The Stark Reality Of Benzodiazepine Dependence & Availability
When it comes to anxiety, the truth is that coping mechanisms (medically & behaviorally) are different for everyone. There are some who wholeheartedly feel that anxiety meds are not the answer, and while they may relish in other forms of distraction, we all share common a desire to make ourselves feel better in the moment through whatever means we respectfully deem necessary. Individual rights to one's perceived sense of adequate treatment should not be infringed upon by another's skewed perception of what only works best for his or herself.
So in a rather complex and controversial outlook to the way anxiety should be treated, it seems that doctors and psychiatrists alike have taken a timid stance to prescribing benzo's - But is it really ethical and fair to the well-being of so many patients who have already become dependent over the course of several months or years? A roadblock in the supply chain could turn out to be life-threatening for countless individuals who'd suddenly be at risk of seizures and other diabolical maladies...
 Are mainstream doctors consciously aware of the sheer magnitude of benzodiazepine withdrawal? Are physicians trained to face and solve the real traumas of everyday human beings or are they simply textbook smart, generously appointed the M.D. crown for memorizing information throughout their education? These are important questions we sometimes have to ask ourselves, as many of these doctors have earned our deepest trust. When they recommend something, we are the ones who try it.
Some would say that society's perception of anxiety has an effect on the availability/accessibility of mental health services and treatment. For if we truly understood how different our brains operated at the level of each individual, anxiety and its multidimensional array of treatment options (specifically benzos) would inherently be accepted in a nonjudgmental and open-arms manner, despite the odious acts of those who misuse them.
I write all of this in the belief that benzodiazepine addiction & dependence should be treated with increased availability and access to proper tapering methods instead of just yanking the rug out from underneath our feet. Without proper protocol in place, black markets flourish with counterfeits, that only put more lives at risk. Similar to the current opioid epidemic, here we stand at the Mordor of capitalism; when one ember fades (doctors) another begins (dealers).  There are many solutions to the same problem, but which one have you chosen?
About 5 years ago my primary physician (who I have since fired) gave me a prescription for Klonopin/Clonazepam due do sudden death of my Mother and my developing "fear" of my public speaking (need this for my job). He started me at 1mg 3 times a day. Well, needless to say, I became dependent on these and he continued to write refills for almost 2 years.
Fast forward in trying to refill close to this 2 year period- and he refused to refill unless I came in (I was in China on business!). So with no recourse I just stopped cold turkey (after 2 years of 3mg per day). Let me tell you, I almost ended up in the ER! Unbeknownst to me - and NEVER discussed by my physician - stopping these poison pills "cold" can cause DEATH! I truly believe he had no idea of this ..he had stepped waaaay out of his league by prescribing these pills. So for the next 6 MONTHS I went through withdrawals....Yes, 6 months! First came the electric shocks to your brain. Yep, you may be lying in bed and BAM!... you feel this jolt of electricity pulsating from your head. Extremely unpleasant to say the least. Those jolts lasted at least 3 months. So during this 6 month "Brain Reset" you have constant anxiety, fear of people and social situations and generally just want to go blow your brains out!
As I found out later, Clonazepam is the WORST Benzo to detox from as it has an enormous half life. Unlike regular Xanax (Alprazolam), which goes in and out of your body quickly, Clonazepam sticks around (literally as it binds to your GABA receptors in your brain ) for over 12 hours.
Bottom line is you are absolutely right about Benzo's. Do not ever let your primary physician mess around with these drugs as they are clueless. Get yourself a good Psychiatrist who are trained in these very tricky drugs and can work with you in their use - and work with you on their discontinuation...and God forbid a Benzo shortage...our ER's would be flooded.
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They have chosen to abandon their patients who are facing a very real physical and anatomical "dependence" on medications from a physician they trusted in all honesty looking for help with anxiety or whatever the Benzodiazepine was/is prescribed for. Abandoning patients who trusted their off-label usage past the 7-14 day acute setting Benzodiazepines are FDA approved for. The FDA has that guideline for a reason because there is a very real increased risk beyond that time frame. Patients are being stopped cold turkey for simply complaining of "tolerance" withdrawals while still taking their medications. They are even speeding up tapers if a patient says doctor your taper schedule is too fast for "me". I am having severe withdrawals, I am bedridden unable to function, full of unexplainable anxiety, I am getting Akathisia plus more. You would think that would be a clue that their taper schedule was too fast for that person and to simply slow down for that person. The Aston Manuel has researched methods and guidelines all laid out. The patients are simply asking for help to come off a medication they took as prescribed. Either the medication stopped working or the doctor is tapering too fast for his own reasons. How are patients being treated? Doctors are outright calling these honest patients liers, accusing them of abusing medication, then even ripping them off additional medications that also have a withdrawal syndrome associated with them like SSRIs, SNRIs & Gabapentinoids, now labeling them a liability and profiling them to be abusers instead of "as prescribed" and suffering from dependence.
