Is It Bedtime for Benzodiazepines?

https://vanwinkles.com/bedtime-for-benzodiazepines-addicted-drug-most-popular-sleeping-pills

by LesZedCB • 11 years ago

59 65 11 years ago

tsotha7• 11 years ago

For a great many people (myself included) benzodiazepines are lifesavers. I would really hate to see these kinds of articles prompt yet another moral panic which has doctors reluctant to prescribe drugs to people who need them.

ocfx• 11 years ago

Lots of fear mongering (I'm assuming in this article). I suffer from bad panic attacks, but I also have a history of drug abuse so benzo's are basically not an option for me except in extreme cases. I tried buspirone instead and it works great for panic attacks. However, I've never once had a doctor who didn't lecture me for at least 20 minutes on the dangers of benzos whenever I brought it up for anxiety. I think these people are going to "special" doctors. We have a lot of them in seedier nearby areas where you can get anything you want prescribed to you within reason. Maybe these are the places they are referring to? It just seems weird that any doctor would be downplaying the side effects and dangers of benzos.

beat5• 11 years ago

There's the rub... people like to get high on this stuff. For whatever reason that I can't fathom, they like having their mind wrapped in gauze. :(

Responsible doctors will strongly warn about the addictive nature. Irresponsible doctors will simply write a prescription, knowing that either their patient is an addict or they're creating an addict.

Ambien is the latest version of this. Ambien is "perfectly safe", even if they warn about Xanax. Xanax used to be "perfectly safe" as an alternative to the obviously addictive Valium. Sigh.

DanBC5• 11 years ago

It would be great if doctors prescribed benzos more carefully.

Benzos probably shouldn't be used for sleep, and certainly shouldn't be the first thing that's tried.

This article doesn't seem to be saying "stop prescribing benzos", but just "stop being so careless when prescribing benzos".

This article mentions the Z drugs and suggests that they're less addictive, but it doesn't mention the rise in referals to Dublin drug and alcohol services for people struggling with zopiclone; or the fact that zopiclone is one of the meds most frequently obtained using stolen prescription pads in Paris. The z drugs probably have similar addiction potential as diazepam.

tsotha7• 11 years ago

My fear is the same thing that happened with opiods will happen with benzodiazepines. There was a moral panic and the government started cracking down. The government can't do anything with finesse, though, so for awhile people who were in terrible pain had a lot of trouble finding doctors who were willing to risk prescribing them the drugs they needed.

pc2g4d3• 11 years ago

I'm curious what has led you to feel that benzos saved your life. Care to expand on that?

tsotha7• 11 years ago

I'd rather not get that specific about my medical problems. Sorry.

thrownaway124• 11 years ago

They have been for me as well.

A few years ago when things got bad for me, my practical options were heroin, trust a doctor, or suicide. I might add buprenorphine/suboxone to the list now, but we'll see.

I chose heroin initially as a guaranteed short term solution, it did literally save my life at the time.

I was lucky to have the skills and resources to carefully purify and prepare it in isotonic sterile injection vials, ready for quick use. Moderate dosages worked perfectly, it instantly ended 4AM "episodes", I could function and think clearly again, and avoid missing work while I figured out what to do long term.

More importantly, I'm lucky to either have massive self control or lack the propensity for addiction. I tapered off on my own and saw a doctor, worked with them trying a variety of medications until finally given a choice of several benzos, which worked reasonably well overall.

I do recognize side effects with them, but without them I know I would be doing much much worse right now, at least I have a chance to keep going.

beat5• 11 years ago

Ugh, I hate those drugs.

I recently had to take two Valium in preparation for a nerve-wracking medical procedure (an injection into my eyeball). I was a senseless zombie the rest of the day, my sleep got all messed up, and I was hung over the next day. Next injection, I'm weaning myself to one, and hopefully zero for the injection after that.

When I was a kid back in the 1970s, I had migraines - had 'em as long as I can remember. Back then, there weren't migraine-specific meds, just painkillers. They didn't want to give me Demerol or other opiates, because those were dangerous and addictive! Instead, they gave me nice, safe phenobarbitol. I'd take one, stumble to the couch, pass out, and wake up 14 hours later uncertain what had happened. I hated it, hated my mind being so lost, but the migraines were worse sometimes.

