Temazepam, sold under the brand name Restoril, is a prescription sleep aid and member of the benzodiazepine class of drugs, which possess sedative effects that make them medically useful for combating the symptoms of panic, general anxiety disorders, and sleep disorders such as insomnia.
Unlike other sleep aids, temazepam is meant to not only induce sleep but also maintain it throughout the night. With roughly 40 million adults in the United States afflicted with some form of anxiety disorder and more than 50 million suffering sleep-related problems, it’s unsurprising that temazepam is a popular choice of prescription for doctors attempting to treat the symptoms associated with both.
In fact, according to the DEA, as of 2011, temazepam was the fifth most prescribed and abused prescription sedative in the United States, with nearly nine million prescriptions dispensed.
Yes, even though it is currently classified as a Schedule IV drug, which means it has been shown to have a comparatively low potential for abuse and addiction, it is still a benzo, and people are still abusing temazepam and becoming dependent on it in large numbers.
Because of this danger, most doctors prescribe temazepam in the same manner as other benzodiazepines: at a very restricted dose and for only a short period of time, generally no more than 10 days.
However, many users can develop a tolerance to temazepam in as little as three days of regular use. This leads them to need more and more to achieve the same effects as before until they are taking dangerously large doses and have become dependent on temazepam to make it through the night.
At this point, in order to relieve their insomnia or anxiety, some people go as far as forging prescriptions, buying them off the street or visiting multiple doctors to get a stockpile of prescriptions in order to continue self-medicating.
Long-term abuse of temazepam is certainly dangerous and can cause amnesia, blackouts, and, according to a 2015 study, raise an individual’s risk of developing Alzheimer’s by a whopping 84 percent. However, deciding to quit using temazepam cold turkey can be just as dangerous, if not more so, due to intense and even life-threatening withdrawal symptoms.
As with all benzodiazepine detoxes, undergoing temazepam withdrawal is best done at a professional medical detox center, under the supervision of an experienced staff.
Like other benzodiazepines such as Valium or Klonopin, temazepam works by enhancing the effects of a neurotransmitter in the brain called gamma-aminobutyric acid, or GABA. GABA is responsible for regulating the body’s response to stress, anxiety, and fear, blocking the nerve signals that create those feelings in order to keep the body calm.
Temazepam is what’s known as a central nervous system depressant. It binds itself to the brain’s GABA receptors.
Increasing the amount of GABA in the brain and strengthens its anxiety-blocking effects, which is what produces the feelings of relaxation and drowsiness experienced by users.
When someone who has become not only psychologically dependent on temazepam but also physically dependent, it means that their brain will have stopped producing its own GABA, relying instead on the amount produced by the medication, requiring it to function. This is why when someone decides to quit temazepam, the body experiences a shock and crashes as the GABA levels bottom out.
This crash is what causes temazepam withdrawal symptoms, and the lack of GABA is why so many of them are psychological in nature, as there is now nothing blocking the signals of anxiety and stress from assaulting the brain.
The symptoms of temazepam withdrawal are in-line with those commonly associated with benzo withdrawal and can range from unpleasant and uncomfortable to nightmarishly intense and possibly lethal, depending on the severity of someone’s dependency on temazepam.
The symptoms generally experienced during temazepam withdrawal include more mild, early symptoms such as:
These are usually followed by the more serious symptoms that signal the peak of the withdrawal period:
As we previously mentioned, benzodiazepine withdrawal is among the most unpleasant withdrawal experiences someone can go through, and temazepam is no exception. While the process of temazepam withdrawal itself is not an inherently life-threatening situation, detoxing without medical intervention and attempting to manage the symptoms on your own can create potentially deadly circumstances.
Two of the most unpleasant symptoms that people undergoing detox have to suffer through are rebound insomnia and rebound anxiety.
Which one a given individual will experience depends what they were taking temazepam for.
Once someone stops taking temazepam, their old symptoms return. Whether they are from anxiety or insomnia, in rebound form they are significantly worse than they were before taking temazepam, as the body will have become dependent on having the drug manage these symptoms.
Rebound anxiety can result in extreme panic attacks and paranoia, and rebound insomnia can cause total sleeplessness for as long as days on end.
