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Reduction of Benzodiazepine Use in Patients Prescribed Medical Cannabis 1 Dalhousie Medical School Class of 2019, Dalhousie University Faculty of Medicine, Undergraduate Medical Education, Xanax (benzodiazepine) addiction is a major problem worldwide. Many people are starting to turn to CBD as a means of weaning themselves off benzodiazepines.

Reduction of Benzodiazepine Use in Patients Prescribed Medical Cannabis

1 Dalhousie Medical School Class of 2019, Dalhousie University Faculty of Medicine, Undergraduate Medical Education, Halifax, Canada.

Andrew Davis

2 Department of Economics, Acadia University, Wolfville, Canada.

Nico Moolman

3 Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada.

S. Mark Taylor

3 Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada.

1 Dalhousie Medical School Class of 2019, Dalhousie University Faculty of Medicine, Undergraduate Medical Education, Halifax, Canada.

3 Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada.

* Address correspondence to: Chad Purcell, BScH, BSc(Pharm), Dalhousie Medical School Class of 2019, Dalhousie University Faculty of Medicine, Undergraduate Medical Education, 5820 University Avenue, 3rd Floor Dickson Building, Halifax B3H 4R2, Canada, [email protected]

This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Benzodiazepines are a class of medication with sedative properties, commonly used for anxiety and other neurological conditions. These medications are associated with several well-known adverse effects. This observational study aims to investigate the reduction of benzodiazepine use in patients using prescribed medical cannabis.

Methods: A retrospective analysis was performed on a cohort of 146 medical cannabis patients (average age 47 years, 61% female, 54% reporting prior use of cannabis) who reported benzodiazepine use at initiation of cannabis therapy. These data are a part of a database gathered by a medical cannabis clinic (Canabo Medical). Descriptive statistics were used to quantify associations of the proportion of benzodiazepine use with time on medical cannabis therapy.

Results: After completing an average 2-month prescription course of medical cannabis, 30.1% of patients had discontinued benzodiazepines. At a follow-up after two prescriptions, 65 total patients (44.5%) had discontinued benzodiazepines. At the final follow-up period after three medical cannabis prescription courses, 66 total patients (45.2%) had discontinued benzodiazepine use, showing a stable cessation rate over an average of 6 months.

Conclusion: Within a cohort of 146 patients initiated on medical cannabis therapy, 45.2% patients successfully discontinued their pre-existing benzodiazepine therapy. This observation merits further investigation into the risks and benefits of the therapeutic use of medical cannabis and its role relating to benzodiazepine use.

Introduction

Benzodiazepines are a class of medications commonly used to treat a variety of neurological conditions. 1 Hypnotic and anxiolytic properties make benzodiazepines a mainstay in the treatment of insomnia and anxiety disorders, as well as alcohol, seizure, and spasticity disorders. These effects are exerted by amplification of inhibitory neural signaling, primarily via gamma-aminobutyric acid receptors. 2 A comprehensive review of the pharmacologic properties of benzodiazepines is outside the scope of this study, but can be found elsewhere. 3

Annual incidence rates of benzodiazepine use vary across North American populations and regions, with estimates upward of 10%. 4,5 Likewise, Canadian survey data suggest benzodiazepine use has consistently been within the range of 5% in 2003 to 10% in 2012. 6 Benzodiazepines are considered to have a relatively good safety profile in comparison with older sedative hypnotics, such as barbiturates. However, common side effects include ataxia, dizziness, drowsiness, fatigue, slowed reaction, and muscle weakness. 1 Complications of long-term use include lack of concentration, dependence, tolerance, overdose, and addiction. 2 A recent meta-analysis found increased mortality in benzodiazepine users compared with nonusers, with a hazard ratio (HR) of 1.6 (p≤0.05). 7 This has similarly been shown in a systematic review demonstrating an increase in overall mortality in regular benzodiazepine users, with a HR ranging from 1.2 to 1.7 in the studies reviewed. 8 While benzodiazepines remain an essential class of medication, there is certainly need for caution regarding its side effect profile.