The only thing the patients are asking is to be supported, treated with empathy, compassion during a very traumatic time in their life and what they are dealing with due to no fault of their own. They are asking to be trusted, believed, supported in as slow a taper that is needed for that individual. We are all different our brains are not textbook one size fits all. Some people do just fine on the FDA suggested guidelines. The fact of the matter is millions of people don't. The answer to this question is two fold.
. Doctors humble themselves and listen to their patient's needs and support them. Read the Aston Manuel and Safe Tapering Guidelines for psychotropic medications of 10% less that is suggested for other medications that have a withdrawal syndrome. If the patient says they are suffering from withdrawals, believe them. Why they constantly tell people that medications like Gabapentinoids have no withdrawal symptoms is unbelievable - they are GABA medications and the withdrawal syndrome mimics Benzodiazepines for some people to the same and differing degrees. The withdrawal syndromes are all clinically noted. So, why in the world is a patient standing in front of you a liar and abuser that has been an honest patient for years? With no drug seeking, Doctor or pharmacy shopping? Does that even make sense? NO!
. Be cautious in prescribing mind-altering medications like SSRIs, SNRIs, Benzodiazepines and Gabapentinoids. Be cautious about polypharmacy instead of adding more medications chasing side effects of one medication after another. Think this medication has side effects and perhaps that's the problem, not a new diagnosis that is mimicking a new health issue. Support the patients who are suffering from the more difficult end of the withdrawal symptoms of these medications at 10% or LESS! Allowing the patients to feel safe and supported on one medication at a time. They are terrifying people and ruining lives. The symptoms are life changing, mind altering & incapacitating. Honest people are forced to be dishonest for the first time in their life as a simple survival mechanism. They are having to act like the perfect patient for years so they can come off the medication safely at their own pace with each visit, scared the Doctors might have a change of heart and say we want to switch your medications. I won't say people are being forced onto the black market to help themselves, though some are. Most are suffering and trying to heal and manage symptoms on their own. Becoming unnecessarily bedridden and losing their jobs, family and medical reputation ruined before doing that. This is cruel and pushing people to suicide and causing more anxiety and trauma than the original "anxiety" the person was scripted for.
1. Prescribe cautiously from now on. 2. Read and believe the Aston Manuel and 10% guidelines available for other medications and believe and trust it's what some people need. 3. Be more cautious in the polypharmacy that simply compounds the problems with a person suffering from withdrawal symptoms. 4. Simple support and taper at the patient's very real physical need. Why is this so difficult?
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I couldn't agree more, dr.s need to treat each patient as an individual not as a group. We are all different in every way.
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Big Mike Says:
Absolutely, we need to understand and realize that we cannot just cut off people's medication just cause some don't agree with it. Everyone wants to complain about the opioid problem but nobody actually wants to help the victims of injury, chronic pain and the recklessness of companies like Perdue Frederick for making and pushing Doctors to prescribe meds like oxycontin back in the late 90s and early 2000s. That reckless greed for money is what has so many people still addicted or dependent on opioid medication today. It does not matter if the people have legitimate pain or not...people are suffering severely, lives and families damaged and many dead! So now we want to hurt the victims of this reckless greed by pharmaceutical companies even more by making them suffer more. For God sakes, the only way to solve this is to open free help and private help for all these people, not throw them all in jail. These people are victims. When it comes to benzodiazepines, it is especially dangerous and deadly to discontinue use suddenly and would cause deaths from seizures and a whole world of health and safety issues. Everyone needs to understand how serious some of these medications can be when it comes to physical withdrawal. It's dangerous. Offer help. This is the only answer. Stop the business as usual attitude for once and understand that when someone calls a rehabilitation center for help and are told they cannot be treated cause they don't have insurance or for whatever reason people are denied help everyday cause all health care in this country cares about is money....Not Lives! When it comes to this type of treatment of people of all classes it is absolutely a crime against humanity to allow people to suffer and die due to greed and money! Open more detox facilities. A city with a million people has a detox center with 16 beds for crying out loud! This is not excusable. The people and government agencies responsible need to take responsibility for their actions and deal with the problem in a humane manner. People care more about pets than human beings these days!
