The Confusing Terminology of Benzodiazepine Withdrawal
Benzodiazepines, a class of drugs widely prescribed for anxiety, sleep disorders, and muscle relaxation, can cause many complex, long-term symptoms while taking the medication, tapering off, and after cessation. Patients, healthcare professionals, and the wider community need to understand the confusing vocabulary associated with benzodiazepine withdrawal and post-withdrawal syndromes. As semantics can significantly impact patients’ treatment and recovery journeys, developing a unified language to describe the healing process is vital. In this blog post, we will attempt to demystify the terms “benzodiazepine withdrawal,” “Benzodiazepine-Induced Neurological Dysfunction” (BIND), and “protracted withdrawal.”
Benzodiazepine Withdrawal
Let’s start by clarifying “benzodiazepine withdrawal.” This term generally refers to the time when someone is experiencing withdrawal symptoms until the drug has entirely left the body. These symptoms can be from inter-dose withdrawal or tolerance withdrawal (when more of the drug is needed) or tapering or stopping the medication. Symptoms can include anxiety, restlessness, insomnia, memory and cognitive issues, and more.
Benzodiazepine-Induced Neurological Dysfunction or BIND
Following this, we encounter the term “Benzodiazepine-Induced Neurological Dysfunction” or BIND. BIND describes symptoms that persist even after the drug has been eliminated from the body. These symptoms can be physical, such as muscle tension, pain, tingling, burning, formication, etc., or psychological, such as anxiety or depression. The term BIND came about due to hard work by people dedicated to shedding light on the benzodiazepine problem. It is a new term that better describes what goes on in the body.
Protracted Withdrawal
Lastly, we delve into the term “protracted withdrawal.” Within the benzodiazepine recovery community, protracted withdrawal refers to symptoms that continue after 18 months post-cessation. This period can be particularly distressing as patients may have expected to be symptom-free by this stage.
However, there needs to be more consistency in the use of these terms. For instance, in its new prescription insert, the FDA identifies symptoms persisting beyond four to six weeks after cessation as protracted withdrawal. This time frame is much shorter than the 18-month guideline traditionally used in the benzodiazepine community. This inconsistency needs to be clarified among patients and healthcare providers. Are we dealing with protracted withdrawal at four weeks, or are we in BIND?
Semantics Matter
Indeed, it may seem that the semantics do not matter. After all, the symptoms don’t change based on what we call them. However, the issues of terminology matter because it informs healthcare workers and patients alike on how to manage and cope. A patient classified as being in “protracted withdrawal” might be treated differently than one diagnosed with BIND, although their symptoms might be the same. Moreover, misunderstandings may cause further psychological distress to patients who are already navigating through the painful aftermath of benzodiazepine use.
There’s no question that these terms are complex and often overlapping, adding an additional layer of difficulty to a challenging journey. However, what’s clear is the urgent need for a consensus on the labels we use to describe the experiences associated with the use and discontinuation of benzodiazepines.
Better Understanding
As we move forward, fostering dialogue and collaboration between medical professionals, researchers, regulatory agencies, and patient communities is essential. This collaboration could drive a more comprehensive understanding of benzodiazepine withdrawal and post-withdrawal syndromes, leading to more effective treatment strategies, clearer communication, and ultimately better patient outcomes.
In summary, while we might currently be lost in a confusing sea of jargon, there is hope for a future where our vocabulary is as clear and unified as our understanding that benzodiazepine use can be hazardous.
Beyond semantics, it’s paramount that we recognize the individual struggles and victories of those healing from benzodiazepine use and withdrawal. Each person’s journey is unique and deserves respect and validation, no matter the label attached to their experience. Shared understanding and empathetic language are potent tools in fostering hope, healing, and the resilience of the human spirit in the face of adversity.
In Conclusion
In conclusion, while the terminology associated with benzodiazepine withdrawal and post-withdrawal syndromes can be confusing, they are essential components of the conversation surrounding benzodiazepine usage and recovery. These terms are more than just labels—they’re descriptors of real experiences and distressing symptoms people face during their journey toward healing. We must strive for clear, unified terminology to support those navigating this challenging path.
Let us look forward to a future where our understanding of benzodiazepine withdrawal and post-withdrawal syndromes is as unified as the language we use to describe it. Until then, it’s crucial to remember: whatever the terminology, your symptoms are valid, and your healing journey is important. As we continue to explore, study, and discuss these syndromes, we hope to alleviate not just the confusion over terminology but also the physical and emotional distress faced by so many in their recovery process.
