> Having kicked opiates cold turkey in the past, I felt nostalgic for three simple days of traditional nausea, sweatiness, and bone-deep ache.
I am one of few people stupid enough to have, at one point, been addicted to and subsequently withdrawn from, almost everything but alcohol.
There is no way to explain the hell on earth that is benzo/GABA-ergic drug withdrawal, and I would not wish it on my worst enemy. It is an order of magnitude more intense than opiate withdrawals, and the timeline is weeks/months rather than days.
Like the author, I managed to quit via a year-long Ashton protocol taper.
The irony is that benzos were the one class of drugs I wasn't abusing for recreation. I was using mega-doses of Etizolam to cope with PTSD flashbacks, and only discovered I had become physically addicted after flushing it all and winding up in the ER.
I was on Ativan for acute trauma avoidance (to try to prevent PTSD) for about 6 weeks. I hate taking medicating and stopped it cold turkey. It took me another 3 weeks or so to feel "normal" again and the withdrawal period was so phenomenally physically uncomfortable and panic-inducing that I will never take it again for any reason. I spent most of that time thinking I was going to die. In the long run, I guess it helped with PTSD avoidance (which seems to be one of the things they do now), but even just thinking back to those few weeks makes my skin crawl.
14 months. (Usually) not every day, maybe 3-4 times a week. And 8 months to taper off. How long it takes to taper depends on the level of discomfort you’re willing to tolerate.
Diazepam half life is so long that dependence can develop even when not taking it every day.
Edit: and I totally believe there are people who can take the same amount as me and not become dependent as easily as I did. Everyone is different
This is a desirable trait when tapering a dose. It reduces hour-to-hour blood level variation which reduces the whole up-down of alternating between euphoria and rebound anxiety. Idea is to target a constant level which is tolerable and slowly lower it.
The article implies this (a Valium taper is mentioned) but I don't think it outright states it so I'll say that for anyone who is addicted to a fast-acting one like Xanax or Klonopin - a switch to Valium might help.
'Discomfort' is one of those words that technically encapsulates the feeling, but feels too weak to use. Kind of like 'anxiety.' It runs the gamut between slight nervousness to abject terror.
I did everything under the sun, got sober, did klonopin for a bit to help with anxiety and was lucky -blessedly lucky that it didn't do too much for me.
My best friend was not so lucky and was on ativan and had the worst experience getting off of it, and had years of problems with it because it aggravated the anxiety she was already experiencing.
Benzodiazipenes (sp?) has it's medicinal uses, particularly with injury or surgery; but yeah -if you're not very careful and very lucky it's hell to get off of if you end up dependant on it.
I'm very glad to see the word is getting out and is more wide-spread. I hope that it doesn't result in a complete freakout the way that oxycotin did. It's vital when it's needed, hopefully it will remain available.
What gets me, as someone with chronic anxiety, is that they've only come up with one thing that reliably works -and it's this. It feels like the research stopped in the nineties or so. I often wonder wtf about that.
It seems like benzos are only suitable to be used as a short term solution, but in typical human's of capitalism fashion, we use them as a long term solution since the long term cost is usually far beyond the horizon of the next financial quarter.
There are other drugs since the 90s that are effective for anxiety, but they're either way more subtle and take longer to work than benzos (SSRIs, SNRIs, lavender pills, buspar and derivatives) or don't have the same withdrawal syndrome but come with a much worse package of side effects (quetiapine and other antipsychotics).
I have had clinically significant anxiety since I was a young child, and in the end, treating other mental illnesses effectively (I developed bipolar 1 in my late teens) and exercising very regularly seems to pull my baseline level of neuroticism down to within the normal range. If I get good cardio in, usually an outdoor run, 3 days a week, I feel normal.
I took buspar for like 4 years because it basically didn't scramble my brains the way other anti-depressants worked and I could say I was 'cooperating' with treatment -despite getting no benefit from it.
I had no issues getting off of it; not to say that other people don't either -they very well might.
I'm convinced a small percent of people get addicted to anything much more easily. Ive enjoyed various things but it's like meh- though Ativan is fucking amazing (but only for fear of flying). I think it is a brain reward structure thing; I get bored very easily and i guess it takes a decent amount of danger or effort to get me very interested.
I think that's a common impression. Interestingly, while there are still a lot of questions marks around what makes someone predisposed to addiction, the few things we do know tend to run counter to the idea that people dealing with addiction are overly sensitive to feelings of reward and pleasure. Or that being less sensitive would make someone more resistant.
One of the most well studied genetic risk factors for addiction vulnerability is the DRD2 gene which encoded the dopamine receptor D_2. People who are particularly vulnerable to addiction commonly have a deficiency here, meaning getting bored very easily and feeling under stimulated/rewarded by typical things is in part what makes riskier sources of pleasure (i.e. drugs) so appealing.
Disclaimer: Not a medical professional, just like reading about addiction and genetics.
Interestingly, thinking this way is how many people get addicted.
A couple of the people I knew who ultimately ended up in rehab would describe themselves as not having addictive personalities. One even bragged about how boring drugs had become to himself.
This is the hubris that opened the window to their addiction. They thought it was a thing that happened to other people, so it was safe to dabble. Then dabbling became a little more frequent, then they decided the drugs were actually helping them and therefore it was logical to do more, then they took little breaks to prove that they could stop but came right back to the drugs as soon as their life got a little hard again.
About a decade ago, my doctor prescribed me Klonopin for sleepwalking. 0.5mg daily.
After two or three months I discontinued it. He suggested to just stop, but I thought better of that, tapering through 0.25mg and 0.125mg. What followed was weeks of unrelenting insomnia and headache.
It seems like Jordan Petersen really permanently messed himself up trying to shorten the timeline of getting off prescription benzos in a dangerous way.
I always feel awful when I hear people making fun of him for this. It seems like it's one of the most horrible and difficult things out there.
At his daughter's urging, he went to a sketchy Russian clinic where they subjected him to an unresearched protocol: stop the medication cold turkey, then put the patient into an induced coma. Who knows what kind of number this did on his nervous system. Based on his subsequent behavior and illnesses, I think it's safe to say he's been permanently disabled.
I was on low-dose Ativan for a few weeks casually prescribed for anxiety. What followed is an absolute year of hell. The most unimaginably difficult time in my life. Usually they tell you that short-term low dose poses lower risk or protracted withdrawal, but it's not a purely statistical risk. There are potentially pharmacological, physiological, and other factors that govern how these drugs affect each individual and those are largely unknowable.
I was on oxycoton (among other things) for pain relief after heart surgery, and during recovery. That lasted about a month -I was worried because of my history of substance abuse but I think between being aware of that and knowing they would not be available later gave me the will power (if you can call it that) to taper off of them without much fuss.
I agree, it depends on what else is going on -and why you're taking things. No way in hell I could have gone that month without them, that's for sure.
To give a different point of view: I've been taking Bromazepam for 25 years, but very occasionally when I'm very anxious or can't sleep, a few times a year, never more than 1-2 days in a row. It's been helpful, especially when I was younger as sometimes I was paralyzed by anxiety. I never had the slightest sign of addiction but was also careful not to rely on that too much (and never had any addiction problem).
I've also seen friends or family members who used and stop these drugs without much difficulty.
This isn't medical advice obviously, but I wouldn't rely on anecdotal experience to form an opinion on this. These drugs can certainly be helpful to some people.
Seconding your experience. Used on an occasional basis, benzos can be helpful without resulting in the horror stories related here. Of course, everyone is different and YMMV, but confirming that your positive experience is not unique.
They really are extremely effective drugs when used correctly. That's why the calls to ban them (as seen elsewhere in this thread) are not terribly compelling. There's no replacement for what they do.
That said: do not abuse benzos. They will fuck you up.
I was prescribed temazepam for insomnia. It was the only sleep medication that worked, and it was the best sleep I've had in my life. It stopped being effective after around 30 days (or maybe 60, I forget). That was the end of that. I could have argued for a higher dose or a refill or whatever, but... you don't fuck with benzos.
>They really are extremely effective drugs when used correctly. That's why the calls to ban them (as seen elsewhere in this thread) are not terribly compelling. There's no replacement for what they do.
>That said: do not abuse benzos. They will fuck you up.
This is pretty much my perspective, except I'd say that it doesn't even necessarily require abuse per se. I'd say just be very careful when using them, and get off of them ASAP. Myself, I only take them if there's a procedure of some sort they're called for.
I'd say awareness is more called for than a total ban. A total ban would be messed up because there is zero replacement for them for what they do -none.
There seems to be a reduction in psychological dependence in people treated with benzos and barbiturates for seizure disorders compared to people who don't have seizure disorders.
I think other disorders in gaba/glutamate functioning (or in an adjacent disorder that affects these systems) could be similar.
My guess is that low doses of benzos used to treat neurological disorders have a lower risk because GABA/Glutamate/related systems in that population are pathologically dysfunctional and benefit more directly from these medications.
Benzos can fuck you up good and proper without abuse. I was prescribed some for panic attacks. Take as needed, up to every 4 hours.
I took one a day for 4 days, as the panic would flare up right before I tried to sleep. I figured, I could be taking 6 a day, so 1 a day shouldn't hurt. And it was only 4 days in a row. No problem.
Day 5. Bang. Dt's. Immediate anxiety attack. Suicidal thoughts. Brain zaps. High blood pressure. Vertigo.