This study seeks to investigate benzodiazepine discontinuation rates in a population of patients referred for medical cannabis therapy.

Materials and Methods

A retrospective analysis was performed on a cohort of patients using medical cannabis. These data are part of an ongoing database gathered by Canabo Medical Clinic on medical cannabis patients. At the time of this study, there were 10 clinics operating in Ontario, Alberta, Nova Scotia, and Newfoundland, accepting patients exclusively through referral. Canabo clinics comprised physicians who specialize in the controlled prescribing of medical cannabis for a variety of medical conditions, to whom other health care providers can refer patients. All patients in the study were referred to Canabo by practicing physicians outside the clinic network. Deidentified patient data were obtained in collaboration with Canabo Medical and the electronic health records provider, InputHealth.

Canabo physicians collect self-reported patient information at each clinic visit. Three follow-up appointments were considered adequate to ensure sufficient collection of patient-reported information. Physicians typically wrote prescriptions for 2-month periods, with an average period between visits of 61.3 days, although exact times varied with patient schedules and physician discretion. Based on average prescription durations, patients could reach three follow-up visits in just over 6 months. Due to variability in prescribing practices and adherence, patients enrolled within 9 months of the study end date could be included. The study end date was October 31, 2016, and patients were eligible for inclusion if their first visit to Canabo was before January 31, 2016. Canabo records identified 884 patients who were using benzodiazepines at the time of their initial visit to the clinic, before prescription of cannabis. Six hundred seventy-seven patients were excluded because sufficient information could not be collected before the study end date. Of the 207 patients who initiated cannabis before January 31, 2016, 146 (70.5%) completed three follow-up visits and formed the study sample. No patients were excluded for any other reason, including past medical cannabis usage, indication for medical cannabis or benzodiazepines, previous discontinuation, or any observable characteristics. To evaluate patient’s perceived burden of disease, they were asked “how often is your life affected/impacted by your medical condition,” and given options to answer were as follows: “all the time,” “most of the time,” and “occasionally/rarely” ( Table 2 ).

Table 2.

Self-Reported Impact of Medical Condition on Quality of Life by All Patients at Initial Visit to Canabo Clinic, and by Benzodiazepine Use Status After Three Visits

Impact on life First visit—all patients After three visits—BD use After three visits—no BD use
How often is your life affected/impacted by your medical condition All the time 74.0% 45.0% 30.3%
Most of the time 22.6% 38.8% 43.9%
Occasionally/rarely 3.4% 16.3% 25.8%
Chi-square >0.1

Benzodiazepine management and discontinuation was not a specific goal of any Canabo physician, and benzodiazepine cessation may have been initiated by a physician or patients. Patients were not tested for verification of reported benzodiazepine discontinuation. Referring physicians were sent consultation and follow-up notes regarding their respective patient’s progress under medical cannabis treatment.

Statistical testing via binomial t-tests was used to assess population mean differences in benzodiazepine use after each clinic visit, following initiation of medical cannabis therapy. Approaches involving estimating regression models were deemed unsuitable, given sample size limitations. The potential relevance of the Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) content of cannabis used, and differences in the patients’ perceived impact of their medical condition(s) on their life were evaluated using chi-square tests.

Results

Sample demographics did not identify any significant discrepancies between patients who discontinued their benzodiazepines and those who did not. The mean age of participants was 47.7 years with a standard deviation of 12.7 years. Prior use of cannabis was self-reported by 54% of patients. A total of 97.6% of patients were not currently using other recreational drugs and 73.3% had never used recreational drugs that were not cannabis. Concurrent alcohol and cigarette use was reported in 41.4% and 30.8% of patients, respectively. Results on the discontinuation of benzodiazepine use by each of these groups are presented in Table 1 .

Table 1.

