Benzodiazepine medications are some of the most widely prescribed psychiatric drugs in the United States. Clonazepam, known by the brand name Klonopin, is one of the top five prescribed, the U.S. Drug Enforcement Administration (DEA) publishes. More than 25 million prescriptions were dispensed for clonazepam in 2011.
Klonopin is an anticonvulsant medication that is prescribed to treat seizure disorders. It is also an anti-anxiety medication used in the management of panic disorders.
When used regularly, benzodiazepine drugs like Klonopin can easily lead to drug dependence. This is because of the way the drug interacts with brain chemistry.
Klonopin is believed to amplify the activity of GABA (gamma-Aminobutyric acid) in the brain. GABA is an inhibitory neurotransmitter that works on the central nervous system and the stress response. By slowing heart rate, respiration, and heart rate, GABA also reduces anxiety and muscle tension. Klonopin decreases the nerve firings that can result in seizures as well.
Regular interaction of Klonopin on GABA activity and brain chemistry can make it so that the brain will have trouble regulating its own chemical makeup without the medication. When Klonopin then wears off, nerve firing and the central nervous system functions that had been suppressed can spike, causing dangerous withdrawal symptoms.
Klonopin withdrawal can be dangerous, and its associated rebound seizures can even be fatal. Medical detox is the safest way to manage Klonopin withdrawal.
The Emergency Medicine News journal reports that the most common symptoms from benzodiazepine withdrawal include changes in behavior. Nausea, vomiting, insomnia, tremors, anxiety, agitation, and headache are considered relatively mild and typical side effects of Klonopin withdrawal. When someone has been taking high doses of Klonopin for a long time and stops use suddenly, major and even fatal withdrawal seizures can occur, per the FDA.
Klonopin is a medication that is not designed to be stopped cold turkey after taking it for any amount of time. Doing so could be deadly.
Klonopin has a long half-life of between 30 hours and 40 hours, so it can take a few days for withdrawal symptoms to fully kick in. While individual experiences vary, Klonopin withdrawal often follows this general timeline after stopping use of the drug:
Typically, benzodiazepine withdrawal lasts about a month; however, between 10 percent and 25 percent of people who struggle with it may have lingering symptoms for up to a year. Klonopin withdrawal can be influenced by many things, including how often the drug was taken, how much was taken each dose, if the drug was abused and in what way (swallowed, injected, snorted, or smoked), if other drugs were used or abused at the same time, any co-occurring medical or mental health disorders, and genetic and biological factors. The timeline and intensity of withdrawal can be affected by these indicators.
Withdrawal can be deadly when Klonopin use is stopped suddenly after the brain is used to it being there all the time on a regular basis. People who die from Klonopin withdrawal do so because the drug is no longer depressing the nerve firings that keep seizures to a minimum, and the rebound of these signals causes fatal seizures to develop.
Klonopin and benzodiazepine withdrawal deaths are not widely documented, in part, because they may be mistaken for an overdose instead. For example, a case that was found to actually be a fatal benzodiazepine withdrawal reaction was initially recorded as an overdose, the American Journal of Forensic Medicine and Pathologypublishes.
Several cases of withdrawal-related deaths also have been reported in jails and prisons, per the Center for Health and Justice at TASC. This may occur as a result of recreational benzodiazepine use that must be stopped upon entering prison, which may not be disclosed or known by the wardens or prison staff.
To avoid a negative and potentially fatal reaction when stopping Klonopin use, don’t stop it suddenly. Klonopin needs to be tapered off slowly. This allows the drug to be weaned out of the body instead of shocking the system with abrupt cessation of the medication.
Medical detox provides the best avenue for allowing Klonopin to process safely out of the body and brain. During medical detox, you can be monitored constantly by highly trained medical and mental health professionals who can check vital signs and watch for signs of irregular behaviors.
Other anticonvulsant medications may be substituted for Klonopin during medical detox and can be used during the taper to minimize withdrawal symptoms Supportive and therapeutic methods are beneficial during medical detox, as they can help to manage drug cravings, improve coping skills, and provide tools for stress relief.
Acute withdrawal is the most vulnerable time for Klonopin detox and when a person is most at risk for relapse or potentially dangerous and life-threatening side effects. Medical supervision during the first two weeks is essential; at any point during this time, Klonopin withdrawal symptoms can turn deadly.
For benzodiazepine drugs, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that acute withdrawal generally lasts between one and four weeks, or three and five weeks if the drug is being tapered off. Protracted withdrawal is the collection of symptoms that may continue for several weeks to months after stopping Klonopin use.
Medical detox can help a person to become physically and emotionally stable and prepare them for direct admission into a complete addiction treatment program, which should be the next step in treatment.
Additional measures that can be beneficial during Klonopin withdrawal include:
To stay safe during Klonopin withdrawal, it is important to be in tune with your body. During a taper, be honest with your health care provider about your symptoms, so they can adjust the dosage as needed. Sometimes, the dosage may need to be increased or reduced depending on how you are feeling. Other medications may also be needed to control specific symptoms.
Klonopin withdrawal can be safely accomplished when detox is done under the watchful eyes of trained professionals.
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(December 2001). Benzodiazepine Withdrawal: Potentially Fatal, Commonly Missed During Benzodiazepine Cessation, Withdrawal Symptoms May Begin Within 24 Hours or Take Up to Two Weeks to Develop. Emergency Medicine News. Retrieved October 2018 from https://journals.lww.com/em-news/fulltext/2001/12000/Benzodiazepine_Withdrawal__Potentially_Fatal,.13.aspx
(October 2013). Klonopin Tablets (Clonazepam). U.S. Food and Drug Administration. Retrieved October 2018 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/017533s053,020813s009lbl.pdf
(June 2009). A Fatal Case of Benzodiazepine Withdrawal. The American Journal of Forensic Medicine and Pathology. Retrieved October 2018 from https://www.ncbi.nlm.nih.gov/pubmed/19465812
(January 2018). Safe Withdrawal in Jail Settings. Center for Health and Justice at TASC. Retrieved October 2018 from http://www2.centerforhealthandjustice.org/sites/www2.centerforhealthandjustice.org/files/publications/Safe%20Withdrawal%20in%20Jail_010918.pdf
(August 2017). Benzodiazepine Withdrawal Syndrome: Presentations and Emergency Department Management. EmDocs. Retrieved October 2018 from http://www.emdocs.net/benzodiazepine-withdrawal-syndrome-presentations-emergency-department-management/
(July 2010). Protracted Withdrawal. Substance Abuse and Mental Health Services Administration. Retrieved October 2018 from https://store.samhsa.gov/shin/content//SMA10-4554/SMA10-4554.pdf