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I have severe anxiety and was taking opiates as a coping mechanism for it among many other things. I also would take benzos and i built a tolerance. My dr cut me off of my medication because i had taken an illicit benzo and could not stop cold turkey like he demanded i do. I tried but as everyone knows benzo withdrawal is scary and i feel it was unrealistic for the dr to expect me, an addict, to just stop. Of course there's a stigma about any one recovering from addiction but if a legal drug works for you drs should let you be on it...anyway very well said article or post.
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Re: Hamster (# 1)
I'm on 40mg's of Diazepam/Valium. Have been for 20+ years, 1/2 life min 70 hours, most agree at 96 hours give or take 4 days!
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Well written David!
I am experiencing this right now. I have an appointment to see a new doctor to get my "Benzos". Been on Valium for 25 years.
The newest information on the CDC'S website clearly states that these types of medications are still available to those patients who need them. I was told by old doctor this past Monday that there is in fact a link to Benzos and Alhemizers. It has been proven. I personally have known there was a possible corrilation for a long time. As a patient, you have to decide if that is a risk you are willing to take. I think the only way to decide is after a good deal of therapy. Thank you for your post.
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Thank you for your input! I was prescribed Xanax by my Dr years ago! He has since retired. My new Dr is excellent.... she is weaning me off! In the meantime name brand Xanax is running me over 500.00 a month which I cannot afford anymore which is the reason I am switching to generic which will be 5.00! Big difference! At this point I am only trying to see if I would experience withdrawal symptoms by switching from name brand to generic until I have weaned off totally?
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Re: Big Mike (# 4)
We need more voices like yours. I just received a letter from my insurance company. Today.They plan to severely limit the monthly amount prescribed. I take Tramadol 50mg. tabs.I suffer from degenerative disc disease. Chronic back pain I've been taking this medication for over 4 years now. It, along with Tylenol, twice a day, make life livable. I have never abused this medication, and they are good days when I don't need it. But it's reassuring to know it's there when I need it.
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RE: Klonopin / other Benzodiazepines - I do not believe that a drug is harmful OR addictive IF you need it. The problem is being honest with your doctors & yourself to evaluate if you do. Sure, I've had ***** doctors that like to yell at me that "I'm addicted to Benzodiazepines"; but if they're not an expert in panic attacks - then I'm the expert! About 20yrs ago I was prescribed Klonopin. It didn't work for me cos it took to long to feel any relief, and also made me tired! They are NOT sleeping pills, ppl!! They're for intense anxiety, panic attacks and dyspnea. Unfortunately our gov't (Aussie) has been making it hard to get xanax, and even with a prescription- the chemist was out of stock for almost 2 mos! I spent those 2mos in bed totally.
I've been taking valium or xanax for the past 20yrs and have developed NO addiction problems.
The first thing is to only take them when you need them, and not at a specific time of day everyday cos addiction could arise from your body "expecting" it.
I had my first major panic attack at age 3. I was attempting to play a jukebox at a bar my mum took me to; and I couldn't read too well; didn't know about "reset" and was horrified when all the colored lights lit up and it just sat there. I was *sure* it was gonna blow up! Maybe it was the time I grew up in with the Cuban missile crisis; or could've been the severe child abuse I grew up with; but as a kid, this went on for months - and me so afraid I'd throw up if I heard police sirens in the distance. Finally we went there and I just knew there'd be a bomb hole in the ground & be arrested. But, as everything looked ok, I finally snuck a peek at the jukebox & it was back to normal. I was so relieved, I couldn't believe my luck! Another time it happened at a hall in a bar where I took dancing lessons and thought I stuffed up the pool table; again afraid they'd find me! I had no-one I could even ask about this; all these episodes and more were a lot of being screamed in the face to "CALM DOWN!". How is anyone to calm down while you're being screamed at? And unfortunately it would take for me til I was 18 & looking out for myself to seek therapy (as we lived in America and were always told by my mum we had no $ for docs)!
Now, after a long life of more abuse and a problem that'll never go away; I developed Emphysema 17yrs ago (even though I quit back then) and now have dyspnea when I can't breathe! It feels like you're choking to death, then you get SO scared that you panic, and on the cycle goes unless you can break it as quickly as possible with something that works. Puffers don't work on emphysema; so I need xanax to even be able to talk again!