Add Your Voice
I prefer BIND to refer to symptoms after a benzodiazepine has left the body and protracted withdrawal to refer to symptoms 18 months or more after cessation. What are your thoughts?
There is definitely intricate language involved here. And to make it even more complicated, after the final dose of a benzo has been taken, it takes another 20-30 days for the medication to be completely out of the bloodstream.
Regarding BIND, I thought the Consortium came up with that term because they wanted to eliminate the word “withdrawal” from any situation when people were symptomatic several months or years after cessation. The reason for that is most medical professionals (and many patients) tend to associate the word “withdrawal” only with the tapering period, and possibly a few weeks following cessation. The word “withdrawal” also has strong connotations with addiction, and true addiction is rare with prescribed benzos. I’ve been under the impression that BIND was a replacement for “protracted withdrawal” and “post-acute withdrawal syndrome”. Perhaps I’ve been misusing the term. Then again, perhaps BIND does not yet have an official published definition. Personally, I prefer BIND as a replacement for any term containing the word “withdrawal”.
I agree! I like the term BIND much better than withdrawal. You’re right in that withdrawal is often associated with addiction, and most people suffering from benzo damage are not addicts, but rather are chemically dependent on the medication. Many of us in the benzo community are finding our way with the new languaging, but I’m sure we will come up with a better lexicon than what we’ve had in the past.
I fear the term Benzodiazepine-Induced Neurological Dysfunction (BIND) is going to run into some resistance from lawyers who care nothing about the harm done, but are just looking out for their clients financial interests. Induced implies causality, opening the door to liability.
That may be. We will have to see what continues to transpire with the new terminology. Hopefully, the medical community will embrace it, as it is the truth, the benzos DID cause the neurological dysfunction. I like the term better than the FDAs “protracted withdrawal” as symptoms are far more complex and varied than from what is traditionally thought of as withdrawal symptoms. BIND covers the very wide range of possible symptoms. The term withdrawal also implies, to some degree, addiction, which isn’t the case with benzos. We are chemically dependant. We are not adicts. I’m curious to see where we go from here.
I’m tapering in tolerance withdrawal and I have all the sxs of bws and BIND that you mention above. Plus, I’m in ssri tolerance wd and those sxs are similar to bws. It is very challenging to live like this.
I would like to see terms that include withdrawal and long lasting symptoms from other psyche medications, ie antidepressants, antipsychotics, etc. I am still having symptoms after being off all meds for over 6 years. Although I did take benzos occasionally, it seems to me that the antidepressants did me the most harm. I prefer BIND because it is more explanatory of what is going on.
Thank you for your amazing work. I am in BIND, preferred over protracted withdrawal, 5 years after completing my taper. A doctor very knowledgable in the area suggested that because of my frequent use of fosfomycin (I think that is what he said) for UTIs in my younger years, which also impacts gaba receptors, my gaba receptors were already damaged, which contributed to my BIND. Are you familiar with this theory? When I mentioned to him quite randomly my years of having UTIs in the 80s and 90s and into 2000’s, he connected the dots for me. I would like more women to be aware of this connection.
I understand the thinking behind all of this. Definitely think that the protracted withdrawal time span should stay at 18 months. I am at BIND now but was slow to get some side effects after going off benzodiazepines. I only now have full fledged head side effects and I have been off all meds for 33 months. I have the list of drugs that people would have problems taking and feel that as long as I have nerve burning, stomach issues, head issues, I should try to avoid those meds. How is my body different now than at 18 months? The benzo is gone but the drug caused the side effects. I prefer the word protracted used to go with how my body is feeling. Yes, the brain receptors are still damaged hence BIND is used. Too complicated. It makes it sound like I can go back to trying all medicines without fearing a negative reaction.
Thank you for your comment. I am not familiar with that drug, but do feel that if we have damaged our gaba receptors in other ways, that we have a higher risk of BWD/BIND symptoms.
Thank you for your input.
I know. But keep going. We do recover! Thanks for adding your voice here.
I am tapering of after over 10 years of use, since I am clearly only dependent on it and I am so horrified 😭 I never knew of a community for this and I am so glad to have stumbled upon you 🖤🖤🖤
I am glad you are discovering resources that can help you get benzo free and heal. Benzoinfo.com is a wonderful site for information. You can do this! Cheering you on.