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How Long Do Benzodiazepines Stay in Your System?

Every year, millions of benzodiazepine (benzo) prescriptions are filled across the country to treat anxiety, seizures, and insomnia. Of the many people who use benzos, be it as a part of treatment, self-medication, or recreational use, an estimated 44% become dependent on them at some point.

Because benzo prescriptions are so widespread, we are often blindsided by both the harmful side effects of long-term use and the devastating challenge of withdrawal. These drugs cloud the mind, making it difficult to hold on to jobs and relationships. They are also acutely harmful to the body, with evidence linking benzodiazepine addiction to permanent cognitive impairment, Alzheimer’s disease, and premature death.

Withdrawing from benzo dependence is a complicated process regardless of whether you are phasing out of medical treatment or recovering from addiction. Detox programs in substance use treatment facilities like ours exist to make this process safe, comfortable, and permanent.

What Are Benzos?

As a category of drugs, the benzodiazepine family is relatively large and diverse. These central nervous system depressants are listed under Schedule IV of the controlled substances act by the Drug Enforcement Administration (DEA) but remain commonly prescribed, frequently misused, and unfortunately addictive.

When we talk about benzos, we are talking about dozens of different medications, each with their own characteristics and reasons for being prescribed.

The most common types of benzos are:

  • Alprazolam (Xanax)
  • Chlordiazepoxide (Librium)
  • Clonazepam (Klonopin)
  • Clorazepate (Tranxene)
  • Diazepam (Valium)
  • Estazolam (Prosom)
  • Flurazepam (Dalmane)
  • Lorazepam (Ativan)
  • Midazolam (Versed)
  • Oxazepam (Serax)
  • Temazepam (Restoril)
  • Triazolam (Halcion)
  • Quazepam (Doral)

Benzos in the Body

Benzos are most frequently taken orally. They are lipophilic and pass easily beyond the blood-brain barrier and into the central nervous system. Here, they take effect quickly by interacting with specific brain cell proteins called gamma-aminobutyric acid (GABA) receptors.

These receptors are key chemical pathways that enable our nervous system to modulate its own activity. In the simplest terms, GABA is a neurotransmitter that produces sedative effects across our brain, reducing messages, physiological functions like heart rate, and anxiety. Benzos amplify the effects of GABA while they are in our bodies.

However, as with all foreign toxins, benzos don’t stay in your system forever. They are slowly processed out from the bloodstream by the liver and broken down into their component building blocks or metabolites.

For some types of benzos, breaking down the original chemical brings an end to its psychoactive effects. Still, others, such as diazepam, have active metabolites, which stretch out the period of influence.

Dependence and Withdrawal

Prolonged use or misuse of benzos can lead to chemical dependence – this means that the nervous system has adjusted its functioning to assume the presence of these drugs or their metabolites. Quitting benzo use in these cases can lead to the development of benzodiazepine withdrawal syndrome.

Symptoms of withdrawal include:

  • Sleep disturbances
  • Panic attacks
  • Deep muscle pains
  • Shaking and tremors
  • Loss of concentration
  • Memory problems
  • Nausea and dry retching
  • Rapid weight loss
  • Heart palpitations
  • Psychosis
  • Hallucinations
  • Seizures
  • Suicidal ideation

Unlike some other drug abuse withdrawal syndromes, benzo detox symptoms do not simply taper off on their own. These symptoms come in waves that are difficult to predict and even harder to cope with.

Unassisted detox is risky. If you have reason to believe that you or a loved one has developed a physical dependence on any category of benzo drug, reach out to a qualified admissions representative at a licensed treatment center.

How Long Do Benzos Stay in Your System?

The different formulations of this type of drug were all created for various purposes, to treat very different symptoms, for example. Some start acting and climb towards peak levels almost immediately, while others slowly release and build up in the system over several days.

Because of this, there is no hard-and-fast rule for the length of time it takes for a dose to be entirely eliminated from a person’s system. However, you can make a broad estimate based on which subcategory (short-acting, intermediate-acting, or long-acting) the specific drug you have been using falls into.

These subcategories are just descriptions of the biological half-lives of the various types of benzo. In other words, these categories describe the amount of time it takes for half of the initial dose of the drug to be eliminated naturally by the body in lab tests.

And what about the rest? Half-lives decay exponentially. This means that every time the initial half-life period passes by, the amount of the substance in your body cuts itself in half again. If the half-life of a drug is one hour, it would be down to 25% after two hours. However, for our intents and purposes, it takes about five half-lives for a benzo to be effectively eliminated.

Short-Acting Benzodiazepines

Short-acting benzos have the shortest half-life. These compounds take between one and 12 hours to be halfway eliminated by your body’s natural processes, while the most persistent of them takes up to four days to disappear completely.

