Outpatient treatment for Xanax and other benzodiazepine dependence — individual counseling at four clinics across Southeast Tennessee and North Georgia.
Same-day appointments available · TennCare, BlueCare, BCBS, UHC, and most commercial insurance accepted.
Updated September 2026
What Are Benzodiazepines?
Benzodiazepines are a class of sedative medications that act on GABA, the main inhibitory neurotransmitter in the brain. By enhancing GABA activity, they produce calming, anti-anxiety, sleep-inducing, and anticonvulsant effects. First introduced in the 1960s, benzodiazepines quickly became some of the most widely prescribed medications in the United States — originally intended for short-term use in anxiety, panic, acute insomnia, alcohol withdrawal, and seizure management.
Xanax (alprazolam) is the most recognized name in this class because it is among the most commonly prescribed medications for anxiety and panic in the country, but benzodiazepine use disorder covers a broader family of molecules. The medications most often involved in benzodiazepine dependence are:
Alprazolam (Xanax, Xanax XR, Niravam). Short-acting. Quick onset, short duration, strong reinforcement profile — one of the most habit-forming benzodiazepines in clinical use.
Clonazepam (Klonopin). Intermediate- to long-acting. Often prescribed for panic disorder and seizure disorders. Long half-life makes tolerance and withdrawal less obvious day-to-day but very real.
Diazepam (Valium). Long-acting. Frequently used during tapers because stable blood levels make dose reductions smoother.
Lorazepam (Ativan). Intermediate-acting. Common in emergency and inpatient settings as well as outpatient anxiety treatment.
Temazepam (Restoril), oxazepam (Serax), chlordiazepoxide (Librium), and others. Less commonly prescribed today but still encountered.
Closely related are the Z-drugs — zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata). These are not technically benzodiazepines, but they act on the same GABA receptor system, and produce similar dependence. Treatment at Restoration Recovery covers Z-drug dependence alongside benzodiazepine dependence.
Benzodiazepines were never designed for long-term daily use. The original FDA labeling and current clinical guidelines recommend short-term prescribing — typically 2 to 4 weeks — precisely because physical dependence develops quickly. Tolerance (needing more to feel the same effect) can begin within weeks; physiological dependence (withdrawal symptoms when doses are missed) is common after a few months of daily use; and many patients find, months or years later, that they cannot stop without severe rebound anxiety, insomnia, or worse. This is not a personal failing. It is the pharmacology of the medication, and it is why coming off benzodiazepines should be done with a clinician, not on your own.
Benzodiazepines in Tennessee overdose deaths
Polysubstance co-involvement, 2019 – 2021 SUDORS data
93%+ Opioids
71%+ Fentanyl
83%+ Fentanyl (illicit benzos)Polysubstance is the rule
Of TN benzodiazepine-positive overdose deaths, 93% also involved an opioid and 71% involved fentanyl specifically. Counterfeit benzo pills push that fentanyl co-involvement rate to 83%.
Counterfeit pills in the supply
DEA lab testing of fake prescription pills, 2024
42%2021
60%2022
60M+2024 seizedXanax, oxy, Adderall copies
Roughly 6 in 10 counterfeit pills tested by DEA labs now contain a potentially lethal dose of fentanyl. In 2024, DEA seized 60+ million fentanyl-laced fake pills, many pressed to look like Xanax, oxycodone, or Adderall.
The Benzodiazepine Picture
Benzodiazepines rarely make overdose headlines the way fentanyl does — but they play a large, quiet role in Tennessee’s drug mortality, and the supply itself has changed in ways most patients don’t realize.
Benzodiazepines are a polysubstance problem. Peer-reviewed analysis of Tennessee SUDORS data (2019–2021) found that 93.3% of benzodiazepine-positive overdose deaths also involved an opioid, and 71.3% involved fentanyl specifically. Benzos alone are rarely the sole cause of an overdose; benzos plus opioids or alcohol is the fatal combination.
Prescription and illicit benzos both show up. In the same Tennessee study, 80.7% of benzo-positive deaths involved a prescription benzodiazepine and 12.0% involved an illicit (counterfeit or non-prescribed) benzodiazepine — and the illicit group had a fentanyl co-involvement rate of 82.5% versus 68.6% for the prescription group.
Anxiety disorders are common in the decedent history. 45.5% of benzo-positive overdose decedents in Tennessee had a documented anxiety disorder, and 52.3% had a documented substance use disorder — which tracks with the most common pathway into benzo use disorder: a legitimate prescription for anxiety that escalates over time.