And, n/o but just wondering why all these ppl are worrying about how long it remains in your blood? I get blood work & U/A's often and of course they see it - I'm *prescribed* it!! It's not an illegal drug, it's a restricted drug. Jeez, if you can go 72hrs without using it to wait for blood work- I doubt you need it in the first place! When my panic attacks happen they feel like heart failure, so - when that happens, blood work be damned! I have long, long, ago stopped feeling that first-time euphoria, no matter how much I take.
I can still drive, pay bills, etc so why worry?
So, there you have maybe the difference between an addictive state or not. I'd die if they ever take it off the market, cos nothing else works fast enough to help you breathe again; & comes down to the end of the day - not breathing is the most serious thing I know! What pisses me off is people who want a prescription for the wrong reason; thereby making it harder for *me* to stay alive. I only have 2-3yrs left anyway.. I hope the gov't can't do anything that drastic in that short a time! Please leave the xanax for us out here who need them! If all you need is a good night's sleep, then take Seroquel! I was given a pile of that crap to try and it's useless for anything except putting you half in a coma!
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Absolute garbage. Shyness should be treated just as pain. Exposures are great. Their efficacy is very low if not attacked where it starts- in a brain that was damaged around the time of birth or if the infant does not receive tactile love, and compassion. Add Cerebral Palsy and you have me. I've struggled with social anxiety for 54 years and knew the reason and treatments as a child. I'm a burning ember patient who ran out of patience with my dim-witted doctors. I saw a tv special and read research on farm animals and chimps.Young, like myself, deprived of touch developed poorly. Cowered in corners of cages for their entire life. I was phobic. Could not speak when spoken to. Could not eat or drink in public or swallow a drink. When touched I jumped or reacted strongly. Spasticular cerebral palsy and the muscle tenseness added to the problem. Sweating was profuse. Will cut this short. A benzodiazepine stopped all this. I married. My spasticity abated for the first time after 40 years of abusive doctors. Still, doctors pontificate about benzodiazepines and opioids which beat all other treatments to this day. Laughably, doctors and the fda are replacing xanax with benadryl or hydroxizine. GOOD FOR HIVES THOUGH! And by the way, try a 20 year withdrawal from 200 mg Amitriptyline. The first two years nearly killed me and left me homebound. Had no withdrawal ever from a benzodiazepine. Taper or no taper. To each his own.
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Re: Alan (# 11)
I agree with this 100%, i take Klonopin regularly, do not abuse it at all, and i also have Ativan if i need it, sometimes i never need it, sometimes once every 6 months i might need one....
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Re: Mickey (# 12)
I agree as well Allen. I am a retired research nurse, who also being driven neurotic due to implosionary emotional skills and at the same time now hypertensive related to severe panic anxiety and falling through medical cracks as im perminantly disabled now on medicare medi-cal and my heart cant stake it, that guy standing on my severly inderweight chest from a dead sleep with a script from my dr. Just breathe.... im a dead woman... Klonplopin btw is 1-150 for 1mg and a 2mg xanax bar is 4-5each in LA streets and Klonopin has 2x the half life.... i wish more dealers had klonopin. So this is the end of my 17 year nursing education.
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Re: Lauralee (# 10)
I was instructed to take it at night. It does not matter when you take it as long you have the right amount in your system.
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Benny boy Says:
Re: Alan (# 11)
Amitriptyline withdrawal I've been taking that for several years 50 mg to bed if I stop taking this cold turkey what will happen
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So many Drs have no real understanding of anxiety at all other than what they've learned in books. Even trying to get treated for it they treat everyone like they're drug seeking. Once the "opiod epidemic" became the catch phrase (which btw, was created by the pill mills and unethical Drs who wrote scripts for cash with impunity for years) All patients meds and dosages were cut. I had been on diazepam for a few years and they just discontinued them over a 2 month period. I developed terrible rebound anxiety, mild agoraphobia, and hard to explain symptoms that lasted 6-9 months. They do not look at individual treatment or patients, as long as the amount the Drs are prescribing goes down. The hell with patients
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Yes, what you are saying is right, like me I have been on klonopin 2x daily for around 15 years. I have PTSD but my Dr that was getting me off of opiates quit and left the practice leaving me without my subutex and my klonopin so I had the facilities write me out a 1 month script until I could find a new Dr and most Drs will not let you take both meds at the same time. But I finally found a Dr that let me take both until my script of klonopin ran out. He told me my family Dr would refill but she said no. Now I have no Dr that will prescribe both meds and I am scared as hell. I cannot go without these meds. I feel that the Drs that got you addicted to certain meds should be responsible if something happens to you like having no one who will prescribe. They should be held accountable for this. I know a legal suit will not help but if they got you addicted then they should help you get unaddicted and fill your scripts. It is not fair that you have to go through very very bad withdrawals. Someone should help you. Then I have the subutex withdrawal on top of this. Someone needs to be held accountable for this.