They are no joke, but doctors throw them around like they used to with opiates.
An yet, I've been on and off them for decades. No problem.
But many people have trouble and I am still at risk.
Benzos are miracle drugs for many including myself, but have to be taken carefully, and discontinued slowly (hyperbolic taper) if withdrawal symptoms are too bad.
This needs the caveat that following the maxim "do not abuse benzos" means telling well meaning doctors no if they suggest taking benzos for extended periods of time. Which is a bit of a stretch of the definition of abuse.
Not quite luck, there was a bit more to it than that. Temazepam has a bit different risk profile than some of the others. And the stop signal was developing tolerance; increasing dose would have been the exact thing to do if I wanted to get addicted. So I didn't ask for that!
I also take it on as needed basis. .5 mg clonzepam before bed. Sometime I’d take 2 if the day has been especially rough and I need a good night sleep. It mostly help with falling asleep and feeling more centered the day after.
During a crisis I took it for a month. Then stopped. Stupid as it may be, I only fairly recently learned that this drug can cause hell but for the life of me I couldn’t understand how. All it did for me is help me sleep. I didn’t understand how it can be abused or what’s the recreational part of it. When my doc told me about the dependence, and how it may creep stopped even my occasional use and the bottle I got last Jan still sits in my meds canbinet.
Could it be that different people have different reactions or may be more susceptible to addiction to it?
Maybe there are different types of downside; and different people have different experiences?
For example, if I take some sort of sleep aid (e.g. US OTC antihistamines, Ambien, or low-dose benzos) then after ~2 nights my subsequent ability to fall asleep without help is noticeably impaired. That’s already the start of a physiological change that, if not reversed, would continue to a dependency (albeit not necessarily an ‘addiction’.)
It’s a process of analogue change, not binary, and individuals’ pace of change will vary.
My involvement in inpatient drug abuse clinics has been benzo addiction is one of the hardest to treat and accounted for nearly half the patients, the rest split between alcohol and opioids, even during the height of the oxy crisis. It’s much less reported on because it’s widely prescribed and it’s nearly impossible to OD on. The effects aren’t as dramatic as alcohol, but are no less debilitating. Furthermore because benzos and alcohol have similar pathways they are often abused together and they amplify each others effect. You can satisfy the addiction with either - so people withdrawing from alcohol are often given benzos and people addicted to benzos often drink to relieve their addiction. People describe klonopin and similar long lasting benzos as a six pack that lasts 18 hours - which is a long time to have than level of declined inhibition. This further leads to more drinking, but also to other out of character behavior like overspending - some patients have bankrupted their families through excessive and bizarre spending.
Many people receive opioid treatment and do not become addicted. In fact most do. Most people can drink alcohol without becoming an alcoholic. This isn’t a proof that “anecdotal experience” that opioid addiction and alcoholism aren’t serious problems. In fact it is a demonstration that they are insidious for that exact reason - it’s fairly easy to slip through the cracks in the system into a serious problem that is life altering and extraordinarily difficult to emerge from.
Finally, the hardest withdrawals I’ve seen are benzo withdrawals. Relapse is also extremely high because the profound anxiety that led to the addiction is amplified in the years of subsequent withdrawal with very little as effective as a benzo to mitigate it. Paralyzing irrational fear is in many ways worse than pain, and pain is often a symptom to boot.
I feel that perhaps saying “well not everyone, take my anecdotal experience” isn’t the most empathetic response, and the statistics bear this out. The prevalence of benzodiazepine dependency is roughly on par with alcoholism in the US and several times that of opioids. The distinction is that crisis level addiction is roughly the same as opioid, while alcohol is roughly 7x worse. This likely because acute alcoholic behavior is rapid and very readily observable, while opioid and benzo dependency can be masked behind an otherwise normalish appearing life. The decline is fairly slow often unless you trip over into fentanyl. Further the prevalence of common use of both opioids and alcohol is much higher because surgery and recreational alcohol use is fairly prevalent while anxiety disorders less so.
Stevie Nicks is a popular icon who has been very public about how hard her withdrawal from Klonopin was, including how her skin sloughed off among other horrible effects. She lost a large part of her life span to it. But otherwise it’s also a relatively under reported dependency given its prevalence.
I’d also note in many countries benzodiazepines are highly controlled with much higher bars than US, including the UK, where they’re only allowed in crisis, not general anxiety disorders less.
No one questions if they're helpful. But the danger and the severity needs to be more commonly known.
I certainly wouldn't want them removed -particularly after spending 4 months going through different surgical procedures where benzos were medically indicated. But awareness of the down-side is thin on the ground (from my perspective) and it's good to get out there.
Some people are wired for addiction and some aren't. I knew a guy who did heroin or cocaine a few times a year when he felt like it and never got addicted. I also quickly lose interest in alcohol or marijuana but I can't stop eating sweets no matter how hard I try...
I have GAD and ten years ago when I was on my lowest, I was on 2 mg klonopin daily plus SSRI.When I asked to wean off the klonopin, we did over the course of two months and zero problems (fortunate).
Very similar. I had daily panic attacks for a while. Lorazepam and therapy helped me recognize the signs and slowly they went away.. along with how often I even took the lorazepam. It’s useful every now and then but it’s very rare.
Jordan Peterson has talked at length about his issues with benzodiazepine withdrawals. I know he is a controversial figure, but I wouldn’t wish that on anyone.
Here’s a video of a doctor talking about the dangers of BIND (Benzodiazepine-Induced Neurological Dysfunction) along with some clips of Peterson and his daughter talking about his experience. [1]
Definitely something that it’s good to raise public awareness about, because a lot of people being prescribed these drugs don’t fully understand the risks.
A lot of my friends have a problem with Peterson's beliefs, I have more problem with the lack of coherence in how he expresses things.
For instance Peterson says "you should be a Christian" but refuses to say if he's a Christian. I think we all should agree on the categorical imperative so if somebody is advocating that something is good for you but not good for them it suspicious. Like I have Christian friends who will tell me they personally have benefited a lot from their faith and I will tell you the same thing about Paganism.
Benzodiazepines can mess you up about as bad as Peterson says they have messed him up but his description of his symptoms (Tardive dyskinesia) is somewhere between incredible and fantastic, as is everything else he says these days. I think the saddest thing is that BZs impair learning and memory so that you don't learn to cope with life better with time the way most of us do. A friend of mine who has been taking them for 20 years still talks about the same subjects in the same way that he did back then whereas people who grow pick up new interests. SSRIs are a preferred choice for anxiety disorders because they seem to help people in the short-term with less suppression of long-term development.
I do think there's a need for a message similar to Peterson, that is, somebody who advocates for tradition and encourages young men who've been turned off from learning by a gynocentric educational system to seek knowledge -- but Peterson doesn't deliver what he promises. Neema Parvini does:
I had a friend who got hooked on these and it really messed up his life. He had issues before but one he was hooked to those he became unbearable to even be around.
Yeah, after witnessing a friend's troubles getting off theirs I wouldnt wish it upon anyone.
It convinced me to get me off my own Clonazepam PRN prescription, which thankfully was rather infrequent and had minimal issues weaning off of.
The psych had told me nothing of the nightmare that dependence on those meds can create, a situation somehow far worse than that which they're often prescribed to resolve.
More recently another friend mentioned getting prescribed a rather hefty dose for his anxiety. I convinced him otherwise with science backed evidence and accounts like what OP linked, given his personality type I'm certain it would have ended him.
"The psych had told me nothing of the nightmare that dependence on those meds can create"
I hear this all the time and never get it. Didn't these people go to school? People talk about this every day on the internet. It's right there on Wikipedia, even.
They're dealing with neurotic (not being judgment, these are a powerful class of drugs) people. Like lines of code, (saying) less is more. "oh by the way, some people get how's
hooked on them and it really sucks to get off them". then the patient doesn't take them and get the relief from the problem they saw the psychiatrist for. Any responsible psychiatrist is well aware of the problem and going to get their patient past their current crisis first, and then not give them a script for 18 months for the patient to build an addiction. Unfortunately, not all psychiatrists will do that.
Yeah, that’s a classic dilemma doctors have to face. Even my gastroenterologist stopped giving me details as soon as she convinced herself my issues were due to anxiety (they were not, but that’s another story).
i mean, it says it right on the sheet you get with the medication
"MISUSE OF CLONAZEPAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Never share clonazepam with another person. Selling or giving away this medicine is against the law.
Some people have thoughts about suicide while taking clonazepam. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.
Get medical help right away if you stop using clonazepam and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide.
Do not stop using clonazepam without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Some withdrawal symptoms may last up to 12 months or longer."
I helped my mother go through this after her psych decided it was time for her to cold turkey a 4x a day xanax prescription she'd been taking for 20+ years. 5 total ER trips, 3 separate hospitalizations, and a full year of absolute misery before she started getting some relief. A YEAR.
I have watched family members die of AIDS, cancer, and Alzheimers. I have myself recovered from alcoholism (5 years next month!). Nothing in all my life has ever held a candle to how hellish Benzo withdrawal is. These drugs need to be banned. Period.
I've lived with that as well, but I've also spent months carved up (surgically) and there is no replacement for the role that they play medically.
I can't agree with a complete ban. It's better to get awareness out there about the harm they can do, and put better controls on access to them but not a ban.