Sample Demographics and Outcomes

Mean Final BD use Final no BD use Significance of difference
Age (years) 47.7 47.2 48.3 NS (p>0.1)
Female 61.0% 61.3% 60.6% NS (p>0.1)
Using cannabis at intake 54.3% 50.3% 59.1% NS (p>0.1)
No current recreational drug use 97.6% 98.1% 97.0% NS (p>0.1)
No history of non-cannabis recreational drug use 73.0% 73.1% 72.7% NS (p>0.1)
Current alcohol use 41.4% 41.9% 40.9% NS (p>0.1)
Current cigarette use 30.8% 32.5% 28.8% NS (p>0.1)
Chronic condition (>3 years) 80.1% 80.9% 80.0% NS (p>0.1)

BD, benzodiazepine; NS, not significant.

Reported primary conditions driving cannabinoid treatment were grouped into neurological (7.5%), pain (47.9%), psychiatric conditions (31.9%), and other (12.7%). Small sample sizes prevent a strong assessment of the link between medical condition and benzodiazepine use.

After the first visit, 44 patients (30.1%) had discontinued their benzodiazepines. Another 21 patients, for a total of 65 patients (44.5%), had discontinued their benzodiazepines by the second visit. By the third visit, one more patient had discontinued benzodiazepines, for a total of 66 patients (45.2%) The reduction between the initial visit and first follow-up is significant at the p

Percent decline in benzodiazepine use among patients at follow-up time points after initiating medical cannabis treatment.

On their initial visit, 74% of patients reported that their “life is affected/impacted by [my] medical condition” “all the time.” After three clinic visits, 45.0% of patients using benzodiazepines, and 30.3% of patients who discontinued benzodiazepines reported that their life was impacted by their medical condition “all the time” ( Table 2 ; chi-square >0.1).

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The distribution of cannabinoid (CBD and THC) proportions was not significantly different among patients who continued and those who discontinued benzodiazepines ( Table 3 ; chi-square >0.1).

Table 3.

Δ9-Tetrahydrocannabinol and Cannabidiol Content of Cannabis Used by a Sample Population by Benzodiazepine Use Status

Mean Final BD use Final no BD use
THC level
>20% 20.2% 14.7% 26.8%
15–19.9% 34.7% 36.8% 32.1%
10–14.9% 12.1% 16.2% 7.1%
5–9.9% 13.7% 14.7% 12.5%
1–4.9% 7.3% 7.4% 7.2%
4.0% 2.9% 5.4%
Unknown 8.1% 7.4% 8.9%
Chi-square >0.1
CBD level
>17% 7.3% 5.9% 8.9%
12–16.9%% 13.7% 14.7% 12.5%
8–11.9% 18.6% 14.7% 23.2%
4–7.9% 13.7% 16.2% 10.7%
1–3.9% 8.1% 11.8% 3.6%
17.8% 14.7% 21.4%
Unknown 21.0% 22.1% 19.7%
Chi-square >0.1

CBD, cannabidiol; THC, Δ9-tetrahydrocannabinol.

Discussion

Patients initiated on medical cannabis therapy showed significant benzodiazepine discontinuation rates after their first follow-up visit to their medical cannabis prescriber, and continued to show significant discontinuation rates thereafter. Discontinuation was not associated with any measured demographic characteristic. Patients also reported decreased daily distress due to their medical condition(s) following prescription cannabinoids. The CBD and THC content of cannabis used did not differ among patients who continued and those who discontinued benzodiazepines.