The most common short-acting benzodiazepines include:

  • Triazolam (120 minutes)
  • Midazolam (two to six hours)
  • Alprazolam (six to 12 hours)
  • Oxazepam (four to 15 hours)
  • Temazepam (eight to 22 hours)

Intermediate-Acting Benzodiazepines

Because every individual metabolizes substances differently, intermediate-acting benzodiazepines are the vaguest to define. However, these sedatives normally take between 12 and 40 hours to decay by half and up to a week to be undetectable.

Common generic formulations include:

  • Bromazepam (10 to 20 hours)
  • Lorazepam (10 to 20 hours)

Long-Acting Benzodiazepines

The longest-acting benzodiazepines typically take up to two days to reach the first period of their half-life. After this, it can take two weeks for them to be fully eliminated.

Common versions include:

  • Clobazam (12 to 60 hours)
  • Clonazepam (18 to 50 hours)
  • Diazepam (20 to 100 hours)
  • Flurazepam (two point three hours, lasting metabolites 47 to 100 hours)

Complicating Factors

A few other factors complicate the length of time an actual drug and its metabolites stay in your system. The drug’s half-life in your body, as well as the ability of any specific screen to detect the substance, is affected by all of the following:

  • Dosage amount
  • Mode of ingestion
  • Age
  • Health status
  • Kidney function
  • Liver function
  • Gender
  • Body mass
  • Presence of other drugs
  • Other medical conditions

Drug Testing for Benzodiazepines

Being asked to undergo drug testing is an everyday fact of life here in the United States. The most frequent reason why is employment – many organizations ask new employees to attend their headquarters for drug detection as part of their intake process.

Court cases and other encounters with the legal system often require drug tests, particularly when they relate to child custody or parole. Involvement in athletic organizations and participation in some sports competitions might also demand drug tests as a prerequisite.

Types of Tests

Regardless of the reasons for testing, it is important to understand that benzos and their metabolites can be detected in many of these tests for some time after cessation. The timeframe for how long depends on the type of benzo (short, intermediate, or long-acting) and the type of test sample.

When the body metabolizes a drug, the molecules it breaks into then spread and remain throughout the body. Many organizations will employ more than one type of drug test because of the variability of detectability for different drugs in diverse samples.

Most people going through routine screening will only have to provide samples for a blood and/or urine test.

Benzo Detection in Urine Tests

Urine tests are among the least non-invasive and most cost-effective screening options. This type of test measures the metabolites filtered into the urine when the sample is collected.

Benzo formulations that set in quickly can be detectable in urine samples within minutes of taking a dose. After this, metabolites can lead to a positive result in samples taken up to two weeks of the last use in most cases.

In the most extreme cases (Valium, for example), a urine sample can test positive even one month after the last use. The exact time frame of each benzos detectability in urine is closely related to the half-life of the particular drug.

Occasionally, alprazolam, clonazepam, temazepam, and triazolam may appear as false negatives, but almost every type of benzo is easily screened for using a urine test.

Benzo Detection in Saliva Tests

Saliva testing is another standard and non-invasive procedure for drug screens. A Q-tip sample is taken from either inside the cheek or under the tongue to check for substance abuse.

Benzos of all types can be very accurately tested for in oral fluid in the first hours after use, but this effectiveness drops off quickly. Saliva screens are only accurate within the first two to three days after the cessation.

Benzo Detection in Hair Tests

Hair follicles absorb benzo metabolites as they grow, and this dead matter is capable of holding them for a long time after stopping. Hair tests can accurately determine drug use up to 90 days after use regardless of the elimination half-life of the substance taken. This makes hair testing one of the most effective forms of screening. However, it is also one of the least common.

A hair follicle does take some time to grow, so to test positive, benzo use has to start at least five days to a week before the test sample is provided.

Benzo Detection in Blood Tests

The final potential detection method is the blood test. Blood testing can detect benzos in a person’s system for up to 24 hours after their last use.

This is by far the most invasive type of detection and is generally avoided due to the higher associated discomfort and the narrow window associated with an accurate test. Benzodiazepines stay in your system for far longer than the period required for blood tests.

While they are not frequently used for routine screens, blood tests are occasionally called for in medical situations when an individual is impaired or unconscious to replace other types of drug screens.

Addiction Treatment for Benzodiazepines

If you or a loved one has been using benzos frequently for an extended period, quitting and weathering withdrawal is not easy alone. Benzos have the potential to stay in the body for weeks, leading to a protracted withdrawal period and uncomfortable, potentially life-threatening symptoms.

