Klonopin (clonazepam) is a medication used to treat anxiety, panic disorder, and seizures. Some people abuse the drug for its sedative effects, which can provide a pleasurable sense of calm, relaxation, and anxiety relief.
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Even people who take benzodiazepine drugs such as Klonopin as prescribed may experience some amount of withdrawal when they try to stop using. Chronic abuse of these medications increases the likelihood of a severe withdrawal syndrome. Because withdrawal symptoms can be uncomfortable and difficult to manage alone, you should consider entering a detox program. Detox is a process designed to assist people that are suffering from acute intoxication and withdrawal.2
During detoxification, you receive medical and/or other supportive interventions that help you remain as comfortable and safe as possible while your body clears itself of the last traces of any recently used intoxicating substances.
Detox consists of 3 main components:2
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- Evaluation. You receive a comprehensive evaluation, which includes screening for any co-occurring medical or physical health issues, examining your overall health, and a screening for any drugs being used prior to admission. The evaluation helps to determine the most appropriate level of care for you.
- Stabilization. The second phase of the detox process is the actual detox. You are assisted and supported, in most cases with medical supervision, as your body withdraws from the substance. You may receive medications to help minimize any withdrawal symptoms.
- Fostering entry into treatment. Detox is not a form of treatment, so you will need to begin a formal treatment program once you have successfully detoxed to ensure your best chances of sobriety. Detox center staff will help you find the best treatment program and assist you in making a smooth transition into the next stage of your recovery.
Why Is Detox Necessary for Recovery?
You can become physically and psychologically dependent on and/or addicted to drugs like Klonopin. Dependence means that your body has become accustomed to the presence of the drug and you need to keep using it to feel normal and to prevent withdrawal symptoms. Over time, you can also build up tolerance, which means you need to use more of the substance to achieve the same effects.3
As the first step in the recovery process, detox helps you quit using Klonopin as safely as possible. As your body clears the substance, a supervised detox program can help you to better manage the physical and psychological consequences of withdrawal.
Is Detox from Klonopin Dangerous?
Certain risks and complications can occur during the Klonopin withdrawal period. Some of these symptoms can be serious and may include:4
- Seizures.
- Increased anxiety.
- Increased heart rate.
- Increased blood pressure.
- An acute withdrawal syndrome similar to that seen during severe alcohol withdrawal. Known as delirium tremens, symptoms may include profound confusion, disorientation, hallucinations, agitation, and seizures.
Why Detoxing at Home Can Be Harmful
Because of the risks associated with Klonopin withdrawal, detox at home is not usually advised and can even be harmful. If you develop withdrawal complications such as seizures, depression, anxiety, or other significant mental health symptoms, you won’t have immediate access to necessary medical care. Additionally, if you feel unable to tolerate withdrawal symptoms, you may relapse, which only perpetuates the cycle of addiction.
It is for these reasons that the Substance Abuse and Mental Health Services Administration (SAMHSA) advises medical detox for people undergoing withdrawal from substances such as Klonopin.5
What to Expect During Klonopin Detoxification
Withdrawal looks different for everyone. However, Klonopin has several commonly experienced withdrawal symptoms, including:6
- Nausea or vomiting.
- An increase in sweating or pulse rate.
- Anxiety.
- Insomnia.
- Visual, tactile, or auditory hallucinations.
- Unintended and purposeless movements, such as fidgeting or pacing.
- Hand tremors (shakes).
- Grand mal seizures.
How Long Does Detox Last?
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders states that, in general, people may not experience withdrawal symptoms from long-acting benzodiazepines such as Klonopin for up to a week after they stop using. Withdrawal symptoms tend to increase and peak during the second week, and then decrease substantially during the third and fourth weeks.6
The length of detox can vary from person to person. It can be affected by factors such as dose, length of use, whether you use other substances, and your unique physical makeup. In particular, you may have a higher chance of suffering from severe withdrawal symptoms, such as seizures and delirium, if you have taken high doses of Klonopin over a long period of time.6
Medically Assisted Detox and Withdrawal
With certain types of substances, including benzodiazepines such as Klonopin, medical detox is the safest method for managing withdrawal. When you undergo detox in a treatment center or hospital, you will receive medical supervision and care, and medications to address withdrawal symptoms, manage any co-occurring physical or mental health symptoms, and minimize the risk of certain withdrawal complications such as seizures.