The observed association between medical cannabis use and benzodiazepine discontinuation should not be misinterpreted as causative, and these results do not support inferences about substitution of medical cannabis for benzodiazepine therapy. Substitution of cannabis for opioids is supported by a growing body of evidence, although many challenges and unknowns limit widespread adoption of cannabis use for this indication. 9,10 Extrapolation of self-reported data suggests that there are potentially as many Canadians using cannabis for its sedative and anxiolytic properties as there are patients taking sedatives such as benzodiazepines. 11,12 The substitution effect of medical cannabis has also been seen with medications for pain, anxiety, migraine, depression, chronic pain, and headache. 10,13,14

This study found no significant difference in the proportions of CBD and THC in the cannabis used by patients who continued and those who discontinued benzodiazepines. This study did not intend to address the relationship between cannabis and anxiety, or the physiological mechanisms of THC and CBD. However, review of the literature on this topic is warranted, as the effects of cannabis on anxiety are not fully understood. 15 Animal studies have reported anxiolytic effects of whole cannabis administration. 16 Experimental animal evidence cannot be easily generalized to human consumption because the use of dried cannabis flower may exhibit varying effects. These effects may be dependent on factors such as proportions and interactions among cannabinoids, amount used, and method of use. The potency of cannabis has been increasing over the past two decades. THC content has been increasing and CBD content decreasing, resulting in an increase in THC:CBD ratios from 14:1 in 1995 to 80:1 in 2014. 17 Previous studies have reported associations of high THC/low CBD content with increased risk of anxiety. 18 CBD and THC have proposed conflicting effects on anxiety. CBD has been associated with anxiolytic effects regardless of dose, while THC reliably produces subjective effects of anxiety, but appears to be anxiolytic at lower doses and anxiogenic at higher doses. 15,19 Pre-clinical studies of CBD have demonstrated promise in treating anxiety disorders. 20 Animal models support a reduction of anxiety symptoms in relation to generalized anxiety disorder and post-traumatic stress disorder through CBD treatment. 21,22 Human and animal studies suggest that CBD may have role in attenuating the effects of THC, including anxiety. 15 The observed association of benzodiazepine discontinuation with use of medical cannabis highlights the importance of further characterization of the anxiolytic properties of cannabis in the future.

Medical cannabis use has increased dramatically in recent years. The total number of Canadians registered for medical cannabis as of September 30th increased from 12,409 in 2014, to 30,537 in 2015 and 98,460 in 2016. 23 Canabo clinics experienced similar growth from 2014 through 2015 with patient volumes expanding by more than double each year. Canabo data accessed in October 2016 consisted primarily of new patients from the same calendar year. Of the 207 patients who initiated medical cannabis with Canabo by January 31, 2016, 61 patients did not complete three visits before study end date. The designation of a 9-month window to receive three follow-up visits may contribute to these lost 61 patients. These patients may have received prescriptions for >3 months, or used their medical cannabis less frequently than discussed with their physician. Patient reasons for discontinuing clinic treatment are unknown and may include the typical reasons for loss to follow-up from any medical clinic.

There are several limitations to the current study. This study is not designed to, nor should be used to hypothesize physiological mechanisms to explain this observed association between benzodiazepines and cannabis. The retrospective observational methodology and sample size preclude an inference of a causal relationship between cannabis and benzodiazepine use trends. Sample size limitations also preclude our ability to make inference from the smaller proportion of benzodiazepine discontinuers than continuers who reported that their medical condition affected their life all the time after three clinic visits. Without dependable safety data and evidence from randomized trials for this cohort, cannabis cannot be recommended as an alternative to benzodiazepine therapy. Retrospective analysis of pre-existing Canabo data from ongoing clinic standard operating procedures precludes examination of many potentially valuable parameters for study, such as benzodiazepine dosing, indication and duration of use, and information about patients’ intentions with discontinuation. No objective measure of benzodiazepine discontinuation was used to confirm self-reported data. Future studies could make use of biomarkers to more closely characterize benzodiazepine discontinuation. Although relative proportions of THC and CBD were reported, data did not include the strain of cannabis, or method of use. Consistent use of cannabis was approximated by patients returning to clinic three times after initial visit. Consistent use was thereby inferred from patients consistently returning to clinic. The present study demonstrates an association between medical cannabis therapy and reductions in benzodiazepine use. There is a fundamental paucity of research on the effectiveness of cannabis as a medical therapy, as well as the risks and benefits of its use. 24 Future studies should aim to expand on the current understanding of cannabis and its potential medical applications.

