at rolling hills recovery center
Rolling Hills Recovery Center

Mental Health Writer

About Author:

Geoffrey Andaria is an experienced mental health content writer and editor. With a B.A. in English and Journalism, Geoffrey is highly educated in freelance articles and research. Having taken courses on social work, Geoffrey is adamant about providing valuable and educational information to individuals affected by mental health and the disease of addiction.

Medically Reviewed By:

Dr. Carl Williams Ph.D., LCADC

Carl Williams, medical content reviewer at rolling hills recovery center
Rolling Hills Recovery Center

Expert Contributor

About Reviewer:

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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