Misc Differences between benzo and opioid withdrawal?

[Swimmingdancer]

So I've been talking to a couple people who quit opioids and benzos at around the same time (for example, if they used one drug to help with WDs from the other and hadn't been dependent on the new drug before, or if they've never experienced WDs from either group of drugs before) and they seem unclear on which drug is causing their withdrawal symptoms. Which got me to thinking, what are the real differences between opioid and benzo withdrawal?

Especially mild withdrawal or post-acute withdrawal? (Aside from something vague like "they just feel distinctly different", and please don't say "benzo withdrawal is worse than opioid withdrawal", that is not helpful and does not answer my question). Like I was looking at a list of benzo withdrawal symptoms -

Spoiler: benzo withdrawal symptoms

Aches and pains
Agitation and restlessness
Anger
Anxiety, panic attacks
Blurred vision
Chest pain
Depersonalization/derealization
Depression
Dilated pupils
Dizziness
Dry mouth
Dysphoria
Electric shock-like sensations
Elevated blood pressure
Fatigue or weakness
Flu-like symptoms
Gastrointestinal problems (diarrhea)
Hearing impairment
Headache
Hot and cold flushes
Heightened sense of smell
Hypnagogia hallucinations
Increased sensitivity to touch, light and/or sound
Increased urinary frequency
Indecision
Insomnia
Impaired memory and concentration[37]
Loss of appetite
Metallic taste
Mood swings
Muscular spasms, cramps or fasciculations
Nausea and vomiting
Nightmares or vivid dreams
Numbness and tingling
Paranoia
Perception that stationary objects are moving
Perspiration
Postural hypotension
Restless legs syndrome
Rapid heartbeat
Stiffness
Taste, smell and/or visual disturbances
Tinnitus
Tremor

Severe:

Catatonia
Convulsions
Coma (rare)
Delirium tremens
Delusions
Hyperthermia
Homicidal ideation
Mania
Post-traumatic stress disorder
Psychosis
Self-harm
Severe confusion
Suicidal ideation
Violent urges

and personally I have experienced every one of those (many) symptoms from opioid withdrawal except for:
- Perception that stationary objects are moving
- Convulsions (although they are possible with severe opioid withdrawal, I haven't experienced what I would consider true convulsions and I would say seizures are much more common with benzo WD than opioid WD)
- Severe confusion (I've only experienced very mild confusion)
- Coma (rare)
- Delirium tremens
- Delusions (at least not of the type I assume they're referring to)
- Hyperthermia (I've had a mild fever, don't think that counts)
- Homicidal ideation
- Psychosis
- Violent urges

Obviously not everyone experiences ALL the possible symptoms when going through either benzo or opioid withdrawal, but it's helpful to know what symptoms are exclusive to one or the other. And maybe what symptoms are very uncommon for one but common for the other. For example is it common for people to feel very cold and get goosebumps with benzo WD, like it is with opioid WD?

(I haven't really experienced true benzo withdrawal myself, more just rebound symptoms, so that's part of why I am asking).

 

[liftedgift]

I never had access to benzos every day but I always had weed/beer but I did binge on them when I could, and when I stopped taking them (mostly xanax) I can tell you I felt absolutely horrible. I'm not sure if it was related but I did have nausea a few days and threw up a lot. But the worst was the mental feeling. A combination of anxiety/depression/overall shittiness that I have never experienced.

And I do consider myself to have below normal dopamine/serotonin levels when sober although I have never checked or been on meds for it. I honestly thought that was how I was, but it did get better. Took a few weeks for the fog to start to clear, and a few months for me to be somewhat sociable again.

Probably would have helped to smoke weed, but I had to quit everything abruptly for law situations. I can't imagine people with 10+ years with benzo dosages. I was lucky to have close to a year and not every day use.

 

[irishsarah]

Long term Benzo withdrawal is not pleasant...many people i know became addicted to opiates, but its the other way around with me.

I went through a sudden withdrawal from lack of GBL and valium (dual addiction) and remember using H for only a short time...I had definite cravings for h and felt empty and soulless. H felt as if it could take over your brain and soul very quickly and easily..it was an instant hit and stopped "the pain" very effectively.

Benzo withdrawal is very different from either GBL withdrawals or h, I think. GBL WD's come on very suddenly, after only 2-3 hours of use and there is a terrible fear associated with running out and having that hell...you do literally lose your mind!! Valium withdrawals on the other hand come very slowly, due to the fact that they have a "half-life" of 20-100 hours (This is just valium, other benzo's like xanax have a much shorter half-life). After using valium for a long time - i.e over 6 months/a year - if you do run out, the WD's come on slowly. You will start feeling sh*t after a day or two, but will get worse and be unable to function after about 3/4/5 days. And that feeling gets progressively worse the longer you are without.

The symptoms you describe above will happen but slowly with benzo withdrawal, so you may not notice as you kind of sink into them, and not in the way that they will hit you suddenly after GBL or H. Or if you are lucky and have not been addicted that long or to a large amount, then you may have no WD's at all.

The best way to withdraw opiates is definitely to reduce slowly over time...they say this is the same with benzo's. But I can't say that this method helped me....after a 6 month slow reduction, at the end I became suicidal and experienced something akin to post traumatic stress syndrome. Maybe the reduction went to quickly towards the end...but I couldn't handle it and ended up having to go back to getting an illicit supply to a dose of 20mg again just to "feel normal"...and was also using a lot of alcohol.
Benzo's are NOT a good way to come off H as long term plan...and I say that from experience!