Counterfeit Xanax is a real supply-side risk. DEA laboratory analysis has found that roughly 6 in 10 fake pressed pills contain a potentially lethal dose of fentanyl, with individual pills testing anywhere from 0.02 to 5.1 milligrams of fentanyl — more than twice the lethal dose. In 2024, DEA seized over 60 million fentanyl-laced fake pills, with Xanax-branded 2-milligram “bars” being one of the most commonly counterfeited shapes.
The Louisville Field Division — Kentucky, Tennessee, West Virginia — alone seized 184,000 counterfeit fentanyl pills and 316 pounds of fentanyl powder in the most recent reporting period. Some of those pills were Xanax replicas.
What that all adds up to: if you’re buying Xanax outside a pharmacy, there is a real chance the pill in your hand isn’t alprazolam. It may contain fentanyl, a novel benzodiazepine analogue, or nothing but filler. If you’re taking prescribed Xanax alongside opioids or alcohol, the polysubstance overdose risk is the clinical concern most likely to matter for your safety. Both situations are treatable — and telling a provider honestly what you’re actually taking changes the treatment plan for the better.
Sources: Ziegler et al., “Exploring trends in benzodiazepine-positive fatal drug overdoses in Tennessee, 2019–2021,” Annals of Medicine (2023); TN SUDORS Annual Report 2023 (TDH); DEA Public Safety Alert “One Pill Can Kill” (2021, updated 2024); DEA press release, seizure totals 2024; DEA Louisville Division press releases.
Signs of Benzodiazepine Use Disorder
Benzodiazepine use disorder is diagnosed in the DSM-5 as a sedative, hypnotic, or anxiolytic use disorder — the diagnostic category that covers Xanax, Klonopin, Valium, Ativan, and similar medications. The signs often develop gradually, which is part of what makes benzo dependence so easy to miss in people who started with a legitimate prescription.
Tolerance and dose creep. The 0.25 mg that used to work is now 0.5 mg twice a day, or a 1 mg bar two or three times a day. The original prescription is no longer enough to feel calm, sleep, or prevent panic.
Taking doses between scheduled doses. Using an “extra” to get through a stressful afternoon, or to sleep, or to smooth out a rough morning — outside the prescribed schedule.
Running out early. The prescription is supposed to last 30 days and it only lasts 18. Calling the pharmacy for an early refill. Calling the prescriber for a dose increase. Going to a second prescriber.
Using benzos with other depressants. Adding benzodiazepines to opioids, alcohol, or other sedatives to enhance the effect. This is the single most dangerous pattern in benzo use because it multiplies respiratory-depression risk.
Doctor-shopping or non-pharmacy sourcing. Visiting multiple prescribers, using urgent care visits to refill, or buying from friends, street sources, or online. Any non-pharmacy benzo supply carries counterfeit-fentanyl risk.
Memory lapses and blackouts. Gaps in memory after using — especially combined with alcohol — conversations you don’t remember, texts you don’t recognize sending, or waking up unsure of the night before.
Inability to sleep or feel calm without a dose. Rebound insomnia or rebound anxiety when a dose is delayed or missed. The medication has stopped treating symptoms and started creating them in its absence.
Withdrawal when doses are delayed. Tremor, sweating, racing heart, panic, nausea, perceptual changes — within 12 to 72 hours of missing a dose. These are not “just anxiety coming back.” These are physiological withdrawal symptoms.
Unsuccessful attempts to stop or cut down. Previous taper attempts that didn’t work, usually because the taper was too fast or not managed by a clinician.
Continued use despite cognitive, emotional, or relational consequences. Noticing that you’re slower, flatter, less present — and continuing to use anyway, because stopping feels worse than the side effects.
If several of these apply to you, a clinical evaluation can clarify what is happening and what your options are. You do not have to hit every criterion to benefit from treatment, and you do not need to stop taking anything before the evaluation. In fact, you should not stop on your own — keep taking your current prescribed dose and talk with a provider before making any change.
Benzodiazepine Withdrawal: Timeline and Symptoms
Important safety note. Benzodiazepines — along with alcohol — are one of only two substance classes where untreated withdrawal can be fatal in heavy users. Abrupt discontinuation from high-dose or long-term benzodiazepine use can cause seizures, delirium, severe autonomic instability, and death. Do not stop benzodiazepines on your own. If you are taking daily benzodiazepines, continue your current prescribed dose and talk with a provider before making any change. This risk is the reason the standard way off benzodiazepines is a gradual taper directed by a prescriber.