But ultimately, the problem is that people like to get high on downers, and like to be addicted to them, and the industry will be happy to help.

MichaelGG4• 11 years ago

the problem is that people like to get high on downers, and like to be addicted to them

Why is this a problem?

beat5• 11 years ago

Addiction is a problem. That doesn't mean prohibition is a solution, if that's what you're getting at.

If you don't think it's a problem, you've never really spent time with someone who has a serious drug addiction. Someone who wants to quit, but can't.

Igglyboo• 11 years ago

the problem is that people like to get high on downers

That's not an actual problem, there's nothing wrong with enjoying getting high.

and like to be addicted to them

I highly doubt anyone enjoys being addicted to anything

beat5• 11 years ago

Lots of people enjoy addiction, to all sorts of things.

Heck, look around the healthiest parts of Silicon Valley, and you'll find people addicted to jogging.

3pt14159• 11 years ago

It is truly surprising at how easily Benzos are to get if you don't look like a drug abuser. Even something as mild as bruxism (clenching of the jaw) is enough for a doctor to prescribe it. Most people trust medicines to not be given unless the negative effects are outweighed by the help, but I believe that in Benzos' case, the vast majority of people are better off either taking a different drug or suffering through the pain without them.

CyberDildonics• 11 years ago

What is missing here is that the previous drugs used for anxiety and sleep have been significantly more dangerous. Quaaludes and barbiturates have very different overdose characteristics. Benzodiazepines open up certain receptors instead of binding to them, so overdose is more difficult without mixing them with other drugs such as alchohol.

DanBC5• 11 years ago

The article does mention deaths caused by accidental and deliberate barbiturate overdosing.

And saying that they're safer than that other thing, while important, isn't good enough. Sleep hygiene or sleep studies are even safer than benzos.

tsotha7• 11 years ago

That's the rub, though. People do mix them with alcohol. Isn't that what killed Whitney Houston?

fapjacks5• 11 years ago

I was prescribed benzos without any warning from my doctor (granted, this was the VA). I was on a fairly high dose and had completely forgotten my supply when I went to Sweden for the summer. Cold turkey.

Let me tell you something. I've come off a lot of things. I've been addicted to a lot of things. Nothing, and I mean nothing compares to coming cold turkey off a benzo addiction. You truly have no idea how awful it is. It was at least several times worse than anything else I'd ever experienced coming cold turkey off of. And I'm including opiates, cocaine, tobacco, and alcohol in my list of things. All of those things were a hayride compared to benzo withdrawals. I was sobbing and laughing hysterically at the same time that I had diarrhea and vomiting, it was sweaty and awful and my joints hurt beyond belief, and I couldn't sleep while this lasted for two days. It scared the shit out of my wife. It scared the shit out of me. Later on, another doctor told me that going cold turkey off the dose I was on is deadly, and kills people. If you are taking them recreationally, please please be careful to avoid cold turkey withdrawals.

I think some people will doubt me, but if you have never come off of benzos abruptly, even if you're taking them now, you really have no idea what it's like. It is worse than any negative physiological experience I've ever had. Benzos are poison.

tomphoolery• 11 years ago

Yes, in fact benzo addiction is effectively the same thing as alcohol addiction, since they're both primarily acting on your GABA receptors. The side effects, at least, are the same. Alcohol and benzo withdrawal can be fatal. Thankfully, you were probably not on high enough of a dose for that to occur, but yeah benzo withdrawal can definitely be fatal if the addiction was deep enough.

fapjacks5• 11 years ago

You know, I understand they both act on GABA receptors. I learned a lot in hindsight. But looking back on the experience, and having drank for about twenty years nearly every day, and then abruptly stopped... And here I don't mean sort of having a beer or two. I mean drinking until I pass out. Every day. Anyways, one day I got an ultimatum, and I stopped. And I had some symptoms of withdrawal. It wasn't pleasant. But the benzo withdrawal was so much worse. It was absolute hell.

omgitstom• 11 years ago

I can confirm the withdrawal symptoms, mine weren't as severe as yours sound, but I was probably on a lesser dose.