I'm still addicted GBL and undergoing treatment which isn't working...my tolerance is so high that no amount of vals or baclofen can help :-( Stay away is my best advice xx

 

[Alex000]

Well, they are VERY different, of course, though this may not seem to be the case as they can both cause severe subjective agony and suffering. It should be kept in mind that when asking oneself of a particular wd's symptom's origin, which drugs did what to the mind and body when the one dependent was using them. What the drugs do is a sort of an inverse answer to what the wd's will look like, however it is not totally cut and dry, but it tends to make things clearer. But, with opiates and benzos, there is significant overlap of the drugs' basic effects, though there is a very large difference between what an opiate does and what a benzo does.

Symptoms of derealization, depersonalization, very odd/unusual thoughts (likely racing or jumpy), hallucinations (minor to severe), delusions, perceived sensory 'illusions' (e.g. the wallpaper pattern seems to wiggle), quasi-manic feelings, psychomotor excitation and agitation (e.g. feeling full of unnatural and not necessarily pleasant energy, or perhaps almost electric or wired-up or burnt-out etc.), tremor and/or muscle jerking or twitching, feeling on edge (almost literally on edge - an odd angst), convulsive episodes/seizures, and all of which might be like any of those mentioned above, are symptoms which I would put into the primarily-benzo wd category.

Symptoms of 'flu-like' nausea and vomiting, diarrhea and particular GI-tract hyperactivity, diffuse aches and pains (also 'flu-like'), restlessness of mind and body esp. with dysphoria, profuse cold sweats and distortion of temperature perception (often with feverish-feeling elements, and severe chills), feelings of severe or even profound mental depression (often with markedly anxious features) and general dysphoria of mind and body, intense feelings of vacancy and hopelessness in self and life w/o the use of opiates (involved in the general dysphoria), feelings of a more organic sickness (perhaps - a hypothesis, really) rather than just a smattering of very unpleasant symptoms, a particularly odd increase in ease of erection of the penis and orgasm (masturbation and orgasm proving, perhaps, somewhat successful in VERY temporary wd-relief), extreme fatigue of mind and body, and all of which might be like any of those mentioned above, are symptoms which I would put into the primarily-opiate category. HOWEVER, in thinking on this topic, it seems a symptom of benzo wd's could be much more easily identified as such than one of opiate wd's. I have a feeling, based on my experience and knowledge, that opiate wd symptoms tend to feel more organic, natural, and even curable, than benzo wd symptoms. Another feeling I have is that opiate wd's manifest more like, as mentioned, an organic sickness, but also have particular symptoms which root themselves in the mind and body very connectedly so that, for example, if one has severe chills in opiate wd's, one is likely to feel mentally cold/unprotected/vacant etc. Opiates' mechanisms of action work with the perception of pain, not the actual increase or decrease of it; benzos can take anxiety away by dulling it out, where opiates might do the same by making the anxiety-provoking stimulus seem much less threatening, as an example. I hope that helps to explain, to some extent, where I am coming from with some of these thoughts.

One thing to remember is what the drug does to the one dependent (and how), and then examine the wd symptom to identify it as primarily caused by opiate wd's or benzo wd's. I could write a lot more on this topic, but I feel it is one which does not have terribly straightforward answers. They are different; everyone knows it who has gone through it, but the more well-versed users would likely be able to distinguish one symptom from another. But, do not forget that if one is in both opiate wd's and benzo wd's, their mind and body are going to be taxed overtime and symptoms that might otherwise be directly attributable to the wd's of the opiate or the benzo could become more general symptoms due to the horrible compound of both wd's at once.

I hope all of this helps some, somehow, but do not take my word for gospel; these are just reflections of my experience and knowledge.

 

[pasha]

Opioid withdrawal is basically the lesser of two evils. Benzodiazepine withdrawal is a life threatening withdrawal. Seizures/convulsions are not the norm in opioid withdrawal by any means, in benzodiazepine withdrawal they are much more common. The one and only thing that opioid withdrawal trumps benzodiazepine withdrawal in is pain. Other than that, the anxiety, depression, agoraphobia, fight/flight response, delirium, psychosis and other psychological symptoms are significantly harsher.

Benzodiazepine withdrawal is also excitotoxic to great proportions and could potentially leave you with long lasting if not permanent brain damage, nerve damage, neuropathy, and status epilepticus in rare cases. Benzodiazepine withdrawal tends to be very stretched out as well, and its symptoms remain at a steadier state in decline than opioid withdrawal where improvement occurs from day to day.

 

[Swimmingdancer]

Thanks for the replies everyone. Especially Alex000 and Chromophobia. Maybe I didn't make it clear enough what I meant. I'm not looking for opinions on which one is worse (I know almost everyone has a strong opinion on that, personally I think it completely depends on the circumstances and the person), I wanted to know how someone could someone tell if the symptoms they are getting are from opioid withdrawal or benzo withdrawal if they don't know. So thanks especially for the replies that tried to address that question

Benzo withdrawal is not automatically a life-threatening withdrawal, someone who has been taking benzos in low doses for a short period of time and tapers off, for example, is not likely to have convulsions or die but they could still get some WDs. I will try to be more specific: one of the people I am thinking of used benzos to help get off methadone (no it's not me but I am in a sort of similar situation) and started getting more pronounced symptoms when they stopped the benzos, but they can't tell if it is just that the benzos were masking a substantial portion of the methadone WDs and they are still in methadone WD, or if they are now experiencing WD from the benzos. So in that case the absence of something severe like seizures would not be an indicator that it's likely methadone WD and not benzo WD.

One thing that I think makes the difference hard for me to grasp personally is that I have had so many of the symptoms that people associate with benzo WD from methadone withdrawal. Methadone withdrawal tends to be especially nasty in the realm of opioid withdrawals and to cause more tremors/twitches and seizures than WD from other opioids.

And Chromophobia I don't see improvement day to day with methadone withdrawal!

Also curious if people agree with Alex000's assessment that feeling extremely cold and in a lot of pain are more common with opioid withdrawal?