What untreated benzodiazepine withdrawal looks like depends heavily on which benzodiazepine you’ve been taking, at what dose, and for how long. Short-acting benzodiazepines like Xanax produce earlier, sharper withdrawal. Long-acting benzodiazepines like Klonopin and Valium produce slower, longer withdrawal. A general timeline:
Short-acting benzodiazepines (Xanax, Ativan)
12 to 24 hours after the last dose. Onset of early withdrawal: rebound anxiety, restlessness, tremor, sweating, increased heart rate, insomnia, and irritability.
Days 1 to 4. Peak acute withdrawal: intense anxiety, severe insomnia, tremor, sweating, nausea, muscle twitching, and perceptual disturbances. Seizure risk is highest in this window for heavy daily users.
Weeks 2 to 4. Acute symptoms gradually subside. Sleep remains disrupted. Anxiety and sensory sensitivity persist.
Long-acting benzodiazepines (Klonopin, Valium)
Days 2 to 7. Gradual onset of withdrawal symptoms. Often milder at first than short-acting withdrawal, but longer-lasting.
Weeks 1 to 4. Peak acute withdrawal, generally less abrupt than Xanax but more protracted. Seizure risk remains present.
Weeks 4 to 12+. Gradual resolution, with continued sleep disruption and anxiety.
Post-acute withdrawal (PAWS)
A subset of patients — particularly those who have been on benzodiazepines for years — experience protracted or post-acute withdrawal that continues for months after the taper is complete. PAWS symptoms include persistent anxiety, sleep disturbance, cognitive slowing, sensory hypersensitivity (sound, light), tinnitus, muscle aches, and mood swings. PAWS resolves, but the timeline is measured in months, not weeks.
Core symptoms that can appear at any phase of withdrawal include: rebound anxiety often more intense than the original anxiety being treated, insomnia that can last weeks, tremor, sweating, rapid heart rate, nausea and vomiting, muscle tension and twitching, derealization and depersonalization, visual and auditory hypersensitivity, and — in severe cases — seizures and delirium.
A properly designed taper prevents the peak withdrawal phase entirely. The dose comes down slowly enough that the body can adjust at each step, and the symptoms that do appear are manageable.
How We Treat Benzodiazepine Addiction
At Restoration Recovery, benzodiazepine use disorder is treated with counseling and our outpatient program. This is a fundamentally different treatment model than opioid use disorder. There is no FDA-approved medication-replacement therapy for benzodiazepines — no substitute medication and no monthly injection. When a patient needs a taper, we send them to a higher level of care.
A typical outpatient benzo treatment plan at Restoration Recovery includes:
Individual counseling. Benzodiazepine use disorder typically starts with a legitimate prescription for anxiety, panic, or insomnia. Counseling focuses on building non-pharmacological anxiety and sleep tools — cognitive strategies, relaxation and breathing practice, sleep hygiene, and trauma-informed care where relevant.
Psychiatric co-occurring care, offered at our Chattanooga clinic. When an anxiety disorder, panic disorder, PTSD, or depression is underneath the benzo use — which is very common — our psychiatric providers can evaluate and prescribe non-benzodiazepine medications that treat the original condition without the dependence profile. SSRIs, SNRIs, buspirone, and other options exist and work for many patients.
Intensive outpatient programming (IOP), offered at our Chattanooga clinic. For patients who need a more structured schedule — three days a week, about 2 to 3 hours a session — our IOP provides intensive group-format sessions, additional therapeutic structure, and integrated psychiatric care.
Buprenorphine for co-occurring opioid use disorder. If you also have opioid use disorder, we treat it with buprenorphine alongside your benzodiazepine treatment.
Some situations need medical stabilization first — very high doses, multi-bar-per-day alprazolam use, high-dose polysubstance benzo use, or a prior withdrawal with seizure. If that applies to you, tell us when you call.