I live with anxiety -there's no other drugs that work for it. Luckily I'm able to use DBT and straight up avoidence to cope with anxiety. But if I didn't have that last option then I'd be hosed -because there really is not anything that works effciently for treating anxiety; at least not in my personal experience (which goes back decades).
People who have been taking benzos for decades with no dose escalation should be left alone. Most people develop tolerance quickly to the sedative and hypnotic and anti-convulsive effects. But not everybody develops tolerance to its anxiolytic effect, despite what the recent zeitgeist and sob/horror stories would like us to believe.
Obviously it's been overprescribed. Old school doctors likely still do prescribe it too easily. And new docs often plainly refuse to prescribe it at all. The solution doesn't have to be black or white. Doctors have the ability to limit the number of pills per month a patient can get, imagine that! It doesn't have to be nothing at all vs as-needed-which-means-the-full-30-pills-every-month-inviting-the-patient-to-start-taking-it-daily. It can be "give 5-10-15 pills per month".
That way the doctor can monitor the patient needs more closely and effectively prevent both addiction and tolerance from developing.
This sort of panic about people who have been on a controlled dose for long periods of time or just straight up panic discontinuations of doses is the same crap that exacerbates opioid problems too. Too many stories from family members about their loved ones who were prescribed high doses of ${addictive drug} and then suddenly some other doctor (or sometimes the same doctor) suddenly decides this was all a mistake and cuts them off completely. Soon those family members who maybe did need to come down from where they were are seeking illicit sources of their drug. And it's near impossible to get out from under a doctor if you do think they're overprescribing because of just this.
My own family had a similar problem. The family member was way over-prescribed a drug by a doctor who clearly wasn't helping treat the underlying issues and frankly barely remembered the patient from month to month (for a person they were seeing every month). It still took us nearly a year to find a doctor we could switch to because everyone we called was so freaked out by the dosing the prior doctor had prescribed that half of them wouldn't even touch the case at all, and the others wanted to just stop everything cold and start all over again. The problem with that being that the underlying reason they were getting prescribed these medications was still an issue. Asking someone who does need the medication in question (or similar treatment) to not only suffer without it for a few months but also just stop their escalated doses cold turkey is just needlessly cruel and harmful. We were lucky to finally get a doctor who accepted helping us get things under control, with a pre-made plan of action and a "sole-prescriber" contract, both of which was fine, we just needed someone whose plan didn't start with "and now you stop everything you're taking to treat your condition and we wait until you're detoxed before we try anything else".
I take Xanax when I fly. I have a prescription for a whopping 10 pills, and it usually lasts me three months. It does exactly what it's supposed to. "Banned, Period" is assuming your experience justifies taking everyone else's away, and those of us using them responsibly benefit quite a bit. 4x a day is also over recommended dosages, depending on strength - so that's more on the doctor than the drug.
I don't think so. It should be drilled into doctors' heads to prescribe them very cautiously and always warn about the addiction potential. But they have their legitimate uses and in some cases are irreplaceable.
I need the occasional benzo (midazolam) as a rescue medicine for my seizures a few times a year. Banning these things just makes it harder for people who actually need these life saving medicines. Most epilepsy drugs, including non-benzo, are strictly scheduled and it makes my life hell. It is very hard to get these medicines sometimes because of these rules (fuck the DEA, and your opinion), seizures can be lethal, especially compounded with withdrawal.
I'm gonna ask a stupid question, forgive me. Have you ever tried using THC/CBD as a way to manage symptoms before? I'm always curious to get more people's experience on this since literature is so sparse.
Yes, CBD. Didn’t help me unfortunately, but some seem to have success with it. There is a CBD-based drug called Epidiolex which helps with some severe genetic seizure disorders.
I’ve seen a few friends and coworkers go down this path, usually as a result of work stress or hustle culture. They start on neutropics and energy drinks, then get scripts for Adderall or Vyvanse to handle the perceived insurmountable workload, stabilize on those after an initial euphoria, then build up a heroic tolerance to (dextro|meth)amphetamines. Withdrawals from that high level of addiction leads to anxiety, insomnia, delusions, mania and all sorts of craziness (I suspect the lack of sleep is the culprit).
Eventually this sends the patient to a doctor/dealer to escape their misery of detox/relapse cycles. The gates to hell are finally opened once a benzo is prescribed.
One entrepreneur ended punching a bouncer and attempting to flee on a bus to some random city, spending more than a week in jail. Another fled the U.S. after making a lot of crazy purchases and life choices, he is now living in a war zone voluntarily. The amount of DGAF/YOLO these drugs give the user are very understated. The withdrawals were much worse. I’ve never seen someone down almost a whole handle of bourbon just to get “normal“. The brain zaps and the tics/twitches were very noticeable.
Stevie Nicks has also spoken publicly about her struggles with Klonopin withdrawal. BEWARE!!!
Is it possible you have the cause and effect backwards? These people could have highly addictive personalities and were just switching from one drug to another and it’s not the actual drug that’s the issue.
Take the adderall and benzodiazepines out of the equation and they might just as well be using cocaine and barbiturates.
Barbiturate withdrawal can absolutely kill you, as it is the same process of benzodiazepines and alcohol withdrawals. The other issue is that barbiturates themselves can easily kill you due their MOA, and low therapeutic index
There's approximately three possibilities that could lead to you believing that. Either you haven't formed close relationships with such people (unlikely), you lack the awareness to realize who they are, or you are one yourself and lack the self awareness to recognize the patterns.
Obviously some people get addiction problems, and obviously some people are more vulnerable to develop them than others, but I can understand the reluctance to ascribe that to their personality.
Why can't it be the situation? Even to call it the internal situation if you find no obvious external reasons, is probably healthier than to ascribe to the essence of who you are.
That was what struck me about the article. No doubt withdrawal is real but baseline for the author seems to be symptomatic anxiety. The focus on withdrawal as the single overwhelming cause is typical of the people I know with anxiety. They seem to be always searching for the one magic trick that will make them better. Which of course never does.
Modafinil is basically nothing compared to other drugs. Like you will go a longer time before feeling sleepy but it's not even on the level of caffeine for stimulation. It doesn't give you much of any wired feeling, you just are less tired when you normally would be.
For many people, modafinil stops being effective as a performance enhancer pretty quickly (days to weeks of daily usage), and withdrawal is basically a few days of excessive sleepiness, so most people don't have an issue with it. Narcoleptics take it for years, mostly without issue, so it has a decent safety profile.
I cycled modafinil/adrafinil and caffeine. For me it was a much stronger focus effect than caffeine and a much weaker effect than amphetamine. However, I developed an intense case of the hives after use which occasionally (1/2y) recurs without use with no prior history. This is not an uncommon side effect according to the doctor who I reported this to.
In my case I experienced no physical dependency on any of the drugs and chose to stop because I wanted to perform other experiments. I’d say it’s about half a decade now since.
I do know others who get weakened impulse control but I just get hyper focus of various degrees.
Pretty wild how common it really is. In places you wouldn't expect. I started working night shift in a warehouse when I was in my 20s, and got to know a couple of the funny yet seemingly regular guys. I asked them for advice on how to adjust to the graveyard shift. They said you gotta stay up on weekends, keep the same nightshift schedule, no exceptions. "Come out with us for a few beer sometime."
So there we are in a regular pub, about 11pm. One guy starts dialing on his phone and says, "I'm gonna pick up. You want in?" I kind of smirked and said, "uhhh I don't smoke weed dude. Thanks." And he looked at me like I was an innocent deer and said, "umm, we're going skiing dude. this is how we stay up."
Oh boy. I was never addicted to it thank god, but what a wild couple of years that was.
I have made it abundantly clear to partners & employees health comes first, made sure they have access to a health plan, and made sure they can actually get appointments with providers. In fact that stance is probably the only reason we’re still in business and they’ve been loyal through some rough patches.
Right before my cofounder and I wrote down our values, when we were done, I said, okay, now we’re both going to schedule the labs and checkups I know we’ve both been procrastinating.
Let’s just say that was the difference between stage 1 and stage 4… by a few months. It has been probably our defining corporate value ever since. And yeah I don’t ever expect an outside investor to like that.
I have a feeling this means something else than in Scandinavia. I am so innocent. I would take it literally "Where?" if someone said that to me. And probably ask if I could join.
Oh so that’s how people turn into drug addicts? So simple solution is not to go for a “drug” fix, performance enhancer, but to just accept that you just “can’t” and figure out a way to not burn out. Seems insane to me that there is 2 roads - one to never be a drug addict, second one is to have an extremely high chance turning into a drug addict.
What am I missing?
Well most people don't actually turn into addicts, it's just the people that do, that's how they start. Lots more people use stimulants and benzos occasionally without crossing into an addiction threshold.
this thread discusses drugs of addiction that are prescribed en masse especially in north america. so a great imaginative starting point would be to imagine being told you must consume a hard drug to cure a condition that is inherently part of you. after a while you develop a tolerance to those drugs you have been taught are your savior. then you need more drugs to achieve the same feeling you were taught is 'normal'. could you begin to see how that might feel, and how the system could possibly be seen to push people to the brink due to systematic indifference in favor of systematic interests?
and time and time again, in the original article, we are shown that when people are reporting to their doctor for withdrawal effects, they get a higher dose prescribed to cover it.