Conclusion

Medical cannabis remains a controversial but potentially effective treatment for patients suffering from a variety of medical conditions. Within a cohort of patients initiated on medical cannabis therapy, a large proportion successfully discontinued their pre-existing benzodiazepine therapy. This study therefore supports the continued research of medical cannabis and urges further exploration into its therapeutic value.

Acknowledgments

No sources of funding were obtained for completion of this study. No grants or stipends were received by any authors for their work in completing this study. The Acadia University Research Ethics Board declined to engage in full review, deeming the research exempt from review mandates, as per article 2.4 of the Canadian Tri-Council Policy Statement on Ethical Conduct for Research Involving Humans.

Abbreviations Used

CBD cannabidiol
HR hazard ratio
THC Δ9-tetrahydrocannabinol

Author Disclosure Statement

A.D. has an ongoing financial relationship with Canabo Medical, in which Canabo Medical financially compensates A.D. for private corporate data analysis services of patient prescriptions for strictly commercial purposes. This arrangement has no impact on the academic data analyses of this anonymized data set and is therefore unrelated to the present study. We acknowledge this as a potential competing interest. C.P., N.M., and S.M.T.: No competing financial interests exist.

Cite this article as: Purcell C, Davis A, Moolman N, Taylor SM (2019) Reduction of benzodiazepine use in patients prescribed medical cannabis, Cannabis and Cannabinoid Research 4:3, 214–218, DOI: 10.1089/can.2018.0020.

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How People Are Kicking Xanax Addiction With CBD

Xanax (benzodiazepine) addiction is a major problem worldwide. Many people are starting to turn to CBD as a means of weaning themselves off benzodiazepines.

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Xanax is a brand-name anti-anxiety medication in the benzodiazepine class of drugs.

It is used to force the nervous system into a relaxed state — effectively stopping anxiety in its tracks.

The problem with benzodiazepines, in general, is that they’re highly addictive. After just a few weeks of use, people may become dependent on them. As soon as the effects wear off, the brain goes into a state of hyperactivation — resulting in severe anxiety attacks. This can lead to debilitating insomnia and emotional instability.

Because of the severe side effects, many people are trying to get off benzodiazepines but find it difficult because of their highly addictive nature. When the drugs disappear from the system, users can be faced with disabling anxiety attacks.

People are turning to cannabidiol (CBD) as a way to alleviate withdrawal symptoms while they reduce their dose of benzodiazepines. The goal is to stop using them altogether.

In this article, we’ll discuss how people are using CBD as an intermediary to wean themselves safely off benzodiazepines such as Xanax. We’ll talk about the promising research being done in this area and what it means for people hooked on anxiety medications.

Let’s get started.

Table of Contents
  • What are Benzodiazepines?
  • Problems with Benzodiazepines
  • Tips for Using CBD for Benzodiazepine Addiction

What are Benzodiazepines?

Benzodiazepines are a class of synthetic anti-anxiety medications.

This class of medications is used for treating anxiety disorders (such as social anxiety disorder, generalized anxiety disorder, and panic disorder) and insomnia.

Some of the most popular brands include Xanax, Valium, Klonopin, and Lorazepam.

Xanax is by far the most common. Recent reports suggest Xanax is the third most prescribed medication in the United States and one of the top 20 prescription medications sold on the black market globally.

Unfortunately, all benzodiazepines are highly addictive — causing tolerance and dependency on the drug in as little as two weeks of regular use.

List of Benzodiazepines

How Benzodiazepines Work

These potent pharmaceuticals work by modifying the GABA receptors in the brain to become more receptive to GABA. We use GABA to control our stress levels and brain activity. The best analogy for GABA is that it behaves like the brake pedal for the brain — slowing us down when we need to stop.