During detox from Klonopin, dose tapering can make withdrawal symptoms more bearable. Under a doctor’s supervision, you receive a gradual reduction in the Klonopin dose over a period of several weeks or even several months.5 In some instances, you may be given an equivalent dose of another long-acting benzodiazepine, such as diazepam (Valium), as a substitute medication to initiate the tapering process.7
Depending on the severity of your withdrawal symptoms, other medications may be used, including:
- Phenobarbital. This is a barbiturate medication that may be substituted for benzodiazepines when appropriate. It can help to suppress withdrawal symptoms and some patients seem to tolerate it well.8
- Carbamazepine or valproate. These are anticonvulsant medications that have been shown to make people more comfortable during withdrawal in some cases of low-dose Klonopin dependence. They may be best used along with phenobarbital or another long-acting benzodiazepine.5
- Clonidine or propranolol. These medications can help with symptoms such as rapid heart rate or rapid breathing.5
Detox Treatment
Detox can take place in a variety of settings and can last as long as is necessary. Depending on your specific requirements, you can choose to undergo detox in the following types of settings:
- Inpatient detox facility. This can take place in a hospital, free-standing residential detox center, or inpatient rehab program. You live at the facility for the length of detox and receive 24/7 monitoring, care, and support.
- Outpatient detox facility. This form of care can include an outpatient clinic at a hospital or a structured outpatient program at a treatment center. You live at home but travel on a regular schedule to the facility to receive detox medications and support.
- Doctor’s office. This is an option used by some people who are experiencing relatively mild withdrawal symptoms and are not at risk of developing severe complications. Your doctor may be able to accommodate frequent visits as needed, especially in the acute withdrawal phase of detox.
Remember that detox does not take the place of formal addiction treatment. Once you complete detox, you will need to transition to an ongoing substance abuse treatment program to increase your chances of long-term recovery.
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Choosing the Best Detox Center
Selecting a detox center can be a very personal decision that should take into account your individual needs and preferences. Make a list of the criteria that are important to you before calling around. Many people consider the following when selecting a detox center:
- Cost. A number of factors can affect the cost, such as amenities, type of program (whether you select inpatient or outpatient), and the duration of detox. Your insurance may cover the cost, or you may need to think of other ways to pay for detox, such as payment plans, credit cards, loans, or asking family or friends to help out.
- Location. You should consider whether you want to detox at a facility that’s close to home (which can be easier to travel to) or whether you’d prefer a location that may offer more anonymity (which can decrease the likelihood of running into people you know).
- Experience with benzodiazepine withdrawal. It is essential that the facility is equipped to manage cases of acute benzodiazepine withdrawal. You might ask the facility directly over the phone or do some online research.
- Reviews of the program. You can find information about the program and learn more about what other people have experienced by reading online reviews and testimonies.
Sources
[1]. University of Maryland Center for Substance Abuse Research. (2013). Benzodiazepines.
[2]. Center for Substance Abuse Treatment. (2006). Quick Guide For Clinicians Based on TIP 45 Detoxification and Substance Abuse Treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration.
[3]. American Psychiatric Association. (2017). What is Addiction?
[4]. Longo, L. & Johnson, B. (2000). Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. American Family Physician, 61(7), 2121–2128.
[5]. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 134131. Rockville, MD: Substance Abuse and Mental Health Services Administration.
[6]. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Arlington, VA: American Psychiatric Publishing.
[7]. Miller, N. & Gold, M. (1998). Management of Withdrawal Syndromes and Relapse Prevention in Drug and Alcohol Dependence. American Family Physician, 58(1), 139–146.
[8]. Lowry, F. (2014). Benzodiazepine Addiction Meds the Same, but Different?