There are tons of ways people turn into drug addicts. Some of us just get started early, build our (sometimes successful) life patterns around it, and here we are :) Others are trying to treat "damages" they've experienced, in any way they can. Others get it prescribed by doctors, end up stuck in those patterns, then need help to get out of those, my mother experience this "legal drug addiction" with painkillers just some years ago but luckily managed to get out of it. There is probably as many reasons people become addicts, as there are things people can become :)
You're missing that properly prescribed meds to the people who use them responsibility and don't have any unfortunate horror stores .... do not write their experiences in online social media sites or blogs.
You found the hard part. The "just accept that you just “can’t”" part. VERY few people can do this. I'd even go so far as to say not being able to say "I can't" is the cause for ALL drug addiction.
All substance abuse is painkilling, in a manner of speaking.
> The gates to hell are finally opened once a benzo is prescribed ... The amount of DGAF/YOLO these drugs give the user are very understated
... let's dial this back a little here. I've been a (prescribed) benzo user for ~15 years, across xanax, valium, and klonopin. I regularly go for weeks at a time without taking them or thinking about them. I have taken some very, very large doses before (as part of a now-resolved fear of flying).
Firstly, yes, obviously, they are addictive. This is compounded by the fact that people are generally prescribed them when they really need them, and they are highly short-term effective. If you have acute mental distress and someone gives you a drug that switches that off in the short term, you are going to really want more of it when that distress comes back. Many people seem to have at least some low-level mental distress, and so many people respond really well to benzos. They also cause physical dependence, so cessation if you've taken them chronically for as little as a few weeks is going to be somewhere between annoying and extremely rough, quite aside from the addiction.
Secondly, the "amount of DGAF/YOLO". Some users experience dose-dependent impaired judgement, probably similar to alcohol? If you've taken a serious dose, you'll know you've taken something psychoactive. This isn't something that needs to factor in to your risk profile for taking 5mg of valium. A very small number (1%?) experience severe impaired judgement. Test one first.
Overall, they are a drug to approach with a lot of caution, and with the help of a doctor who you think understands the risks, like opiates. But like opiates, they are a miracle solution to a very difficult problem. If your doctor thinks you need to carry some Xanax around in your wallet for panic attacks, don't assume all hell will break loose. If your doctor wants you to take klonopin for five days while you switch SSRI, that's probably OK. If you're terrified of flying, but need to make your once-a-decade flight, gladly accept a dose of valium. On the other hand, if your doctor is prescribing a four-week once-a-day schedule, urgently seek out a second opinion unless they sit you down and are very clear on the risks with you first, and even then do some of your own research.
But be aware that they are highly effective at removing your acute mental distress, and if that's an issue for you anyway, you might be about to feel better than you've felt in years, and you need to be sure you're not going to reach for them when you don't actually need them, and kick off an addiction that will be very, very hard to shake.
Bottom line: miracle drug, but be as skeptical of them as doctor-prescribed opiates.
Thanks for the share. I really like these first hand accounts on HN.
Can you theorise on why you are not (less?) affected by the addictive elements of benzos? I'm not here to doubt, rather to ask: What are you doing differently? Are you someone with (insanely) high self-control... so you can back off if you feel the pressure of addiction?
Parent post uses the word "doctor" throughout. People with serious addiction problems are getting their drugs elsewhere, usually from people who make money by selling them more drugs.
I'm not regularly taking them more than once a week, which is more than enough time for it to get out of my system completely. Risky profile appears to be when it's in your bloodstream for several weeks.
I use them too on occasion and have for years. It really is only on occasion, my last prescription of 15 pills lasted over a year. I've had several times where I used them for 3-4 days.
I don't think self control has anything to do with it. Part of it is probably genetic -- I don't have a family history of addiction but a lot of people do.
The other part is I use them for a reason, I like having them available for that reason, and honestly I don't find them that fun to take outside of those reasons. I just feel kinda drunk.
Never had one even bring it up, although I've taken it before as a sleeping pill. I hadn't realized onset is as quick as Xanax, and the effect size looks good, but it's never done very much for me for anxiety.
One point: there is a major difference between addiction and dependence. Addiction is about chasing a high, raising the dose as one builds tolerance.
Dependence is about having problems when quitting after using for a bit. It is an issue with proper use of benzos, antidepressants, etc. A person who is dependent on, say, Xanax may be just taking it regularly in a low dose. But when they quit, unpleasant symptoms can arise - beyond just a return of whatever they were being treated for. So quitting these often requires a long tapering process - see my post on "hyperbolic taper" above.
That person is not addicted, is not an addict, but rather is the usual responsible user of the medication.
I run sometimes in a “party” crowd and see the same thing from the other side. People take drugs on the weekend, and a benzo to come down from it, and soon find themselves hooked just on the benzo.
Oh god, the jolts. They are horrible. They seem to get worse with screens and fluorescent office lights. The only thing that helps is going for a walk and necking some alcohol, which in turn, wrecks the sleep needed to actually fix them.
It's almost like having some sort of momentary seizure.
I agree. The problem here is that these people are tackling symptoms rather than causes and tackling symptoms alone while the cause exists over a long period of time will produce new issues that come with their own symptoms. Then users tackle these new symptoms and the cycle begins anew.
Back in my early 20s starting a company with friends we had boom and bust cycles, and our boom cycles were so extreme that we would work 100+ hours for 3-6 weeks at a time, towards the climax of that given cycle.
We didn't do drugs other than redbull and some of the other guys smoked tobacco. I am really glad there wasn't a hustle culture of taking amphetamines.
> The amount of DGAF/YOLO these drugs give the user are very understated.
Not at all. From amphetamines to benzos, pretty much every doctor tells you what the fuck can and likely will happen if but you are zoned out and either desperate or want to avoid that despair at all costs.
It's why parents let their kids have/start amphetamines pre- to mid puberty and why some give them shots to boost sexual development. They can't handle and have zero desire to build the skill or patience to parent the whiny little bitches they create. But the consequences are always the same.
The extremes you described are just the most cinematic ones.
The extremes you don't see are worse and much much more prevalent. The damage and bullshit these peeps cause outweigh any function they perform in society by crazy high factors. But they get to fake the fun without effort and doubt. And while doubt is imperative for a healthy, growing brain, it's extra painful when your meds' dosage is too low or you are currently off them. Ante up!
Been there, stopped taking them asap and fought for better alternatives that might come with their own price downstream. Side effects have to be mitigated actively, and not just with Magnesium and Electrolytes and eye drops ... ... ... it's a mental effort, a matter of character ... but sure, opt in for that work and that ugly behavior you now don't have a feeling/intuition/instinct for anymore ... it certainly makes for a good recurring story in a YOLO kind of world and if it's the only way you can handle it, why beware?
That is wild to me. I have been on the same low dose (30) of Vyvanse for damn near a decade now. I don’t take it on the weekends or vacation. I have zero desire to up my dose.
I have a lot of friends in medicine in various roles like ER nurse or doctor. The over-prescribing problem in this country is really a problem. They are all so frustrated with the quantity of people being prescribed extreme controlled substance regimens by doctors, somewhere, who seemingly write high dose prescriptions for controlled substances with little thought.
The stimulant over-prescribing problem can be self-limiting for many when they discover that the initial euphoria and feeling of being super productive disappear. It's wild how common the "my Adderall isn't working any more" complaints roll in from people who thought they were signing up for the pill from the Limitless movie instead of a concentration-enhancing pill that isn't fun or enjoyable in the long term.
But not everyone stabilizes on a boring dose or gives up on the medication when tolerance takes away the fun part. It's the people who start stacking crazy supplements or even illicit drugs on top to go deeper. Some of these people wouldn't normally see themselves as drug users or abusers, but something about prescription treatment opens a blind spot in certain personalities. I knew a few people who got all the way to rock bottom and into rehab programs while fully believing that they were "self-medicating" a medical condition, despite using drugs and doses that were not helpful for concentration in any way.
Those who go from unmedicated to being prescribed high doses of amphetamine and a benzo within a year or two are the craziest stories. Now they'll often have a ketamine prescription for depression as well. I don't know where these doctors are that prescribe these regimens so quickly to patients, but they go out and find them. I've heard so many stories of about patients trying to establish care with my friends and then showing up with crazy combinations of scheduled medications and a request for more prescriptions. Many of them haven't realized yet that controlled substances are tracked in a shared database that providers can read, and they can even see if you've been getting prescriptions in neighboring states too.
I know I'm more exposed to these stories than normal by proximity to people who see them a lot, but it's getting really sad. I'm also worried that we're headed for an opioid-style backlash where prescribing medications to people who really need them becomes difficult due to the rampant abuse.
There is such a thing as too much of a good thing. These pharmaceuticals were originally based off valerian root, which works too, and is cheaper, and easy to obtain. You can always try going back to the roots. I find it helps me sleep every now and then.
I'm not a big believer in valerian, based on my experience. It's certainly not a stand-in when it comes to treating panic attacks. For sleep, it could work but I generally tend to prefer melatonin.
A pill of Valerian is enough to make it hard for me to wake up after eight hours of sleep. I can’t imagine how powerful benzos are or what he’ll are the people taking them going through
This also just reminds me of the sensible things to ask your doctor when they try to prescribe a drug. Can I simply stop taking this drug? For two people I know in the last year this would have been a nice question to ask.
I was prescribed diazepam and it was an important part of my healing when I suffered a back injury. The doctor prescribed the 'holy trinity' for severe back pain: diclofenac for anti inflammatory, cocodamol for pain and diazepam to control muscle spasms and help me sleep. It worked like magic.