When GABA activity increases, it slows nerve transmissions in the brain — making us feel relaxed. This stops anxiety attacks in their tracks and calms us down enough to fall asleep.

Problems with Benzodiazepines

1. Addiction

Most people start taking Xanax or other benzodiazepines without expecting to become addicted. Doctors prescribe the medication in small doses for short periods to help people get through periods of severe anxiety. Benzodiazepines are also prescribed for periods of insomnia as they provide short-term relief.

The problem with this is that it only takes a few doses to cause addiction.

After just a few days, the body starts to resist the effects of the drug. It does this by changing the GABA receptors. As this change happens, users need to take higher doses of the drug to produce the same results.

At the same time, our natural GABA levels struggle as well. We can’t produce more GABA to make up for the tolerance, so, instead, we experience side-effects from the poor GABA function. The main side effect of this is the very thing the drugs were intended to treat — anxiety.

Benzodiazepine addiction is characterized by the onset of negative side effects as the drugs wear off. This is called withdrawal.

Withdrawal on benzodiazepines is extremely unpleasant. It includes symptoms such as:

  • Severe anxiety and panic attacks
  • Insomnia
  • Mood disturbances
  • Muscle tremors
  • Muscle pain
  • Suicidal thoughts
  • Nausea and vomiting
  • Sweating
  • Weight loss
  • Seizures
  • Death (with severe benzodiazepine addiction)

As the side effects of anxiety appear, it’s difficult for people to resist the medication. The drug is the only thing that will stop it. This is a nearly impossibly high obstacle to manoeuver when in the process of quitting the drug.

Therefore, most people continue taking the drug despite its negative side effects. The anxiety is just too intense without it.

2. Overdose

Benzodiazepines themselves don’t usually cause an overdose. However, when combined with other drugs such as opiate painkillers or alcohol, the mix can be incredibly dangerous.

Michael Jackson and rapper Lil Peep both had Xanax in their systems at the time of their deaths.

Users think they can avoid these issues by merely sticking to benzodiazepines and avoiding opiates or alcohol — but it’s not this simple.

Doctors won’t continue writing prescriptions for the drug indefinitely, and if they do, they will cap the dose. As tolerance increases, users are forced to seek out other sources of the drug to feed their addiction.

However, black market benzodiazepines aren’t always made using good manufacturing processes. A lot of them contain a mix of other drugs, such as fentanyl, to cut costs for the manufacturer. This is extremely dangerous and all too common.

All it takes is one bad pill to end up like Lil Peep — who died from taking Xanax laced with fentanyl.

If Lil Peep can’t even get clean drugs, what makes you think you can?

Suggested Reading: Can You Overdose on CBD?

How Can CBD Help Someone Wean Off Benzodiazepines?

So, now that we have a good understanding of how benzodiazepines work and what makes them so dangerous, we can get into how people are using CBD to support their recovery.

The basic idea is that we can use CBD to wean off benzodiazepines gradually. As the dose of your benzodiazepines is lowered, you can simultaneously increase the dose of CBD to offset some of the side effects.

Once the benzodiazepines are fully removed from the system, the focus is to stop the CBD — which is significantly easier.

This works because CBD has similar effects on the GABA receptors to benzodiazepines — only with significantly less potency and potential for addiction.

CBD also offers other benefits for people suffering benzodiazepine withdrawals:

  1. Anti-convulsant — CBD relieves muscle tremors and tension, helping to reduce this uncomfortable side effect while going through benzodiazepine withdrawal.
  2. Anti-anxiety — one of the most important benefits of CBD is its ability to reduce anxiety symptoms, which, of course, is the primary side-effect of benzodiazepine withdrawal.
  3. Sedative — CBD is a mild sedative, helping to relieve symptoms of insomnia resulting from Xanax, Trazodone, or Valium withdrawals.

