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Table 2. Risk for Clinically Significant BZD Withdrawal
a
Duration of
BZD use
Frequency of
BZD use
Total daily BZD
dose
Risk for clinically
significant withdrawal
b
Any ≤3 days per week Any
Rare
c
<1 month ≥4 days per week Any Lower risk, but possible
1–3 months ≥4 days per week
Low
d
Lower risk, but possible
1–3 months ≥4 days per week
Moderate
e
to high
f
Yes, with greater risk with
increasing dose and duration
≥3 months ≥4 days per week Any Yes, with greater risk with
increasing dose and duration
a
is table is based on clinical consensus of the Clinical Guideline Committee (CGC). It is
intended to provide general guidance and should not replace clinical judgment.
b
Many factors influence the risk of physical dependence and BZD withdrawal syndrome,
including but not limited to age, co-occurring physical and mental health conditions, other
substance use, and prior history of withdrawal.
c
Half-lives are unknown for some novel synthetic benzodiazepines available in the illicit
market.
d
A low daily dose is estimated as 10 mg diazepam equivalents or less (e.g., ≤0.5 mg
clonazepam, ≤2 mg lorazepam, ≤1 mg alprazolam). See Table 8 for BZD dose equivalents.
e
A moderate daily dose is estimated as 10–15 mg diazepam equivalents (e.g., 0.5–1.5 mg
clonazepam, 2–3 mg lorazepam, 1–2 mg alprazolam). See Table 8 for BZD dose equivalents.
f
A high daily dose is estimated as more than 15 mg diazepam equivalents (e.g., >1.5 mg
clonazepam, >3 mg lorazepam, >2 mg alprazolam). See Table 8 for BZD dose equivalents.