The doctor gave me the minimum amount of pills to get me through the initial chronic period, 7 days, and I was very grateful to be made comfortable.
I was lucky that my back healed quickly, even after a few days on the drugs I detected a feeling of dependency creeping up.
I had a strong reaction to Covid and that was the only time in my life I ever took what you might call mine drugs. I took Ativan for a while, but I read up on it and I was very careful not to take larger amounts. I was cutting the pills and halves or quarters and just using them for some mild relief, but I did have severe anxiety for a while. I think there could be a place for them but unfortunately, the way drug companies are they allow people to get too much and they profit from the addiction.
And by the way to get off of them, I read that the most successful people statistically with the ones who did a very gradually. So again I took the scissors and I was cutting small amounts off of pills so that I was sometimes taking some multiple of 1/8 of a pill And when I made adjustments I might go down by 1/8 or 1/4 per week.
My anxiety problem actually played a role in me being afraid to take too much anxiety medication ha ha and that probably saved me
I just saw a YouTube video about a Soviet era benzo that became somewhat popular in the West as a research chemical. It really sounds like a nightmare:
I've been on fairly low dose Klonopin for about fifteen years due to persistent insomnia (I work in a black room with no windows, and hence no circadian rhythm).
The good news is that the Klonopin let me sleep -- the first regular sleep I'd had in three years, when I first started using it.
However, I'm on a journey to get completely off of it. I managed to do that for several weeks, but when I then tried to ween myself off the other drug I'm on for insomnia, mirtazipine, it came back. So I started taking Klonopin again, temporarily. I'm now in the process of getting off of it for a second time.
Personally, I didn't find this that hard. The key, for me, was just to take it very slowly. Reduce 10%-25% at a time, and stay at that dose for 4-8 weeks. Repeat. Be patient with yourself. It took around six months the first time.
Almost a decade ago now, I was a happy, high-functioning alcoholic. Winery tours, Scotch tastings, workplace drinks, etc.
It was all "fine" until I started struggling to get to sleep without a little "nudge"; then it was getting back to sleep in the wee hours; then it was every hour or two, 24x7.
Then I decided to go cold turkey while on vacation in Hawaii with my family, because who wants to be the drunk asshole in search of a cocktail while everyone else is having a good, sober time at the beach?
Boom: detox seizures, ER visit, and the ever-so-helpful prescription of Ativan so I wouldn't seize again. I was discharged with the instructions to "take as needed, up to every four hours." Since I was an addict in pain, I took that to mean, "take them every four hours, or maybe more often."
Cut forward 3-4 days, and the scrip ran out. Boom: more DTs, this time from the benzos.
It wasn't long after that when I went through my first inpatient psych visit b/c I was in no way equipped to handle withdrawals from two highly-addictive drugs at the same time.
Sadly it took another couple of years and another trip through the ER + inpatient care before I realized that doctors would and did prescribe me meds that were actively harmful in the interest of short-term comfort.
It's been six years since the last big episode and I'm genuinely grateful I only threatened myself with my shitty brain chemistry (however aggravated by poor medical intervention) rather than putting other people at risk. It could have been much worse if, say, I routinely drove people around or did any kind of safety-critical work.
Regardless: benzos are not "lightweight" drugs, and giving them to people with any kind of history of substance abuse disorders is a Bad Idea.
I appreciate the bravery of you and others in this thread, sharing details of really horrible - and at the time likely very shameful experiences.
I'm glad to hear you (all) made it to the other side, and hope your stories give others who are struggling with addiction courage to seek help and free themselves.
Honestly, having gone through recovery and grappling with all the shit I didn’t want to acknowledge has been a gift.
Learning to not hate myself for bad decisions I made in the past creates a lot of space to be compassionate and (hopefully) skillful in helping other people who are struggling. (Not to mention myself, when I fuck up…which is often.)
It can always be worse, and I’ve lived through enough “bad” to be grateful for how much easier mundane shit like taxes, politics, and argumentative kids are by comparison. :)
How are you feeling now, and how well does your brain recover from these things? I always wonder whether these kind of things have some lasting effect on, say, your ability to focus.
Happy to say I'm in a much better place now. Recovery was/is hard, but therapy, meditation, sleep, and exercise -- plus boring old antidepressants -- keep me on much more stable ground. Also family: I have kids now, and being there for them and my wife is a bigger source of motivation than taking care of myself a good portion of the time.
With regards to focus: I've struggled with that for my entire life, starting long before I ever took a drink or anything harder. Perhaps unsurprisingly, bipolar (which I 100% am) and ADHD (~95% sure; just not medicating for it b/c, y'know, "fun" drugs are a problem) are very common dual-diagnoses with substance disorders.
So it's not so much that the substance abuse made me less able to focus; it's more that I've _always_ struggled with slowing down and staying put. Alcohol and other downers were always a form of self-medication.
> before I realized that doctors would and did prescribe me meds that were actively harmful in the interest of short-term comfort
The number of times I've read about celebrities and random people in deep addiction (or eventual death), whose starting point was just pain relief from a run of the mill injury. Makes me wonder what idiocy has overtaken these doctors. "Here, take these so you don't have to suffer a sore back for the two next weeks. And btw, you may become deeply addicted and it might cost you your life. Good luck!"
In the states part of doctor compensation is based on patient satisfaction surveys and rates of complaints. People are very quick to complain about not getting what they want out of an appointment (which is often pain or anxiety relief) and much slower to complain about the long term consequences of these prescriptions, which happen often, but not to most people who are initially prescribed these drugs.
I've been on klonopin for sleep and prescribed xanax or ativan for acute anxiety at a couple points over the years, and never had any trouble getting off them. I usually stayed at the lowest dose and often skipped doses, and I'm searching my brain for any memories of withdrawal symptoms, and I don't remember ever having any.
I would bet that more patients have my experience with these drugs than have the long term addiction and severe withdrawal, and doctors have often passed people on before the consequences start stacking up.
I still think they should be prescribed extremely sparingly, because even in my experience with them, they didn't really do too much that some running and yoga didn't do, and they come with much bigger risks.
Benzodiazepines are really gnarly stuff. Like alcohol, withdrawal from a benzodiazepine can be fatal. IIRC, some post-acute withdrawal symptoms can last indefinitely for some people. Benzos have their utility but they can be really, really awful stuff to become dependent upon.
I've had anxiety issues my entire life, and I feel exceedingly grateful that I haven't fallen into the benzo trap. I've had prescriptions for them, but I always found them too impairing for anything other than very sporadic use (like on airplanes, back when I had anxiety around flying).
I actually find beta blockers, taken as-needed, to be infinitely more beneficial when it comes to managing anxiety. There's some really interesting research on propranolol specifically and how it disrupts memory reconsolidation - which (deceptively) sounds like a bad thing, but it actually has beneficial implications on fear extinction and trauma responses.
Just to drop a couple links. There's a good amount of research out there.
I successfully eliminated my fear of flying with beta blockers (this was after xanax made it much worse, which turns out is a documented phenomenon https://pubmed.ncbi.nlm.nih.gov/9299803/). I like that, at least for more specific fears/anxieties, propranolol's fear-extinction mechanism means that you often need the drug less and less the more often you take it for that purpose. I haven't flown medicated in many years; my "amygdala is rewired" in that area and it seems it's more or less permanent.
I take beta blockers maybe a few times per year, on average, but I always keep my prescription up to date.
I'm something of a beta blocker evangelist (if it wasn't obvious), but I think they're deeply underappreciated when it comes to treating anxiety. I think a lot of people get spooked when they see that it's "heart medication", but it's really well-tolerated medicine for most people.
Funny, I tried beta blockers before xanax for flying. They didn't seem to do anything, and the xanax I take a dozen times a year works wonders. Everyone's different.
I was on klonopin for years but apparently not at those levels. It was by far the most effective anti anxiety med I had found. I feel like I dodged a bullet: my prescribing psychiatrist (requires) never mentioned the symptoms described by OP. Ironically after being off it for over 10 years my life has taken a turn that has made me want to go back on it. But I will absolutely be sharing this story with my Rx. Yikes.
I've been on a very long journey with mental health for many years now. It's astonishing the number of doctors who see any hint of mental health issues and then immediately claim you must be catastrophizing your symptoms. I've had a number of issues related to my ears/nose/throat, the worst being an inability to deal with pressure changes (without excruciating ER-inducing pain). The first ENT I went to walked in, scanned my file, made a small comment about my mental health issues, and then proceeded to explain there was nothing wrong with me and it was all in my head.
It's like the jackpot for patient mill doctors. Aha, there we are, we can just blame it on that, collect their insurance, and send them on the way.
I'm not sure if it's just the US and Canada, but doctors here (in my experience) are absolutely atrocious and not properly trained when it comes to getting off benzos (but in fairness my experience was from the mid/late 00s).
Many years ago my partner at the time was prescribed Klonopin, primarily as a sleep aid. When he decided to go off it, he talked to his psychiatrist and was given basically no helpful guidance on how to go off. In retrospect I consider that malpractice. It was absolute hell and it took him well over 18 months to finally kick it (and it's not like he had a large prescription in the first place).