What to Expect at Your First Appointment
Your first visit at Restoration Recovery typically lasts 2 to 3 hours and follows a four-step clinical flow, adapted for sedative/hypnotic use disorder:
Intake. You’ll complete paperwork and a clinical intake. For benzodiazepine use disorder, this includes a DSM-5 assessment for sedative, hypnotic, or anxiolytic use disorder — confirming the diagnosis and its severity — plus a thorough history: which benzodiazepine you take, at what dose, how frequently, for how long, prior taper attempts and how they went, co-occurring anxiety/panic/PTSD diagnoses, and any other substances or medications involved (alcohol, opioids, stimulants, antidepressants). We do not use the COWS scale here — COWS is an opioid-withdrawal measure and doesn’t apply to benzodiazepine care.
Counseling. You’ll meet with a licensed counselor to discuss your substance use history, prior treatment, and the role the benzodiazepine currently plays in your life — sleep, panic attacks, social situations, chronic anxiety. This sets the stage for the non-pharmacological tools you will build in counseling.
Doctor evaluation. A medical provider reviews your intake and counselor notes, assesses your medical stability, and talks with you about how co-occurring anxiety will be managed.
Treatment plan. You’ll leave with a treatment plan and your next visit booked.
You should continue taking your current prescribed dose of benzodiazepine right up until your first visit. Do not cut back or stop before that visit. Bring a valid photo ID, your insurance card if applicable, and a complete list of medications you currently take — especially your current benzodiazepine (name, dose, frequency) and any other prescriptions or substances. Bring your pill bottle if you have it.
How a Benzodiazepine Taper Works
If you need a taper, we send you to a higher level of care for it. The clinician-managed benzodiazepine taper is the evidence-based standard of care. It is recommended by the American Society of Addiction Medicine, the American Psychiatric Association, and clinical guidelines drawn from decades of research — most famously Professor C. Heather Ashton’s foundational work on benzodiazepine withdrawal and taper protocols (the “Ashton Manual”), which remains one of the most widely cited taper references in the addiction medicine literature. More recent APA and ASAM guidelines refine and extend that approach.
An effective benzodiazepine taper combines four elements:
Slow, individualized dose reduction. The standard starting pace is 5 to 10 percent every 1 to 2 weeks — but “slow enough that your body can adjust” matters more than hitting a specific pace. If a step produces too much withdrawal, the taper pauses at the current dose until symptoms stabilize. Longer is better. Tapers spanning 3 to 12 months are routine for long-term benzodiazepine patients, and a slow, multi-month timeline is exactly what good benzodiazepine tapering looks like.
Use of longer-acting benzodiazepines where helpful. Patients on short-acting benzodiazepines like Xanax often find the taper significantly smoother after crossover to a longer-acting medication. Steady serum levels eliminate the inter-dose withdrawal peaks that make short-acting tapers so unpleasant.
Concurrent treatment of the underlying condition. If you started benzodiazepines for anxiety or insomnia, those symptoms will return during the taper if they haven’t been otherwise treated. Counseling, psychiatric medication management, sleep interventions, and trauma-informed care during the taper make it sustainable. Tapers that fail usually fail because the original condition was untreated.
Ongoing clinical monitoring. Regular follow-up catches complications early — breakthrough anxiety that needs a different approach, sleep problems that need non-benzodiazepine intervention, or taper steps that need to slow down. The taper schedule can change as you go; if a step is too hard, the prescriber slows it down.
Patients who complete a clinician-managed benzodiazepine taper typically report meaningful improvements in cognition, memory, mood, energy, and overall quality of life — often noticed in the months after the taper finishes. The long-term data is encouraging: most patients who complete a properly paced, well-supported taper remain off benzodiazepines in the years that follow. It takes time, but it works.
Why Restoration Recovery
Serving Chattanooga since 2017. Our providers have decades of clinical experience managing benzodiazepine, opioid, stimulant, and alcohol use disorders in Southeast Tennessee.
CARF accredited. The Commission on Accreditation of Rehabilitation Facilities is an independent, nonprofit accreditor that reviews treatment programs on-site against its published standards.
Four clinic locations across Southeast Tennessee and North Georgia, with telehealth follow-up available for established patients.
Most major insurance accepted — TennCare, Georgia Medicaid, commercial plans, Medicare, and supplemental Medicare. Our patient services team verifies your benefits before your first visit so there are no surprises.
Same-day appointments available. You don’t have to wait weeks to start treatment.
One integrated team. Medical providers and counselors at every clinic, with psychiatric care at our Chattanooga clinic — so co-occurring anxiety, panic, and sleep disorders can be treated in parallel with your benzodiazepine treatment, not on a separate referral track.
