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Benzodiazepine Information Coalition

Physical Dependence

Physical dependence is a phenomenon that can develop as early as a few days of regular benzodiazepine prescription. Physical dependence is the reason benzodiazepine withdrawal symptoms manifest. Estimates show that between 20-100% of prescribed long term (more than 2-4 weeks) benzodiazepine patients have difficulty stopping because of withdrawal symptoms. The presence of physical dependence does not indicate addiction. 

What Does Physical Dependence Mean?

Developing a physical or physiological dependence to benzodiazepines means that persistent change in GABA receptor conformation has occurred due to repeated prescribed dosing of benzodiazepines. More simply, the body now relies on a benzodiazepine to prevent withdrawal symptoms. Physical dependence is a normal and predictable outcome and one that should be expected after chronic exposure to many commonly prescribed tolerance-forming medications, not just benzodiazepines.

How is Physical Dependence Different Than Addiction?

It is common for people to conflate  physical dependence and addiction, believing they are synonymous. 

According to the FDA: 

Physical dependence is not synonymous with addiction; a patient may be physically dependent on a drug without having an addiction to the drug. Tolerance, physical dependence, and withdrawal are all expected biological phenomena that are the consequences of chronic treatment with certain drugs. These phenomena by themselves do not indicate a state of addiction. 

Drug addiction is a cluster of behavioral, cognitive, and physiological phenomena that may include a strong desire to take the drug, difficulties in controlling drug use (e.g., continuing drug use despite harmful consequences, giving a higher priority to drug use than other activities and obligations), and possible tolerance or physical dependence.nd obligations), and possible tolerance or physical dependence.

This helps clarify that while sometimes with addiction physical dependence is present, the presence of physical dependence alone does not indicate an addiction.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):

“Dependence” has been easily confused with the term “addiction” when, in fact, the tolerance and withdrawal that previously defined dependence are actually very normal responses to prescribed medications that affect the central nervous system and do not necessarily indicate the presence of an addiction.

Conflating addiction with physical dependence is very dangerous to prescribed benzodiazepine patients as the treatments for physical dependence and addiction are very different and conflicting. While patients experiencing addiction often require access to their drug of choice limited, prescribed physically dependent patients best chance of avoiding a lengthy protracted withdrawal syndrome requires reliable access to their prescription in order to safely taper over many months to years.

Further Reading: 

Addiction vs Physical Dependence 

Benzodiazepine Related Problems: It’s Almost Never Addiction

Dependence is Separate from Addiction

Words Can Hurt Those on Benzodiazepines 

Don’t Harm Them Twice: When the Language Surrounding Benzodiazepines Adds Insult to Injury (Part 1)

Contact Us

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As an awareness organization, we do not offer any support services or guidance. See our resources for services and support.

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  • About Benzodiazepines
    • Benzo Basics
      • Ashton Manual
      • A Brief History Of Benzodiazepines
      • Class Actions and Lawsuits—and Reporting Harm 
      • FDA 2020 Benzodiazepine Boxed Warning
      • Medications and Supplements of Concern
      • Xanax Study Outcomes
    • Benzo Stories
    • Prescribing
      • Addiction vs Physical Dependence
      • Genetic Testing
      • Informed Consent
      • Low Dose Benzodiazepines
      • Mechanism of Action
      • Prescribing Statistics
      • Steps to Reduce Benzodiazepine Overprescribing
      • Therapeutic Actions
    • Prescribing Risks
      • Akathisia
      • Fluoroquinolones
      • Functional Brain Changes
      • Interdose Withdrawal
      • Paradoxical Reactions
      • Physical Dependence
      • Risks of Remaining on Benzodiazepines
      • Red Flags
      • Short-Term Risks
      • Side Effects
      • Suicide
      • Tolerance
    • Deprescribing
      • Ashton Manual
      • Tapering Strategies and Solutions
      • Detox, Cold Turkey, Abrupt Cessation
      • Estimates of Withdrawal
      • How To Find Tapering Help
      • Dosages Prevent Safe Withdrawal
      • Why Patients Shouldn’t Go To Detox or Rehab
    • Desprescribing Risks
      • Akathisia
      • Benzodiazepine Withdrawal Syndrome (BWS)
      • Forced Switching or Stopping
      • Functional Brain Changes
      • Kindling
      • Protracted Withdrawal Syndrome (PWS)
      • Suicide
      • Withdrawal & Post Withdrawal Symptoms
    • Special Populations
      • Benzodiazepines and PTSD
      • Celebrities
      • COVID-19
      • Elderly
      • Women
      • Incarcerated Population
      • Substance Use Disorders
  • About Us
    • Our Mission
    • Board Members and Advisors
    • Press Room
    • Receive Our Newsletter
    • FAQs
    • Volunteer
      • Informed Consent Policy
      • FDA Reporting Program
      • Share Your Story!
      • Media Interview List Registration
    • Contact Us
  • Our Impact
    • Media Outreach
    • Podcasts
    • Programs and Projects
    • Research and Publications
    • Speaking and Events
    • Quarterly Updates
    • Upcoming Events
  • Resources
    • Ashton Manual
    • Benzodiazepine Tapering Strategies and Solutions
    • Financial and Disability Information
    • How To Find Tapering Help
    • Support
    • Information
    • Benzodiazepine Cooperative Providers
  • Blog
  • Donate
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