One reason I was so pissed is that as he was going off it I did some research and discovered that the NHS in the UK had an entire extensive protocol for people getting off Klonopin that required months of tapering and replacing Klonopin with a less powerful benzo (I think it was diazepam, or Valium) so you could taper at a more gradual pace.
It's insane to me that it's not required for doctors to explain the withdrawal procedures before writing a prescription for any drug that is physically addictive.
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[ 0.18 ms ] story [ 80.2 ms ] threadThere is no way to explain the hell on earth that is benzo/GABA-ergic drug withdrawal, and I would not wish it on my worst enemy. It is an order of magnitude more intense than opiate withdrawals, and the timeline is weeks/months rather than days.
Like the author, I managed to quit via a year-long Ashton protocol taper.
The irony is that benzos were the one class of drugs I wasn't abusing for recreation. I was using mega-doses of Etizolam to cope with PTSD flashbacks, and only discovered I had become physically addicted after flushing it all and winding up in the ER.
Weeks to months is actually pretty fast for benzo withdrawl IME.
For me it took nearly an entire year to feel completely normal. I was only taking 10mg diazepam per day (not a big dose).
To anyone on the journey now... hang in there. It feels never ending. But I promise you... you will wake up one day and feel completely normal.
Diazepam half life is so long that dependence can develop even when not taking it every day.
Edit: and I totally believe there are people who can take the same amount as me and not become dependent as easily as I did. Everyone is different
This is a desirable trait when tapering a dose. It reduces hour-to-hour blood level variation which reduces the whole up-down of alternating between euphoria and rebound anxiety. Idea is to target a constant level which is tolerable and slowly lower it.
The article implies this (a Valium taper is mentioned) but I don't think it outright states it so I'll say that for anyone who is addicted to a fast-acting one like Xanax or Klonopin - a switch to Valium might help.
My taper was nearly one year. Ten years off now.
My best friend was not so lucky and was on ativan and had the worst experience getting off of it, and had years of problems with it because it aggravated the anxiety she was already experiencing.
Benzodiazipenes (sp?) has it's medicinal uses, particularly with injury or surgery; but yeah -if you're not very careful and very lucky it's hell to get off of if you end up dependant on it.
I'm very glad to see the word is getting out and is more wide-spread. I hope that it doesn't result in a complete freakout the way that oxycotin did. It's vital when it's needed, hopefully it will remain available.
What gets me, as someone with chronic anxiety, is that they've only come up with one thing that reliably works -and it's this. It feels like the research stopped in the nineties or so. I often wonder wtf about that.
I have had clinically significant anxiety since I was a young child, and in the end, treating other mental illnesses effectively (I developed bipolar 1 in my late teens) and exercising very regularly seems to pull my baseline level of neuroticism down to within the normal range. If I get good cardio in, usually an outdoor run, 3 days a week, I feel normal.
I had no issues getting off of it; not to say that other people don't either -they very well might.
One of the most well studied genetic risk factors for addiction vulnerability is the DRD2 gene which encoded the dopamine receptor D_2. People who are particularly vulnerable to addiction commonly have a deficiency here, meaning getting bored very easily and feeling under stimulated/rewarded by typical things is in part what makes riskier sources of pleasure (i.e. drugs) so appealing.
Disclaimer: Not a medical professional, just like reading about addiction and genetics.
A couple of the people I knew who ultimately ended up in rehab would describe themselves as not having addictive personalities. One even bragged about how boring drugs had become to himself.
This is the hubris that opened the window to their addiction. They thought it was a thing that happened to other people, so it was safe to dabble. Then dabbling became a little more frequent, then they decided the drugs were actually helping them and therefore it was logical to do more, then they took little breaks to prove that they could stop but came right back to the drugs as soon as their life got a little hard again.
After two or three months I discontinued it. He suggested to just stop, but I thought better of that, tapering through 0.25mg and 0.125mg. What followed was weeks of unrelenting insomnia and headache.
I wouldn't recommend.
I always feel awful when I hear people making fun of him for this. It seems like it's one of the most horrible and difficult things out there.
Good job 'choosing life,' as they say.
There’s definitely a lot of factors
I agree, it depends on what else is going on -and why you're taking things. No way in hell I could have gone that month without them, that's for sure.
I've also seen friends or family members who used and stop these drugs without much difficulty.
This isn't medical advice obviously, but I wouldn't rely on anecdotal experience to form an opinion on this. These drugs can certainly be helpful to some people.
That said: do not abuse benzos. They will fuck you up.
I was prescribed temazepam for insomnia. It was the only sleep medication that worked, and it was the best sleep I've had in my life. It stopped being effective after around 30 days (or maybe 60, I forget). That was the end of that. I could have argued for a higher dose or a refill or whatever, but... you don't fuck with benzos.
>That said: do not abuse benzos. They will fuck you up.
This is pretty much my perspective, except I'd say that it doesn't even necessarily require abuse per se. I'd say just be very careful when using them, and get off of them ASAP. Myself, I only take them if there's a procedure of some sort they're called for.
I'd say awareness is more called for than a total ban. A total ban would be messed up because there is zero replacement for them for what they do -none.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6494026/
I think other disorders in gaba/glutamate functioning (or in an adjacent disorder that affects these systems) could be similar.
My guess is that low doses of benzos used to treat neurological disorders have a lower risk because GABA/Glutamate/related systems in that population are pathologically dysfunctional and benefit more directly from these medications.
I took one a day for 4 days, as the panic would flare up right before I tried to sleep. I figured, I could be taking 6 a day, so 1 a day shouldn't hurt. And it was only 4 days in a row. No problem.
Day 5. Bang. Dt's. Immediate anxiety attack. Suicidal thoughts. Brain zaps. High blood pressure. Vertigo.
They are no joke, but doctors throw them around like they used to with opiates.
But many people have trouble and I am still at risk.
Benzos are miracle drugs for many including myself, but have to be taken carefully, and discontinued slowly (hyperbolic taper) if withdrawal symptoms are too bad.
It takes at least a few weeks to a few months of daily use to develop dependence.
During a crisis I took it for a month. Then stopped. Stupid as it may be, I only fairly recently learned that this drug can cause hell but for the life of me I couldn’t understand how. All it did for me is help me sleep. I didn’t understand how it can be abused or what’s the recreational part of it. When my doc told me about the dependence, and how it may creep stopped even my occasional use and the bottle I got last Jan still sits in my meds canbinet.
Could it be that different people have different reactions or may be more susceptible to addiction to it?
For example, if I take some sort of sleep aid (e.g. US OTC antihistamines, Ambien, or low-dose benzos) then after ~2 nights my subsequent ability to fall asleep without help is noticeably impaired. That’s already the start of a physiological change that, if not reversed, would continue to a dependency (albeit not necessarily an ‘addiction’.)
It’s a process of analogue change, not binary, and individuals’ pace of change will vary.
Many people receive opioid treatment and do not become addicted. In fact most do. Most people can drink alcohol without becoming an alcoholic. This isn’t a proof that “anecdotal experience” that opioid addiction and alcoholism aren’t serious problems. In fact it is a demonstration that they are insidious for that exact reason - it’s fairly easy to slip through the cracks in the system into a serious problem that is life altering and extraordinarily difficult to emerge from.
Finally, the hardest withdrawals I’ve seen are benzo withdrawals. Relapse is also extremely high because the profound anxiety that led to the addiction is amplified in the years of subsequent withdrawal with very little as effective as a benzo to mitigate it. Paralyzing irrational fear is in many ways worse than pain, and pain is often a symptom to boot.
I feel that perhaps saying “well not everyone, take my anecdotal experience” isn’t the most empathetic response, and the statistics bear this out. The prevalence of benzodiazepine dependency is roughly on par with alcoholism in the US and several times that of opioids. The distinction is that crisis level addiction is roughly the same as opioid, while alcohol is roughly 7x worse. This likely because acute alcoholic behavior is rapid and very readily observable, while opioid and benzo dependency can be masked behind an otherwise normalish appearing life. The decline is fairly slow often unless you trip over into fentanyl. Further the prevalence of common use of both opioids and alcohol is much higher because surgery and recreational alcohol use is fairly prevalent while anxiety disorders less so.
Stevie Nicks is a popular icon who has been very public about how hard her withdrawal from Klonopin was, including how her skin sloughed off among other horrible effects. She lost a large part of her life span to it. But otherwise it’s also a relatively under reported dependency given its prevalence.
https://time.com/3482462/rolling-stone-stevie-nicks-drugs-mu...
I’d also note in many countries benzodiazepines are highly controlled with much higher bars than US, including the UK, where they’re only allowed in crisis, not general anxiety disorders less.
I certainly wouldn't want them removed -particularly after spending 4 months going through different surgical procedures where benzos were medically indicated. But awareness of the down-side is thin on the ground (from my perspective) and it's good to get out there.
Here’s a video of a doctor talking about the dangers of BIND (Benzodiazepine-Induced Neurological Dysfunction) along with some clips of Peterson and his daughter talking about his experience. [1]
Definitely something that it’s good to raise public awareness about, because a lot of people being prescribed these drugs don’t fully understand the risks.
[1] https://youtu.be/_q44phEpFjA
For instance Peterson says "you should be a Christian" but refuses to say if he's a Christian. I think we all should agree on the categorical imperative so if somebody is advocating that something is good for you but not good for them it suspicious. Like I have Christian friends who will tell me they personally have benefited a lot from their faith and I will tell you the same thing about Paganism.