Sobriety from benzos is the best choice you can make for your long-term physical and mental health, and the process of quitting should not put anyone in danger.

Choosing to detox and receive professional addiction care in a licensed treatment facility allows you to stay safe during the crucial period and build the foundations for a successful recovery.

To find out more about addiction treatment, contact us today.

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Caty Burns

Clinician

Caty graduated from Indiana University Bloomington in 2015 with a Bachelor of Arts in Psychology and minors in Counseling and History. Throughout her undergrad, she worked at the local CASA program, supporting volunteers advocating for children who had experienced abuse and neglect. Caty worked for seven years at a community mental health center (CMHC), partnering with children, adults, and families.

During those seven years, she taught life and coping skills as well as behavior management, provided case management and peer recovery services, and facilitated treatment teams that included the client, family, providers, and community members. I have also worked at an IOP providing group therapy services. She is currently working towards my Master of Social Work.

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Madison Knowles

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Megan Carmona, LMHC

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Ronn Daigle, MSW

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Ronn Daigle services as a Therapist and Utilization Review Clinician at the Neuro Psychiatric Addiction Clinic. He has been working in the field of substance use disorder treatment since 2011, with experience in all facility-based levels of care. Ronn earned, both an Associate of Arts in Psychology (2013) and Bachelor of Science in Human Services, with an Addiction Studies Concentration (2015) from Indian River State College. 

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Erika Melecio, LMHC, MCAP, CEI

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Erika Melecio, LMHC, MCAP, CEI is the Assistant Clinical Director at Neuropsychiatric Addiction Clinic who specializes in the treatment of LGBTQ, addiction, as well as mental health disorders ranging from depression and anxiety, to Bipolar Disorder, trauma, personality disorders, psychotic disorders, and eating disorders. Erika utilizes a number of modalities including Cognitive Behavioral Therapy, Solution Focused Therapy, Motivational Interviewing, Dialectical Behavioral Therapy, and Mindfulness amongst others. Erika has been in practice for close to a decade and has earned her license in Mental Health Counseling, as well as being a Master’s Certified Addiction Professional. Erika has worked with many individuals including couples counseling and family therapy, and is fluent in Spanish.
 
Throughout my years of practice, one of the things I enjoy helping people find is inner peace. Whether you are in the deepest parts of depression, overrun by your anxiety, controlled by your addiction, or there are certain issues in your life that are negatively impacting your ability to function, and have a happy, healthy life, maybe now is the time to talk about it. I am a big believer in empowerment, working hard in therapy, and utilizing different techniques to help you regain that inner peace that may have been lost along the way. I want to work with you as a team because with two people, absolutely everything is possible. I want to be there as a therapist, to help build you up, support you, but also help you be honest with yourself and accountable. At the end of the day, when all is said and done, my biggest goal for you is going to be simple….for you to no longer need my services. Why? Because if you no longer need my services, it means that you have regained your peace, you have regained your strength, you have regained your confidence. It means that you now have the tools to address any issues that try to derail you, and best of all, you will have the insight to overcome and thrive. So let’s begin this journey together, and get you to the place you want to be, emotionally, mentally, psychologically, and in your sobriety.

Aurelio Ayuso, MSW, LCSW, CAP, ICADC

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Aurelio has worked with those that suffer from the disease of addiction in adults and juveniles alike for over 10 years, beginning in the United States Navy where he proudly served for 20 years, working with those that were succumbed by addiction due to trauma and continuing his passion for helping those in need locally in Central Florida.

He specializes in both Addictions and Trauma, he has worked first as a therapist then as the clinical supervisor to both the Juvenile and Adult Drug Court programs in Brevard County. Aurelio has been instrumental in developing substance abuse treatment programs directly tailored to help those that also suffer from complex trauma due to their addiction. He has been recognized by several organizations for his forward thinking and ability to tailor treatment to individuals in the most restrictive environments.

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Bob Lehmann is the Chief Operating Officer at the Neuro Psychiatric Addiction Clinic. He has a Master’s Degree in Human Services Administration with a concentration in Mental Health Administration and over twenty-five years of experience as a senior executive at addiction and mental health treatment facilities.

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Jose R. Toledo, M.D.

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A well-rounded and accomplished individual, Jose R. Toledo, M.D., is the Medical Director of Neuro Psychiatric Addiction Clinic.

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He also completed 24 months of acute inpatient psychiatry at the Western Missouri Mental Health Center, University of Missouri in Kansas City. In 2008, Dr. Toledo participated in and was certified in the continuing medical education activity entitled “Buprenorphine and Office-Based Treatment of Opioid Dependence” from The Medical University of South Carolina during which began his quest to found and head Neuropsychiatric Addiction Clinic.

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