Benzos
Benzos
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The information contained in this website is of a general nature, is for informational purposes only and does not constitute professional advice
Drug testing
Drug testing
Of the most common drugs of misuse, cannabinoids and benzodiazepines stay detectible in urine for the longest; 7-30 days and 3-6 weeks respectively.
Resources
Drugs.ie How long do drugs stay in your system?
NICE. Drug Misuse in Over 16s: opioid detoxification. CG52. 2007.
Public Health England. Alcohol and drug misuse prevention and treatment dependence. Updated 2024.
Withdrawal
Withdrawal
Seizures may occur following abrupt withdrawal of substances, particularly benzodiazepines and alcohol, and are a marker of increased risk of mortality.
Seizures may occur following abrupt withdrawal of substances, particularly benzodiazepines and alcohol, and are a marker of increased risk of mortality.
Benzos
Benzos
When trying to reduce the dose of benzodiazepines or Z-drugs in primary care, one option is to convert them to an equivalent dose of diazepam and then begin dose reduction. This is because diazepam has a longer half-life, reducing any withdrawal symptoms. 5mg of diazepam is equivalent to 7.5mg of zopiclone. The other suggested doses of drugs are not equivalent.
Resource:
Lucas J. Dependence on prescription medication. InnovAiT 2022; 15(4): 202–208.
A 43-year-old man comes to see you for help with his diazepam addiction. He wants to come off them altogether and asks for your help. He is currently on 10 mg daily.
What is the MOST appropriate course of action?
Reduce diazepam by 2 mg every 1-2 weeks
GPs should be able to reduce diazepam especially when the patient is keen to be helped and referral is not needed (although this could change). There is no need to switch to a different benzodiazepine if the patient is already on diazepam.
Stopping his diazepam too quickly is not sensible and the British National Formulary provides a step-down schedule for diazepam in the sleep disorder section, outlining a reduction by 1-2mg every 1–4 weeks (if the patient is on a higher dose of benzodiazepines, reducing the dose by one tenth every 1-2 weeks may be appropriate). If uncomfortable withdrawal symptoms occur, maintain this dose until symptoms lessen. Towards the end of withdrawal, the dose may be reduced in smaller steps if necessary.
Resource:
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