How to Wean Off Benzodiazepines with CBD

Weaning off benzodiazepines with CBD is reasonably straightforward. You start with a low dose of CBD and your regular dose of benzodiazepines. Over time, the dose of benzodiazepines is gradually reduced, while the dose of CBD is steadily increased.

Eventually, the benzodiazepines are stopped completely. Once this stage is reached, the CBD is gradually reduced as well — which is significantly easier and much safer.

Step 1: Tell Your Doctor

Before you stop taking your medication, tell your doctor.

You need to discuss the plan with them even if they don’t approve (many doctors appear to prefer to keep their patients on the medications to avoid withdrawals).

Ultimately, however, your health is your responsibility. If you’re persistent with your doctor, they will need to help you wean off the medication. They’ll give some advice on a plan, along with some tips for getting through the worst of it.

Most doctors will also schedule visits throughout the process to monitor how the body is responding.

Step 2: Make a Dosage Plan

This step should be done with your doctor or another qualified practitioner. Some doctors and naturopaths specialize in weaning off drug addictions. If you can find one of these specialists, we highly recommend using their services to optimize success.

Here’s a simple dosage plan to give you an idea of what it might look like:
Week Xanax Dose (Daily) CBD Dose (Daily)
Week 1 6 mg 0 mg
Week 2 6 mg 5 mg
Week 3 5 mg 15 mg
Week 4 5 mg 30 mg
Week 5 4 mg 40 mg
Week 6 4 mg 50 mg
Week 7 3 mg 55 mg
Week 8 3 mg 55 mg
Week 9 2 mg 60 mg
Week 10 2 mg 60 mg
Week 11 1 mg 60 mg
Week 12 0 mg 60 mg

These dosages can vary significantly depending on your daily dose of Xanax or other benzodiazepines and how your body reacts to CBD. Some people need higher doses of CBD to be effective; others need lower doses.

You can try out our CBD Dosage Calculator to estimate your ideal dosage to begin.

The key to using CBD is to start low and build up gradually until you get the desired effects. You may need to increase the dose slightly when you lower the benzodiazepine dose.

Step 3: Order Your CBD

Before you start the weaning-off process, make sure you have enough CBD to get through the first couple of weeks. We recommend opting for a high-potency product — this can always be diluted to smaller doses, but it can be hard to hit higher doses with low-potency products.

We recommend finding a decent CBD oil and a CBD vaporizer. Oils offer long-lasting effects that can be taken both first things in the morning and in the afternoon or evening.

Vaping is good for spot treatment whenever withdrawal symptoms start and for eliminating the habit of popping pills whenever anxiety appears.

You could also check out the best CBD gummies for anxiety relief. Gummies are discrete and easy to take on the go.

Tips for Using CBD for Benzodiazepine Addiction

1. Seek Professional Medical Help Before Attempting the Weaning-Off Process

First and foremost, whenever stopping a medication such as a benzodiazepine, you need to seek out medical advice from a qualified doctor.

Benzodiazepine withdrawals can be dangerous — even lethal, in some cases.

Consult your doctor and return for follow-up visits every time you reduce your benzodiazepine dose so the doctor can assess your vital signs periodically as well as your overall wellbeing and emotional health.

2. Wean Off Benzodiazepines Slowly

It’s better to wean off benzodiazepines slowly over a few weeks instead of as fast as possible — this is especially true for people with a history of using benzodiazepines for more than six months.

Reducing your dose too quickly increases the chances of severe panic attacks, which can lead to a relapse. Instead, plan to wean down by roughly 25% every two weeks.

A good schedule is to lower the dose by about 1 mg every second or third week.

This gives the body enough time to readjust its dependency on the new dose. Once the body has stabilized, you can move on to the next stage and start the process again.

3. Perseverance is Key to Success

Even with the help of CBD, getting off benzodiazepines can be a challenge. Although CBD can significantly improve withdrawal symptoms, it won’t eliminate them.

