How Long Do Benzodiazepines Stay in Your System?
Benzodiazepines belong to a class of drugs that produce central nervous system (CNS) depression and are primarily prescribed to treat anxiety, sleep disorders, and seizures as well as a number of medical conditions.1,2 Benzodiazepines, like Valium (diazepam) and Xanax (alprazolam), are controlled substances in schedule IV under the Controlled Substances Act, meaning there is a low potential for misuse and dependence.1,3
How Benzos Work
Benzodiazepines enhance the effects of the neurotransmitter, gamma-aminobutyric acid (GABA), which produces a calming effect in the brain.1,4 Neurotransmitters carry information between brain cells. When there is overstimulation in the brain—because of insomnia or anxiety, for instance—individuals take benzodiazepines, which send messages to calm the overstimulated brain, slowing its activity and making it easier for the individual to sleep or feel less anxious.4
There are a number of various benzodiazepines. Each differs in many ways, including:4
- How fast they take effect.
- How long their effects last.
- Their tendency to remain in the system or build up in the body.
Besides being prescribed to treat anxiety, insomnia, and epilepsy, benzodiazepines can also be used for:1
- Anesthesia (as an adjunct).
- Panic disorders.
- Treatment for alcohol withdrawal.
Benzodiazepine Drugs and Uses
The most commonly prescribed benzodiazepines—and their uses—include:1,6
- Xanax, Librium (chlordiazepoxide), Ativan (lorazepam), and Valium for anxiety.
- Ativan, Valium, and Klonopin (clonazepam) for seizures.
- Valium, Ativan, and Versed (midazolam) as anesthesia.
- Restoril (temazepam), Halcion (triazolam), and Dalmane (flurazepam) for insomnia.
- Valium, Librium, Ativan, and Serax (oxazepam) for alcohol withdrawal.
- Valium for muscle spasms.
Benzodiazepines largely replaced another class of drugs, barbiturates, which historically had been used to treat insomnia and epilepsy and used as an induction to anesthesia.7 Yet, barbiturate misuse became a significant societal concern in the 1950s.7 Thus, barbiturate use came to an end except in specific applications, such as the induction of anesthesia and certain epileptic conditions.7 Benzodiazepines became the barbiturate successor—with a lower risk of potential misuse—and the ability to treat the same conditions.7
Though the potential for misuse is lower than other prescription drugs, benzodiazepine misuse is definitely a concern, according to the statistics, which include:8-10
- About 4.8 million people aged 12 or older misused prescription benzodiazepines in 2020.
- Of those, over 3.4 million individuals aged 12 or older misused alprazolam products such as Xanax in 2020, 723,000 misused lorazepam products like Ativan, and 971,000 misused diazepam products, including Valium.
- Benzodiazepine-involved overdose visits to the emergency department increased from 2019-2020.
- Over 92% of the benzodiazepine-involved deaths in 2020, also involved opioids.
- More than 66% of the benzodiazepine-involved deaths in 2020 also involved fentanyl.
Research indicates that benzodiazepines may not be the primary drug that individuals misuse. However, benzodiazepines are often misused in conjunction with other drugs, including other benzodiazepines, alcohol, cannabis, some stimulants, and opioids. In fact, in 2020, 16% of overdose deaths involving opioids also involved benzodiazepines.11
How Long Do Benzodiazepines Remain in the Body?
Benzodiazepines differ in the amount of time it takes the body to eliminate them. Benzodiazepines might be detectable for days or even months, depending on the dosage and by what means the sample is taken. Common drug testing specimens include:12-13
Urine. Short-acting benzodiazepines like Halcion may be detectable in urine for up to 24 hours. Intermediate-acting benzodiazepines such as Xanax, Klonopin, Ativan, and Restoril may be detected 1-5 days after use. Longer-acting benzodiazepines like Valium may show up in a urine sample 5-8 days after use. Additionally, chronic misuse of benzodiazepines may be detectable for up to 30 days after the last use.
Blood. Benzodiazepines may only be detected in blood samples for 12-24 hours after use.13
Hair. Benzodiazepines may be detectable in hair follicles for 4-6 months.13
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Factors other than the properties of the drug itself can influence how long the drug remains in a person’s system, including.13
- The type of benzodiazepine taken.
- The speed of the individual’s metabolism.
- The dosage, manner of ingestion, frequency, and duration of benzodiazepine use.
- The individual’s physical health.
- Individual characteristics such as exercise, diet, weight, age, gender, and fluid intake.
- Polysubstance use.