Benzodiazepines can mess you up about as bad as Peterson says they have messed him up but his description of his symptoms (Tardive dyskinesia) is somewhere between incredible and fantastic, as is everything else he says these days. I think the saddest thing is that BZs impair learning and memory so that you don't learn to cope with life better with time the way most of us do. A friend of mine who has been taking them for 20 years still talks about the same subjects in the same way that he did back then whereas people who grow pick up new interests. SSRIs are a preferred choice for anxiety disorders because they seem to help people in the short-term with less suppression of long-term development.
I do think there's a need for a message similar to Peterson, that is, somebody who advocates for tradition and encourages young men who've been turned off from learning by a gynocentric educational system to seek knowledge -- but Peterson doesn't deliver what he promises. Neema Parvini does:
https://www.youtube.com/@AcademicAgent
More recently another friend mentioned getting prescribed a rather hefty dose for his anxiety. I convinced him otherwise with science backed evidence and accounts like what OP linked, given his personality type I'm certain it would have ended him.
I hear this all the time and never get it. Didn't these people go to school? People talk about this every day on the internet. It's right there on Wikipedia, even.
"MISUSE OF CLONAZEPAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Never share clonazepam with another person. Selling or giving away this medicine is against the law.
Some people have thoughts about suicide while taking clonazepam. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.
Get medical help right away if you stop using clonazepam and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide.
Do not stop using clonazepam without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Some withdrawal symptoms may last up to 12 months or longer."
https://www.drugs.com/clonazepam.html
I have watched family members die of AIDS, cancer, and Alzheimers. I have myself recovered from alcoholism (5 years next month!). Nothing in all my life has ever held a candle to how hellish Benzo withdrawal is. These drugs need to be banned. Period.
I've lived with that as well, but I've also spent months carved up (surgically) and there is no replacement for the role that they play medically.
I can't agree with a complete ban. It's better to get awareness out there about the harm they can do, and put better controls on access to them but not a ban.
I live with anxiety -there's no other drugs that work for it. Luckily I'm able to use DBT and straight up avoidence to cope with anxiety. But if I didn't have that last option then I'd be hosed -because there really is not anything that works effciently for treating anxiety; at least not in my personal experience (which goes back decades).
Obviously it's been overprescribed. Old school doctors likely still do prescribe it too easily. And new docs often plainly refuse to prescribe it at all. The solution doesn't have to be black or white. Doctors have the ability to limit the number of pills per month a patient can get, imagine that! It doesn't have to be nothing at all vs as-needed-which-means-the-full-30-pills-every-month-inviting-the-patient-to-start-taking-it-daily. It can be "give 5-10-15 pills per month".
That way the doctor can monitor the patient needs more closely and effectively prevent both addiction and tolerance from developing.
My own family had a similar problem. The family member was way over-prescribed a drug by a doctor who clearly wasn't helping treat the underlying issues and frankly barely remembered the patient from month to month (for a person they were seeing every month). It still took us nearly a year to find a doctor we could switch to because everyone we called was so freaked out by the dosing the prior doctor had prescribed that half of them wouldn't even touch the case at all, and the others wanted to just stop everything cold and start all over again. The problem with that being that the underlying reason they were getting prescribed these medications was still an issue. Asking someone who does need the medication in question (or similar treatment) to not only suffer without it for a few months but also just stop their escalated doses cold turkey is just needlessly cruel and harmful. We were lucky to finally get a doctor who accepted helping us get things under control, with a pre-made plan of action and a "sole-prescriber" contract, both of which was fine, we just needed someone whose plan didn't start with "and now you stop everything you're taking to treat your condition and we wait until you're detoxed before we try anything else".
I don't think so. It should be drilled into doctors' heads to prescribe them very cautiously and always warn about the addiction potential. But they have their legitimate uses and in some cases are irreplaceable.
These drugs stave off suicide (and worse) for many families.
This is the only viable pharmaceutical treatment for some people who face extraordinary mental health challenges.
Denying this option may mean denying them life.
How is it ethical for you (or a government) to make that decision?
Eventually this sends the patient to a doctor/dealer to escape their misery of detox/relapse cycles. The gates to hell are finally opened once a benzo is prescribed.
One entrepreneur ended punching a bouncer and attempting to flee on a bus to some random city, spending more than a week in jail. Another fled the U.S. after making a lot of crazy purchases and life choices, he is now living in a war zone voluntarily. The amount of DGAF/YOLO these drugs give the user are very understated. The withdrawals were much worse. I’ve never seen someone down almost a whole handle of bourbon just to get “normal“. The brain zaps and the tics/twitches were very noticeable.
Stevie Nicks has also spoken publicly about her struggles with Klonopin withdrawal. BEWARE!!!
Take the adderall and benzodiazepines out of the equation and they might just as well be using cocaine and barbiturates.
Benzodiazepines, and alcohol, can actually induce death if you withdraw too quickly
Why can't it be the situation? Even to call it the internal situation if you find no obvious external reasons, is probably healthier than to ascribe to the essence of who you are.
In my case I experienced no physical dependency on any of the drugs and chose to stop because I wanted to perform other experiments. I’d say it’s about half a decade now since.
I do know others who get weakened impulse control but I just get hyper focus of various degrees.
So there we are in a regular pub, about 11pm. One guy starts dialing on his phone and says, "I'm gonna pick up. You want in?" I kind of smirked and said, "uhhh I don't smoke weed dude. Thanks." And he looked at me like I was an innocent deer and said, "umm, we're going skiing dude. this is how we stay up."
Oh boy. I was never addicted to it thank god, but what a wild couple of years that was.
Right before my cofounder and I wrote down our values, when we were done, I said, okay, now we’re both going to schedule the labs and checkups I know we’ve both been procrastinating.
Let’s just say that was the difference between stage 1 and stage 4… by a few months. It has been probably our defining corporate value ever since. And yeah I don’t ever expect an outside investor to like that.
I have a feeling this means something else than in Scandinavia. I am so innocent. I would take it literally "Where?" if someone said that to me. And probably ask if I could join.
All substance abuse is painkilling, in a manner of speaking.
... let's dial this back a little here. I've been a (prescribed) benzo user for ~15 years, across xanax, valium, and klonopin. I regularly go for weeks at a time without taking them or thinking about them. I have taken some very, very large doses before (as part of a now-resolved fear of flying).
Firstly, yes, obviously, they are addictive. This is compounded by the fact that people are generally prescribed them when they really need them, and they are highly short-term effective. If you have acute mental distress and someone gives you a drug that switches that off in the short term, you are going to really want more of it when that distress comes back. Many people seem to have at least some low-level mental distress, and so many people respond really well to benzos. They also cause physical dependence, so cessation if you've taken them chronically for as little as a few weeks is going to be somewhere between annoying and extremely rough, quite aside from the addiction.
Secondly, the "amount of DGAF/YOLO". Some users experience dose-dependent impaired judgement, probably similar to alcohol? If you've taken a serious dose, you'll know you've taken something psychoactive. This isn't something that needs to factor in to your risk profile for taking 5mg of valium. A very small number (1%?) experience severe impaired judgement. Test one first.
Overall, they are a drug to approach with a lot of caution, and with the help of a doctor who you think understands the risks, like opiates. But like opiates, they are a miracle solution to a very difficult problem. If your doctor thinks you need to carry some Xanax around in your wallet for panic attacks, don't assume all hell will break loose. If your doctor wants you to take klonopin for five days while you switch SSRI, that's probably OK. If you're terrified of flying, but need to make your once-a-decade flight, gladly accept a dose of valium. On the other hand, if your doctor is prescribing a four-week once-a-day schedule, urgently seek out a second opinion unless they sit you down and are very clear on the risks with you first, and even then do some of your own research.
But be aware that they are highly effective at removing your acute mental distress, and if that's an issue for you anyway, you might be about to feel better than you've felt in years, and you need to be sure you're not going to reach for them when you don't actually need them, and kick off an addiction that will be very, very hard to shake.
Bottom line: miracle drug, but be as skeptical of them as doctor-prescribed opiates.
Can you theorise on why you are not (less?) affected by the addictive elements of benzos? I'm not here to doubt, rather to ask: What are you doing differently? Are you someone with (insanely) high self-control... so you can back off if you feel the pressure of addiction?
I don't think self control has anything to do with it. Part of it is probably genetic -- I don't have a family history of addiction but a lot of people do.
The other part is I use them for a reason, I like having them available for that reason, and honestly I don't find them that fun to take outside of those reasons. I just feel kinda drunk.
But they definitely create "dependence," which is very different and comes with proper user of them.
The meds can change one's life for the better and do so for millions. But they have to be used to treat a problem, not to get high.
Dependence is about having problems when quitting after using for a bit. It is an issue with proper use of benzos, antidepressants, etc. A person who is dependent on, say, Xanax may be just taking it regularly in a low dose. But when they quit, unpleasant symptoms can arise - beyond just a return of whatever they were being treated for. So quitting these often requires a long tapering process - see my post on "hyperbolic taper" above.
That person is not addicted, is not an addict, but rather is the usual responsible user of the medication.
It's almost like having some sort of momentary seizure.
We didn't do drugs other than redbull and some of the other guys smoked tobacco. I am really glad there wasn't a hustle culture of taking amphetamines.
Not at all. From amphetamines to benzos, pretty much every doctor tells you what the fuck can and likely will happen if but you are zoned out and either desperate or want to avoid that despair at all costs.
