What Is World Benzodiazepine Awareness Day, and Why Is It Held on July 11?

When is the day, and who started it?

World Benzodiazepine Awareness Day (W-BAD) is held every year on July 11. It was started in 2016 by patient advocates who had themselves been injured by benzodiazepines that their doctors prescribed.

The date was chosen on purpose. July 11 is the birthday of Professor C. Heather Ashton, the British physician whose guide to benzodiazepine withdrawal, built on twelve years of running a withdrawal clinic, is known around the world as the Ashton Manual.

So, the day is not about drug misuse. It is about ordinary prescriptions, taken as directed, that turned out to be very hard to stop.

What does the day ask doctors and the public to understand?

The first subject is iatrogenic, or doctor-caused, dependence. The day speaks for people who took Xanax (alprazolam), Klonopin (clonazepam), Ativan (lorazepam), or Valium (diazepam) exactly as prescribed and then became ill when they tried to stop.

The second is protracted withdrawal, meaning symptoms that continue for months, and sometimes longer, after the last dose. Chapter III of the Ashton Manual describes them, and it says they almost always decline steadily with time.

The third is safer prescribing. That means informed consent before the first pill: the risks first, the alternatives, including no medication at all, a plan for how the drug will be stopped, and the right to decline.

What should a person prescribed a benzodiazepine know?

Benzodiazepines work by enhancing gamma-aminobutyric acid (GABA), a natural calming chemical in the brain. With regular use, the nervous system adapts to the drug. The first chapter of the Ashton Manual says dependence can develop within a few weeks or months of regular use, and it repeats the long-standing advice that these drugs should generally be reserved for short-term use of 2 to 4 weeks.

In 2020, the United States Food and Drug Administration (FDA) put the risk of dependence on the label. It required an updated boxed warning on every benzodiazepine, and it stated that physical dependence can occur when the drug is taken steadily for several days to weeks, even as prescribed.

So, a person can follow the prescription to the letter and still develop tolerance, where the same dose does less, and withdrawal symptoms when the dose is lowered. This is physical dependence. Physical dependence is not addiction, and the addiction label is the wrong one for a patient whose body adapted to a prescribed medicine.

Why is a rapid detox the harm, and a slow taper the answer?

Many people who decide to stop begin by searching for a benzodiazepine detox. Unfortunately, a detox in the usual sense means a facility stay that removes the drug in days or weeks, and that speed is the harm the day warns about. Safe discontinuation is a gradual, medically supervised taper over months.

The FDA’s 2020 update warns that stopping abruptly or reducing the dose too quickly can cause withdrawal reactions, including seizures, which can be life-threatening. Chapter II of the Ashton Manual tells readers they may need to resist attempts by clinics and doctors to persuade them into a rapid withdrawal. For a seizure or any other medical emergency, call emergency services right away.

Fortunately, the alternative is well described. The Manual lays out a taper that the patient controls, taken in small steps at a tolerable pace, and it notes that many people take a year or more. The Maudsley Deprescribing Guidelines add that each reduction should get smaller as the dose gets lower.

An airplane lands by a long, shallow descent. Nobody would call a dive a faster landing.

How can a reader take part on July 11?

Taking part does not take a rally or a donation. A reader can open the Ashton Manual, which is free online, and send it to a family member or a prescriber who has never seen it.

A person who takes a benzodiazepine can ask the prescriber the questions that should have come with the first prescription. How long is this meant to last? What is the plan for coming off?

Family members can help too, by learning why a person in withdrawal is not a person with an addiction. The organizers explain how to join in each year on the day’s own website, worldbenzoday.org.

The slow taper is the daily work of one Florida practice.

Dr. Mark Leeds is an osteopathic physician and deprescribing specialist in Fort Lauderdale, Florida. His practice’s primary service for patients in Florida is medically supervised tapering of benzodiazepines and z-drugs, the sleep medications such as Ambien (zolpidem), and he works with every patient himself.

The taper is gradual and patient directed. Where it helps, it uses the crossover to diazepam described in the Ashton Manual, and the steps shrink as the dose falls. If a reduction proves too hard, the taper slows or holds, and that decision belongs to the patient.

World Benzodiazepine Awareness Day asks for one day of attention to a problem that patients live with for months or years. In Dr. Leeds’ practice, that attention is the work of every day. Contact the office to talk about a gradual, medically supervised taper.

This article is educational. It is not medical advice, and reading it does not create a doctor-patient relationship. Decisions about starting, continuing, or tapering any medication should be made with your own physician.