There are two things that doctors have prescribed me that I regret taking. Ambien and Chantix. Ambien for the withdrawal symptoms, and Chantix for the side effects...

I carefully review and research information about anything a doctor prescribe now other than an antibiotic.

fapjacks5• 11 years ago

Yeah what's weird is that normally I never would put something in my body if I didn't at least know something about it. But at the time I was going through so many different chemicals, I just didn't even think about it, trusting that they wouldn't intentionally poison me to death. Ironically, a good friend of mine was killed by the VA specifically in this manner (stupid doctors and fatal drug interaction). 100% lesson learned.

tsotha7• 11 years ago

I'm surprised the didn't warn you about going cold turkey. I've never been prescribed something from that class without being warned about the effects of sudden withdrawal.

larrys• 11 years ago

Sure they should have told him but that said the package insert does detail dependence and withdrawl and it's pretty obvious that it's a good idea to always review that (I do for any medicine that I take):

http://labeling.pfizer.com/ShowLabeling.aspx?id=547

rrss1122• 11 years ago

The doctor who prescribed it to you, without any warning, was very irresponsible and did you an extreme disservice. When I was prescribed benzos by my doctor, it came with no shortage of warnings, and she cut me off before I could get addicted. Even coming off the small dose I was taking was unpleasant.

Benzos have their place, but they need to be handled responsibly.

throw_away9999• 11 years ago

I have first hand experience with the hell that is benzodiazepine withdrawal. While in college, I was prescribed Ativan (Lorazepam) for Generalized Anxiety Disorder and Depression. It was a normal starting dose, but I took it compliantly for over a year without dose escalation.

One time I left my pills on a work trip. That consecutive weekend of inadvertently quitting cold turkey was a living hell. Suicidal thoughts, insomnia, and the most intense panic attacks I can imagine terrorized me.

I remember calling the suicide hotline multiple times and was one 911 phone call away from checking myself into the hospital. The only thing that kept me from losing my mind was going on intense, long distance runs where I tired myself to the point of exhaustion.

It wasn't until the following Monday when I could get a new prescription that I realized I was deep in addiction. I spent the next couple years weaning myself off the drugs with the help of the Ashton Manual and full denial of my psychiatrist that these pills had any addiction potential.

univalent• 11 years ago

If used appropriately and sparingly they are very useful for many conditions. I've taken Valium and Xanax as needed for more than 2 decades without becoming addicted.

The article is very biased. Doctors don't tell patients that these drugs don't have much downside! Most of them know that benzos are not a long term solution due to tolerance.

stordoff• 11 years ago

They certainly shouldn't be prescribed lightly (and not as a first choice), but for some people they work without causing side effects in situations where alternatives don't. Keeping them as an option is still a good idea IMO.

I've been taking tamazepam for insomnia, off and on, for months now, and experienced no side effects or addiction (when I don't need it, I can stop taking it for a week plus without any adverse effects). I tried multiple alternatives, but none were suitable (diphenhyramine/Nytol - no effect, currently using it as a anti-histamine; zopiclone - severe side effects, including memory loss and visual changes; amitriptyline - effective, but left me extremely tired for ~24hrs after each dose).

It's worth pointing out my experience and the lack of addictive effects may not be typical - I was prescribed tramadol (an opiate) for about six months at the maximum dose, and was told by my neurologist to taper slowly and stopping them will be worse than stopping heroin. I stopped cold turkey and had no problems or side effects (other than the original symptoms coming back of cause).

fishingpurple• 11 years ago

I've taken benzodiazepines over a few periods of time, prescribed by a doctor. They helped tremendously with anxiety in a way nothing else (exercise, meditation, relaxation exercises, etc.) did. Quitting them was hard but manageable with a fair amount of planning and gradual dose reduction. The first time was the hardest, the next two times I knew what to expect. The key is very gradually reducing the dose to zero over weeks or even months. Most people probably can't or won't do it but it's possible with the help of a professional who knows what he/she's doing.

In short, they are a tool that needs to be used responsibly. Prescribing them to people who don't need obviously isn't. Quitting them cold turkey is also a terrible idea.

pc2g4d3• 11 years ago

I'm glad to see this issue getting some attention. In spite of being one of the lucky ones with an easy withdrawal (I weaned off of Klonopin over the course of a few months after having taken it for six years) I feel strongly that these drugs are widely misprescribed, causing great harm.

