How Long Do Benzos Stay in Your System? A Guide for Parents

Teenage benzodiazepine abuse carries severe, long-term consequences such as increased risk of mental health problems, memory loss, strained relationships, overdose, and death. 

Benzodiazepines stay in the body for varying lengths of time due to several factors, such as the kind of benzo abused, frequency of use, and presence of co-occurring mental health problems, making treatment for benzodiazepine abuse in teens complex. 

Read on to learn more about what benzodiazepines are, how long they stay in the system, their effects on the body, and how to help teens struggling with benzodiazepine abuse.   

Understanding Benzodiazepines  

Benzodiazepines, also known as “benzos”, are a widely prescribed class of medication for the management of anxiety, insomnia, and seizure disorders in adults. They are also sometimes prescribed to teens. However, this is uncommon because they carry a high risk of addiction. 

Benzos affect the neurotransmitter, GABA, which controls activity in the nervous system, brain, and spinal cord to increase feelings of relaxation and euphoria. Although benzos can offer relief to those with anxiety, stress, sleep disturbances, and chronic pain, when used long-term, they can make problems such as anxiety or insomnia worse [1]. 

Teens may begin abusing benzodiazepines to self-medicate with unresolved mental health problems such as anxiety, manage chronic pain from sports injuries, cope with academic pressure, or use them in social settings with friends to get high.     

Short-Acting vs Long-Acting Benzos

There are two kinds of prescription benzodiazepines that exist: short-acting and long-acting. These differ primarily in their half-life (the time it takes for the substance in the body to be reduced by half), duration of effects, and withdrawal timelines [2]. 

How The Body Processes Benzos 

Benzodiazepines are lipophilic, meaning they quickly cross the blood-brain barrier. After consumption, benzos are quickly absorbed in the gastrointestinal tract and distributed to the central nervous system (CNS). They are primarily metabolized in the liver, where the process can vary based on overall liver health and functioning, as well as the type of benzodiazepine taken. It is then excreted through the kidneys [2]. 

Factors That Affect Benzo Half-Life 

Several factors affect the benzo half-life and the amount of time it takes for the body to fully process benzodiazepines. This can affect the detox timeline and severity of withdrawal symptoms. Some of these include [2][3]: 

• Age: Teens may have a shorter elimination half-life due to a faster metabolism. 

• Liver and Kidney Function: Impaired functioning can increase half-life and the rate at which the body eliminates the drug.

• Type of Benzodiazepine: Different benzos have varying half-lives depending on whether they are short or long-acting.

• Dosage and Frequency: Higher doses and long-term use extend the elimination half-life. 

• Route of Administration: Oral, intravenous, or intramuscular administration can influence absorption rates. ‍

• Presence of Other Drugs: Polydrug use in teens can drastically complicate the detox process and extend the elimination of benzo's half-life. 

• Overall Health Status: Factors such as body weight, gender, ethnicity, and medical conditions can influence body composition and elimination of half-life. 

Typical Detection Windows by Drug Test Type

Teens who are thought to be abusing benzodiazepines may be asked to get a drug test either from their parents, the school, a mental health professional, a medical provider, or law enforcement. There are various ways to test for benzodiazepines in the body; however, the length of time they show up may differ. 

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Urine Testing:

• Short-acting benzos are detectable for up to 24 hours.
• Intermediate-acting benzos are detectable for 1 to 5 days.
• Long-acting benzos are detectable for 5 to 30 days.

‍Blood Testing:

• Detects short and long-acting benzos within a short window (12 to 24 hours after last use).
• Some studies show detection up to 5 days for benzos such as Xanax in individuals with chronic use.‍

Hair Testing:

• Can detect benzos for 90 days or even longer.
• Used for long-term detection, but not a good method for detecting recent use.

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‍Saliva Test: 

• Detects benzos for 2 to 3 days after last use.
• Some long-acting benzos, such as Klonopin or Valium, may be detectable in saliva for 5 to 9 days with heavy use. 

Common Benzodiazepines Abused by Teens

Fortunately, the rates of benzo abuse in teens have reduced drastically over the past decade. Most medical providers do not prescribe benzodiazepines to youth, with studies showing that less than 0.5% of teens receive benzodiazepine prescriptions. Nonetheless, teens still access and abuse benzodiazepines, getting them from the street, online, friends, or their family medicine cabinets [4]. 

The most commonly abused benzos by teens are Xanax, Ativan, and Klonopin. Xanax in particular is abused by over 10% of youth and young adults, leading to a rise in what young people refer to online as the “Xandemic” [1]. 

The Rise of Xanax in Pop Culture 

Although not used among official public health experts, the term “Xandemic” is used by teens and youth on platforms such as TikTok to refer to the recreational use of Xanax to the point of blacking out. Many artists that youth listen to openly discuss “popping benzos” in their songs. And a famous rapper among teens even goes by the name “Lil Xan”. This represents the significant role that social media and pop culture can play in the drug habits of youth.

From 2016 to 2020, over 16 million prescriptions were written in the US for Xanax alone. And emergency room visits for recreational Xanax abuse nearly doubled. Approximately 70% of teens addicted to Xanax report obtaining it from the family medicine cabinet. This highlights the need for increased prevention strategies and keeping controlled medications in the home locked up and away from youth [1]. 

Withdrawal and Detox from Benzodiazepines 

Teens struggling with benzodiazepine addiction require a medically supervised approach to safely detox, and comprehensive, integrated care to support their long-term recovery. Medically supervised detox ensures teens' vitals are stable and medical staff can prescribe medications to alleviate withdrawal pain or cravings. 

Common symptoms of benzo withdrawal in teens include: 

• Physical: Muscle aches, tension, tremors or shakes, nausea, vomiting, dizziness, insomnia, headaches, diarrhea or constipation. In severe cases, seizures, coma, or even death

• Psychological/Emotional: Anxiety, panic attacks, restlessness, irritability or aggression, mood swings, depression. In severe cases, psychosis, such as hallucinations, delusions, and paranoia 

• Behavioral: Isolation, memory loss, academic decline, secretive behaviors, sudden changes in friend groups, withdrawal from activities once enjoyed, or extracurriculars  ‍

After detox and effectively ridding the body of benzodiazepines and other drugs or alcohol from the system, teens participate in a combination of therapies, skill-building workshops, and support services to develop healthy coping skills to prevent relapse.  

Helping Teens Recover from Benzodiazepine Abuse in Florida 

Lotus Behavioral Health is a residential treatment facility for teens located in Florida. Our programs are designed to support teens and their families with the tools they need to recover from substance abuse and co-occurring mental health disorders. 

Our treatment programs help teens recover from benzodiazepine addiction with a combination of medically supervised care, individual therapy, group therapy sessions, skill-building workshops, and aftercare and transition services to support long-term recovery.

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Sources

[1] Surratt, H. L. et al.(2017). Benzodiazepine Dependence among Young Adult Participants in the Club Scene Who Use Drugs. Journal of psychoactive drugs, 49(1), 39–46.

[2] McHugh, R. et al. (2019). The epidemiology of benzodiazepine misuse: A systematic review. Drug and alcohol dependence, 200, 95–114.

[3] Kaye, A. D. et al. (2013). Benzodiazepine pharmacology and central nervous system-mediated effects. Ochsner journal, 13(2), 214–223.

[4] Bushnell GA. et al. 2019.Prescription benzodiazepine use in privately insured U.S. children and adolescents.  Am J Prev Med. 2019;57(6):775-785.