It's why parents let their kids have/start amphetamines pre- to mid puberty and why some give them shots to boost sexual development. They can't handle and have zero desire to build the skill or patience to parent the whiny little bitches they create. But the consequences are always the same.
The extremes you described are just the most cinematic ones.
The extremes you don't see are worse and much much more prevalent. The damage and bullshit these peeps cause outweigh any function they perform in society by crazy high factors. But they get to fake the fun without effort and doubt. And while doubt is imperative for a healthy, growing brain, it's extra painful when your meds' dosage is too low or you are currently off them. Ante up!
Been there, stopped taking them asap and fought for better alternatives that might come with their own price downstream. Side effects have to be mitigated actively, and not just with Magnesium and Electrolytes and eye drops ... ... ... it's a mental effort, a matter of character ... but sure, opt in for that work and that ugly behavior you now don't have a feeling/intuition/instinct for anymore ... it certainly makes for a good recurring story in a YOLO kind of world and if it's the only way you can handle it, why beware?
The stimulant over-prescribing problem can be self-limiting for many when they discover that the initial euphoria and feeling of being super productive disappear. It's wild how common the "my Adderall isn't working any more" complaints roll in from people who thought they were signing up for the pill from the Limitless movie instead of a concentration-enhancing pill that isn't fun or enjoyable in the long term.
But not everyone stabilizes on a boring dose or gives up on the medication when tolerance takes away the fun part. It's the people who start stacking crazy supplements or even illicit drugs on top to go deeper. Some of these people wouldn't normally see themselves as drug users or abusers, but something about prescription treatment opens a blind spot in certain personalities. I knew a few people who got all the way to rock bottom and into rehab programs while fully believing that they were "self-medicating" a medical condition, despite using drugs and doses that were not helpful for concentration in any way.
Those who go from unmedicated to being prescribed high doses of amphetamine and a benzo within a year or two are the craziest stories. Now they'll often have a ketamine prescription for depression as well. I don't know where these doctors are that prescribe these regimens so quickly to patients, but they go out and find them. I've heard so many stories of about patients trying to establish care with my friends and then showing up with crazy combinations of scheduled medications and a request for more prescriptions. Many of them haven't realized yet that controlled substances are tracked in a shared database that providers can read, and they can even see if you've been getting prescriptions in neighboring states too.
I know I'm more exposed to these stories than normal by proximity to people who see them a lot, but it's getting really sad. I'm also worried that we're headed for an opioid-style backlash where prescribing medications to people who really need them becomes difficult due to the rampant abuse.
The doctor gave me the minimum amount of pills to get me through the initial chronic period, 7 days, and I was very grateful to be made comfortable.
I was lucky that my back healed quickly, even after a few days on the drugs I detected a feeling of dependency creeping up.
And by the way to get off of them, I read that the most successful people statistically with the ones who did a very gradually. So again I took the scissors and I was cutting small amounts off of pills so that I was sometimes taking some multiple of 1/8 of a pill And when I made adjustments I might go down by 1/8 or 1/4 per week.
My anxiety problem actually played a role in me being afraid to take too much anxiety medication ha ha and that probably saved me
https://youtu.be/CAm_L6CTnD4?is=o1UjxkDQwFloZ8VM
The good news is that the Klonopin let me sleep -- the first regular sleep I'd had in three years, when I first started using it.
However, I'm on a journey to get completely off of it. I managed to do that for several weeks, but when I then tried to ween myself off the other drug I'm on for insomnia, mirtazipine, it came back. So I started taking Klonopin again, temporarily. I'm now in the process of getting off of it for a second time.
Personally, I didn't find this that hard. The key, for me, was just to take it very slowly. Reduce 10%-25% at a time, and stay at that dose for 4-8 weeks. Repeat. Be patient with yourself. It took around six months the first time.
Was told by the doctor it was a much safer alternative to most other treatments. Could be worth asking about.
Almost a decade ago now, I was a happy, high-functioning alcoholic. Winery tours, Scotch tastings, workplace drinks, etc.
It was all "fine" until I started struggling to get to sleep without a little "nudge"; then it was getting back to sleep in the wee hours; then it was every hour or two, 24x7.
Then I decided to go cold turkey while on vacation in Hawaii with my family, because who wants to be the drunk asshole in search of a cocktail while everyone else is having a good, sober time at the beach?
Boom: detox seizures, ER visit, and the ever-so-helpful prescription of Ativan so I wouldn't seize again. I was discharged with the instructions to "take as needed, up to every four hours." Since I was an addict in pain, I took that to mean, "take them every four hours, or maybe more often."
Cut forward 3-4 days, and the scrip ran out. Boom: more DTs, this time from the benzos.
It wasn't long after that when I went through my first inpatient psych visit b/c I was in no way equipped to handle withdrawals from two highly-addictive drugs at the same time.
Sadly it took another couple of years and another trip through the ER + inpatient care before I realized that doctors would and did prescribe me meds that were actively harmful in the interest of short-term comfort.
It's been six years since the last big episode and I'm genuinely grateful I only threatened myself with my shitty brain chemistry (however aggravated by poor medical intervention) rather than putting other people at risk. It could have been much worse if, say, I routinely drove people around or did any kind of safety-critical work.
Regardless: benzos are not "lightweight" drugs, and giving them to people with any kind of history of substance abuse disorders is a Bad Idea.
I'm glad to hear you (all) made it to the other side, and hope your stories give others who are struggling with addiction courage to seek help and free themselves.
Honestly, having gone through recovery and grappling with all the shit I didn’t want to acknowledge has been a gift.
Learning to not hate myself for bad decisions I made in the past creates a lot of space to be compassionate and (hopefully) skillful in helping other people who are struggling. (Not to mention myself, when I fuck up…which is often.)
It can always be worse, and I’ve lived through enough “bad” to be grateful for how much easier mundane shit like taxes, politics, and argumentative kids are by comparison. :)
With regards to focus: I've struggled with that for my entire life, starting long before I ever took a drink or anything harder. Perhaps unsurprisingly, bipolar (which I 100% am) and ADHD (~95% sure; just not medicating for it b/c, y'know, "fun" drugs are a problem) are very common dual-diagnoses with substance disorders.
So it's not so much that the substance abuse made me less able to focus; it's more that I've _always_ struggled with slowing down and staying put. Alcohol and other downers were always a form of self-medication.
The number of times I've read about celebrities and random people in deep addiction (or eventual death), whose starting point was just pain relief from a run of the mill injury. Makes me wonder what idiocy has overtaken these doctors. "Here, take these so you don't have to suffer a sore back for the two next weeks. And btw, you may become deeply addicted and it might cost you your life. Good luck!"
I've been on klonopin for sleep and prescribed xanax or ativan for acute anxiety at a couple points over the years, and never had any trouble getting off them. I usually stayed at the lowest dose and often skipped doses, and I'm searching my brain for any memories of withdrawal symptoms, and I don't remember ever having any.
I would bet that more patients have my experience with these drugs than have the long term addiction and severe withdrawal, and doctors have often passed people on before the consequences start stacking up.
I still think they should be prescribed extremely sparingly, because even in my experience with them, they didn't really do too much that some running and yoga didn't do, and they come with much bigger risks.
I've had anxiety issues my entire life, and I feel exceedingly grateful that I haven't fallen into the benzo trap. I've had prescriptions for them, but I always found them too impairing for anything other than very sporadic use (like on airplanes, back when I had anxiety around flying).
I actually find beta blockers, taken as-needed, to be infinitely more beneficial when it comes to managing anxiety. There's some really interesting research on propranolol specifically and how it disrupts memory reconsolidation - which (deceptively) sounds like a bad thing, but it actually has beneficial implications on fear extinction and trauma responses.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8201901/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8979654/
Just to drop a couple links. There's a good amount of research out there.
I successfully eliminated my fear of flying with beta blockers (this was after xanax made it much worse, which turns out is a documented phenomenon https://pubmed.ncbi.nlm.nih.gov/9299803/). I like that, at least for more specific fears/anxieties, propranolol's fear-extinction mechanism means that you often need the drug less and less the more often you take it for that purpose. I haven't flown medicated in many years; my "amygdala is rewired" in that area and it seems it's more or less permanent.
I take beta blockers maybe a few times per year, on average, but I always keep my prescription up to date.
I'm something of a beta blocker evangelist (if it wasn't obvious), but I think they're deeply underappreciated when it comes to treating anxiety. I think a lot of people get spooked when they see that it's "heart medication", but it's really well-tolerated medicine for most people.
It's like the jackpot for patient mill doctors. Aha, there we are, we can just blame it on that, collect their insurance, and send them on the way.
Many years ago my partner at the time was prescribed Klonopin, primarily as a sleep aid. When he decided to go off it, he talked to his psychiatrist and was given basically no helpful guidance on how to go off. In retrospect I consider that malpractice. It was absolute hell and it took him well over 18 months to finally kick it (and it's not like he had a large prescription in the first place).
One reason I was so pissed is that as he was going off it I did some research and discovered that the NHS in the UK had an entire extensive protocol for people getting off Klonopin that required months of tapering and replacing Klonopin with a less powerful benzo (I think it was diazepam, or Valium) so you could taper at a more gradual pace.
It's insane to me that it's not required for doctors to explain the withdrawal procedures before writing a prescription for any drug that is physically addictive.