Withdrawal symptoms from high dose benzodiazepines in poly drug users

Among poly drug users attending a treatment service, 33 subjects were identified who had experienced withdrawal symptoms from high dose benzodiazepines (median diazepam equivalent 140 mg/day) at a time uncomplicated by simultaneous cessation of other drugs. Symptoms were rated using the Benzodiazepine Withdrawal Symptom Questionnaire (Tyrer et al. (1990) The Benzodiazepine Withdrawal Symptom Questionnaire. J. Affective Disorders, 19, 53-61). The symptoms experienced were similar to those described in studies of withdrawal from low dose benzodiazepines, but more severe. Greater severity of symptoms was significantly associated with high dosage, the use of multiple benzodiazepines and oral rather than injected use. The implications for clinical management are discussed.