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Re: Benny boy (# 15)
I was on 200mg until 8 months ago and had been tapering at 10 percent per month for 20 months. Patient information is more accurate than your doctors. They should take it. After reaching 25mg I became extremely ill, felt strange. Even had mind trips. It is the most painful withdrawal of any medication including cymbalta. Intense pain, insomnia, neuropathic pain, feeling of concussion, extreme weakness, inability to walk are just a few of the symptoms. On the bright side you will lose weight. Weight gained on amitriptyline. And mood will improve after about 8 months but this may be a two year withdrawal. And according to others it is,very hard to get off of. My life has been shut down for 8 months. And head pressure can get so severe you may have to take 50 mg. I had a small stroke possibly and temporarily, for minutes lost my vision. No other drug has an effect on the withdrawal. Again anyone on 50-and above is in rhe most devastating fight for life like myself. It is worse than chemo and longer. And stomach pain in the morning is intense and signals a bad day. Hope you succeed. My doctor said two weeks and no withdrawal. Not true unless 10mg possibly. That is why doctors dropped the dosage fro 300 to 25.
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RWH RNMS Says:
Re: Vickki1000 (# 2)
Absolutely spot on! It's a wake-up call for everyone. As a nurse, one of the first concepts we learn is patient advocacy. We are the last in line to the patient and have to protect the patient even if it's from an MD error. Some nurses would give their life for their patient if it came down to that.
The MD's are not educated with this concept and actually find it an insult to them. I just bring that up to add to the excellent assessed and knowledgeable statement regarding drug dependency and people that are legally endowed with our trust to prescribe and manage them appropriately.
The opioid crisis has caused a panic among several physician groups, and because they can't do anything about what happens in the public sector (such as friends and relatives stealing or "borrowing" meds) they focus on the one group they can have control over and that is the innocent chronic pain patient. Statistics abound that patients with chronic pain or on drugs that are appropriately prescribed but can be addictive are the least likely group to OD. But suicides are often classified as OD's in this group, particularly now when everything a chronic pain patient does is suspect and the pressure to suicide is only increased as the supposedly "well-meaning' cold turkey withdrawals and non follow up of retiring prescribing physicians and the fear physicians have taking on new patients that need controlled substances is commonplace. The unreasonable fears of the FDA and DEA have on MD's their practice is over the top two... It's number one that is looked after and not 2-1000 of the patients. I'm not saying it's a character flaw or intelligence issue. It's human and the errors that are being driven by big pharma's infiltration of our medical schools, MD clinics, and every facet of health care. I'm hoping one day someone with great courage and leadership will point this out of how it's undermined all aspects of healthcare in order to feed the insatiable money eating machine of big pharma.
People rise up and fight back, get informed, because nobody's going to do it for you.
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Re: Vickki1000 (# 2)
I find your story heartbreaking.
It's very unfair of doctors (or "modern science" in general) to say to you "Well, when we first gave it to you it was a miracle drug. Now we found maybe there are some problems, so you have to bail out NOW!
Are you sure that *you're* the one having addiction problems? Or were you just told you were?
See, to me the difference is all in the fact that every drug produces side-effects. Some will be devastating, others you don't mind much...
But if this has you rendered bed-ridden and the other things you were going through trying to *withdraw* - trust me, your side effects would have to have been so much worse!! Like, being a vampire and unable to keep daylight hours...
It sounds ridiculous I know, but you don't HAVE TO follow your doctor's advice (esp since they seem younger & younger these days). If it's your disorder; then YOU are the expert. You choose. Especially with that "you're not making progress fast enough for me". You poor woman! It's almost like they have a quota to fill & your illness is getting in the way! Ridiculous!!
I'd like to tell you all the true story of the billionaire Howard Hughes at the end of his life. As far as they can figure, he was the longest-lived chronic pain patient (self medicated at that) in history!
He was rich enough to keep himself pain managed for over 50yrs by himself with 3 items: Codiene, Valium, and a type of analgesic with caffeine called Emperin.
Guess which one killed him? The bloody aspirin! After all the abuse it put him into renal failure.
Really makes you think, doesn't it?
Anyway, feel better & take care of yourself. -Lauralee ?