But things can still get worse, as both these and the other symptoms produced by temazepam withdrawal can become even more intense and last significantly longer if the person detoxing is also suffering from what is commonly referred to as benzodiazepine withdrawal syndrome.
Benzodiazepine withdrawal syndrome not only makes the whole temazepam withdrawal process more of an ordeal, but it can also manifest extremely dangerous symptoms not typically associated with temazepam withdrawal, including, but not limited to:
Those most likely to experience benzodiazepine withdrawal syndrome during their withdrawal from temazepam are people who, prior to undergoing detox, were regularly abusing very high doses of temazepam within a short frame of time, typically between two to three months.
With all of these symptoms to contend with, it’s not surprising that those going through temazepam withdrawal are extremely vulnerable to relapse. Also, in an effort to ease the temazepam withdrawal symptoms and find some relief, they are at a high risk of accidentally overdosing with potentially fatal results.
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Beyond that, many of these symptoms can become deadly without the expert care of a medical detoxification specialist. The symptoms of depression, hallucinations, confusion, and suicidal thoughts create a combination with a high risk of self-harm or even attempted suicide. There is also the possibility of seizures, which, while a rarer symptom, become more likely if someone tries to quit temazepam cold turkey.
While in medical detox, a doctor can put someone on a tapering schedule to slowly and carefully decrease their temazepam use until it becomes safe enough to stop using altogether. A person trying to detox alone who suddenly cuts the brain off from temazepam—and by extension, the GABA it created—is likely to trigger that overwhelming shock to the system we mentioned before, which is what can cause these seizures.
There’s simply no sound reason to try to get through temazepam withdrawal alone. It creates unnecessary risks and discomfort and can make for an even longer withdrawal process and has a much higher chance of resulting in death.
Medical detox avoids all of these dangers by providing around the clock care along with a tapering schedule to safely reduce dosage and an experienced doctor that can provide medications to help ease the worst of the symptoms of temazepam withdrawal.
The temazepam withdrawal timeline is similar to that of other benzodiazepines, but the actual length of withdrawal will be different for everyone who experiences it due to factors unique to them, including:
Keeping these factors in mind, the established timeline for temazepam withdrawal is as follows:
Temazepam has a half-life of about eight to 10 hours, which means that it can take someone as much as 12 hours to begin to experience the early symptoms of withdrawal. By the 24-hour mark, they can expect the beginnings of insomnia and anxiety along with the other symptoms.
Over the course of the first week or so of temazepam withdrawal is when all of the withdrawal symptoms will be present and eventually reach their peak, including rebound insomnia and rebound anxiety. This is also the phase of the temazepam withdrawal timeline where people are most vulnerable to relapse.
TWO TO THREE WEEKS
Once past the first week, symptoms will begin to diminish and become more manageable before eventually dissipating. While the symptoms of anxiety and insomnia will have significantly weakened, they will most likely persist after the other withdrawal symptoms have passed.
While most people will typically finish their detox after a few weeks, a benzodiazepine withdrawal syndrome may protract it somewhat. There is also the danger of post-acute withdrawal system, or PAWS.
People in withdrawal from benzos, in particular, are susceptible to PAWS, which is a condition in which the following symptoms can come and go at random for as long as months after someone has stopped using temazepam:
Unfortunately, there is currently no established timeline for how long PAWS can last, but at The Palm Beach Institute, we do our best to provide those dealing with PAWS plenty of resources for finding support.
Detoxification is vital in order to begin recovery, as it is nearly impossible for anyone to focus on recovery while either still on temazepam or otherwise battling the symptoms of temazepam withdrawal.
But while detox will clear your system of temazepam, that’s all it does. It does not “cure” addiction but makes it possible to move into the next phase of treatment: an addiction recovery program.
If you do not follow your temazepam detox with an addiction recovery treatment program, relapse is essentially a guarantee. In order to maintain long-term sobriety and truly change the behaviors behind the addictive behaviors that led to a dependence on temazepam, a rehabilitation treatment program is crucial.
Generally, clients who enroll in a recovery program will collaborate with their counselor and the facility staff in order to create a treatment plan that will work best for them, choosing from a wide range of available treatment programs.