Licensed in both states. Licensed in Tennessee and Georgia, HIPAA compliant, 42 CFR Part 2 compliant — your treatment is confidential from the first phone call.
Insurance and Access
Restoration Recovery accepts most major insurance plans, including TennCare, Georgia Medicaid, a broad range of commercial plans, and Medicare (plus supplemental Medicare plans). Our patient services team can verify your benefits before your first appointment so you know exactly what to expect in terms of cost.
If you do not have insurance, contact us anyway. Our team will go over the cost of self-pay with you before you start. For a full list of accepted carriers and details on the verification process, visit our insurance page.
We operate four outpatient clinics across Southeast Tennessee and North Georgia. All four offer Xanax and other benzodiazepine treatment, with same-day appointments on the days each is open:
Group IOP and psychiatric care are based at our Chattanooga clinic on Shallowford Road. If you start treatment at Cleveland, Soddy-Daisy or Ringgold and either one is part of your plan, we schedule those visits in Chattanooga and keep the rest of your care at your home clinic.
Telehealth follow-up visits are available for established patients who have completed their initial in-person evaluation. For directions, hours, and contact information, visit our locations page.
Frequently Asked Questions
Is Xanax withdrawal dangerous?
Yes. Xanax and other benzodiazepine withdrawal can be medically dangerous and, in heavy daily users, potentially fatal. Abrupt discontinuation can cause seizures, delirium, severe rebound anxiety, and autonomic instability. This is why the standard way off benzodiazepines is a slow taper directed by a prescriber. Do not stop on your own — keep taking your current prescribed dose and talk with a provider before making any change.
Can I stop Xanax cold turkey?
No. Stopping Xanax cold turkey after regular daily use is medically unsafe. Benzodiazepines are one of the few substance classes where untreated withdrawal can cause seizures and death in heavy users. A gradual taper directed by a prescriber — gradually reducing the dose over weeks to months — is the standard of care. If you are taking daily benzodiazepines, continue your current prescribed dose and talk with a provider before making any change.
How long does a benzodiazepine taper take?
Benzodiazepine tapers vary considerably. A typical outpatient taper takes weeks to months, with dose reductions of roughly 5 to 10 percent every 1 to 2 weeks. The exact pace depends on your starting dose, how long you have been taking benzodiazepines, which specific medication you are on, co-occurring anxiety or panic symptoms, and how your body responds at each step. Longer, more cautious tapers are generally better tolerated than rapid ones. For long-term users on high doses, tapers of 6 to 12 months are routine and appropriate.
Will I have to stop Xanax before my first appointment?
No. You should continue taking your current prescribed dose of Xanax or another benzodiazepine right up until your first visit. Stopping on your own before the appointment is actively dangerous. The purpose of the first visit is to evaluate your current use and build your treatment plan — you should arrive stable, not mid-withdrawal.
What about counterfeit Xanax laced with fentanyl?
Counterfeit Xanax pills — often pressed to look like real alprazolam 2 mg bars — have become a serious risk in the Tennessee supply. DEA laboratory testing has found that approximately 6 in 10 counterfeit pills contain a potentially lethal dose of fentanyl. If you have been buying Xanax from a non-pharmacy source, there is a significant chance it contains fentanyl rather than alprazolam, which changes both the overdose risk and the right treatment approach. Tell your provider openly — this information is confidential under 42 CFR Part 2 and guides the clinical plan.
Do you treat all benzodiazepines, or only Xanax?
We treat all benzodiazepine use disorders, not only Xanax (alprazolam). That includes Klonopin (clonazepam), Valium (diazepam), Ativan (lorazepam), and less common benzodiazepines. We also treat dependence on Z-drug sedatives like Ambien (zolpidem) and Lunesta (eszopiclone), which share many features of benzodiazepine dependence.
Take the Next Step
Benzodiazepine dependence is treatable. You don’t need to have all the answers before you call.
Do not stop your benzodiazepine before your first appointment. Keep taking your current prescribed dose. The first visit is for your assessment and treatment plan. If you’re in the middle of a binge of multiple high-dose benzos daily, call the clinic before you change anything.
Same-day appointments are available. Contact us today to schedule your evaluation, or call 423-498-2000 to speak with our team directly.
A place for hope & healing
Ready to start treatment for Xanax use?
Same-day appointments available. Keep taking your current prescribed dose. Don’t stop suddenly.
