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The short answer
If you take a benzodiazepine regularly, do not stop suddenly. Abrupt discontinuation can cause serious and even life-threatening withdrawal, including seizures. A slow, individualized taper guided by a clinician is the safest way to reduce or stop. Dependence is common with long-term use, even when the medication is taken exactly as prescribed.
What are benzodiazepines?
Benzodiazepines, such as alprazolam, lorazepam, clonazepam and diazepam, are prescribed for anxiety, insomnia, seizures and other conditions. They work well in the short term, but regular use over weeks or months can cause tolerance and physical dependence. (See [Addiction vs Dependence vs Tolerance: What’s the Difference?].)
Dependence is not the same as addiction. Many people become physically dependent while taking them as directed. Some also develop a substance use disorder.
Withdrawal symptoms
- Anxiety, panic, restlessness
- Insomnia and nightmares
- Tremor, sweating, headache, muscle pain
- Irritability, trouble concentrating
- Heightened sensitivity to light and sound
- Severe cases: seizures, hallucinations and confusion
Why a supervised taper
A 2025 joint guideline developed by ten medical societies, including the American Society of Addiction Medicine, concludes that abrupt discontinuation or sharp dose cuts can cause serious, potentially life-threatening withdrawal. Its core approach is to taper slowly, individually and flexibly, adjusting the pace to how the patient responds. The guideline also says it should not be used as a reason to abandon patients who need a taper or continued long-term treatment.
Evidence for the best taper schedule is limited, so most recommendations rest on clinical consensus. A flexible taper often takes months, not days, and tapers that give the patient some say tend to work better.
What a supervised taper looks like
- Assessment. Your clinician reviews your dose, how long you have taken it, your health and other medications and substances.
- A shared plan. You and your prescriber decide on goals and pace.
- Gradual dose reductions, adjusted if symptoms are hard to handle. Sometimes the plan includes switching to a longer-acting medication.
- Support. Therapy, such as CBT for anxiety and sleep, can make tapers easier.
- Follow-up after you finish, since some symptoms can linger.
If symptoms get hard to manage, your clinician can slow down or pause. That is part of a good plan, not a failure.
What not to do
- Do not stop on your own, and do not rely on an online chart alone.
- Do not mix with alcohol or opioids. The combination can be fatal.
- Do not buy pills on the street. Counterfeit pills can contain other drugs, including fentanyl.
- Do not stop talking to your prescriber if you feel anxious or unwell.
Special situations
- Older adults. Guidance advises caution in using benzodiazepines at all, and tapering is often recommended.
- Pregnancy. Talk to a doctor before changing your dose.
- Use with alcohol or opioids. Treat the substance use disorder alongside the taper, using a recognized level-of-care framework. (See [Opioid Addiction Treatment: Buprenorphine, Methadone and Naltrexone Compared].)
- Misuse or addiction. A medical detox or addiction treatment may be needed. (See [What Is the Difference Between Detox and Rehab?] and [Can You Detox at Home? Dangers of Alcohol and Benzodiazepine Withdrawal].)
How to get help
- Talk to your prescriber and say you want to taper.
- Ask for an addiction medicine specialist if your prescriber is not comfortable.
- Use telehealth if local access is limited. (See [Is Telehealth Addiction Treatment Effective? Pros, Cons and Costs].)
- Call the SAMHSA helpline (1-800-662-4357) for referrals.
If you are a family member
Encourage your loved one to talk to the prescriber, and do not push them to stop abruptly. Learn the warning signs of withdrawal: seizures, confusion and hallucinations are emergencies.
Frequently asked questions
Can I quit benzodiazepines cold turkey?
No. After regular use it can be dangerous. Taper under medical supervision.
How long does a benzodiazepine taper take?
Often months, adjusted to your response.
Is benzodiazepine dependence the same as addiction?
No. Dependence is physical adaptation. Addiction involves loss of control. Some people have both.
Can withdrawal last after I stop?
Some symptoms can linger. Follow-up care helps.
What if my doctor refuses to help me taper?
Ask for a second opinion or an addiction medicine specialist.
Sources
- Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations When Risks Outweigh Benefits (ASAM and nine partner societies), 2025.
- American Society of Addiction Medicine. New Guideline on Benzodiazepine Tapering. asam.org
- SAMHSA. National Helpline. samhsa.gov
This article is for general information only and is not medical advice. Never change your dose without your prescriber’s guidance.