It’s essential to persevere through periods where withdrawal symptoms can become especially challenging. Remember that the discomfort will eventually pass for good, but only if the process is seen through to the end.

4. Use the Right CBD Products

There are a lot of CBD products on the market — many of which are not going to be sufficient enough for this application.

Look for a CBD product that has the following characteristics:

Using cheap, poor-quality CBD products may be ineffective or, in some cases, make symptoms even worse. This is especially true with contaminants such as pesticides and heavy metals — which can cause anxiety. This is the last thing you want when going through benzodiazepines withdrawal.

We also highly recommend opting for a full-spectrum extract. The full combination of cannabinoids, terpenes, and other phytochemicals in the cannabis plant is more beneficial than CBD in isolation [1].

5. Consider Vaping

Rarely do we recommend anyone starts vaping, especially if they’re not already a smoker.

However, in this case, vaping is very beneficial for changing habits of drug use.

The very action of vaping can help users change habits in their brains. Usually, when benzodiazepine users feel anxiety coming on between doses, they’ll reach for a pill. This forms habit pathways in the brain that can be hard to shake.

This habit of popping pills for anxiety can be replaced with a few hits from a vape instead.

Of course, you don’t want to have compulsive or addictive behavior with anything, including vaping — but during the process of weaning off benzodiazepines, this can be a game-changer.

Vaping also offers the benefits of being fast-acting — especially compared with things such as CBD oils or capsules that can take as long as 45 minutes to start producing their effects. Vaping only takes 5 to 15 minutes to produce the same results.

When anxiety attacks come on, they come on quickly, so relief also needs to be felt rapidly.

6. Use Multiple Forms of Treatments Together

As with any complex medical condition, the best treatment is a multifaceted approach rather than one form of treatment.

Doctors working in rehabilitation centers treating patients for addiction have a variety of techniques at their disposal. It’s the same for people working on correcting addiction at home.

Some common techniques people use to get through benzodiazepine withdrawal may include:

  • Support groups
  • Other herbs
  • Nutritional support
  • Dietary changes
  • Removal of common triggers for drug use
  • Starting a new hobby

What the Research Says

One of the most well-researched benefits of CBD is its anti-anxiety effects.

Interestingly, much of this benefit of CBD is through its activity on the benzodiazepine receptors themselves [2, 3].

This means two things:

  1. CBD can be used to replace benzodiazepines to help wean off the drug.
  2. CBD may increase the effects of benzodiazepines — making it essential to start at a low dose and build up gradually.

A retrospective study published in 2019 analyzed a cohort of 146 medical marijuana patients who were also taking benzodiazepines at the start of the study [4]. By the end of the two-month study, 30% of these patients were no longer taking benzodiazepines. A later follow-up at the six-month mark found that 45% of the patients that took part in the study were off benzodiazepines completely.

Key Takeaways: Weaning Off Benzodiazepines with CBD

Benzodiazepines are posing a significant problem around the world. In the short term, these drugs are incredibly useful for eliminating severe anxiety and panic disorders. However, long-term use can result in addiction. Stopping the medication for any reason causes withdrawal symptoms, which can be excruciating.

CBD is a useful supplement for supporting the recovery process. It has similar effects on benzodiazepine medications, which help alleviate the withdrawal symptoms. In addition, CBD extracts have other benefits that can be used to make the withdrawal process more comfortable — therefore, improving the chances of successful recovery.

Of course, whenever trying something like this, it’s essential to seek medical counsel first. Your doctor should be on board with your plan to stop the medication and will help you form a weaning-off plan — gradually decreasing the benzodiazepine doses while increasing the dose of CBD.

This study was retrospective, looking at the relationship between benzodiazepine use and cannabis use. The original study didn’t look at the effects of weaning off benzodiazepines with cannabis or CBD specifically. The results are likely to be much higher if the intent is to get off the benzodiazepines.

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