I was given Klonopin (clonazepam) for anxiety/panic attacks. I was definitely in the ‘feel anxious, take a pill, feel better,’ mindset, and it made life feel terrifying and out of my control. Not only was I randomly fearful of my life (the anxiety---worrying my heart would stop beating, etc.) but I felt completely dependent on the pills to stave off crippling panic. This resulted in meta-anxieties: what if I forget/lose my medicine? What if it stops working for me? Those were in many ways worse than the root anxiety.

Getting of Klonopin was one of the best decisions I ever made. It was as if a fog had been in my brain but suddenly lifted. I could focus again, do well in school, etc. I hadn't realized how fuzzy it made made my thinking while I took it---only when I got off could I realize what Klonopin had been doing to me.

My anxiety did increase a little bit. But surviving without Klonopin proved to me that I could handle life! I dealt with the anxiety on my own power.

Maybe there are still legitimate uses for these drugs, but my feeling is that is rare. They're a shortcut with high costs in the long term, and as such seem imprudent for general use.

rifung• 11 years ago

Maybe it's just the tone of the article, but I found the article to be extremely depressing. More than just the fact that Benzos are potentially being overprescribed, it really sounds like there are an increasing number of people suffering from insomnia, which I imagine must be caused by the stresses of everyday life.

Maybe I'm overreacting but with all our technological advancement, it almost seems like people's lives are getting worse. Maybe we make more money than before (I'm not even sure about that!) but it seems we've traded our time and even health for wealth.

Are people less happy today than they were before? I don't think I'm in a position to say since I've been working for such a short period of time but it feels that way. But perhaps I'm just glorifying the past.

chejazi• 11 years ago

"The economics of U.S. healthcare are also at play. To address the root causes of anxiety takes more time, patience, dedication and, yes, money."

Big Pharma companies drive drug development in the first place, so obstructing the benzo revenue without a suitable alternative may lead to better drugs taking longer to develop. I'm assuming the non-benzos (SSRIs like Lexapro) aren't functionally equivalent to the benzos in how they "help" patients, by some measure that is unknown to me.

PaulHoule• 11 years ago

One thing they miss is the danger of falls, which are particularly dangerous to the elderly, but are bad enough if you are 17 or 45. These drugs make you clumsy.

Nursie3• 11 years ago

Benzos are lovely.

They are also highly addictive and almost killed me when I combined one with codeine. Approach with caution. Not just because they'll trap you easily but also because withdrawal can cause seizures and death.

OTOH I know of no better (weekly or less) sleep aid. If anyone else has a better alternative I'm all ears.

__z3• 11 years ago

OTOH I know of no better (weekly or less) sleep aid. If anyone else has a better alternative I'm all ears.

Trazodone works very well for me but I haven't taken it in years because my anxiety no longer keeps me up at night.

Nursie3• 11 years ago

Oh I'm not anxious at night, that's not the issue. I'm AWAKE at the wrong times and my brain wants to do stuff.

ac29• 11 years ago

They are also highly addictive and almost killed me when I combined one with codeine.

Curious what dosages of these caused you to "almost die". There should be minimal interaction between a single therapeutic dose of both at once (its not uncommon to be prescribed both at once), but if you were taking very high "recreational" doses, that is something else.

Nursie3• 11 years ago

Not much of either, maybe 20mg codeine and 2mg etizolam (thieno- I know, but same class of drug, roughly equivalent to 20mg valium). To complete the picture I think I'd had a glass of wine as well. I was ill with a nasty cold and trying to relax myself and have a good night's sleep.

I realise now that this combination of three CNS depressants is not good.

I went to bed, and woke up gasping for breath several times, eventually having to prop myself up on some pillows and try to stay awake so I could keep breathing. It was pretty hellish.

palosanto• 11 years ago

"Fun fact! Some of the most commonly prescribed (and profitable!) sleeping pills are as addictive and dangerous as heroin. Meanwhile, the 'War on Drugs' continues."

Ladies and gentlemen: I present to you the U.S. national drug policy.

dragonwriter• 11 years ago

While there are legitimate critiques of the War on Drugs, this seems to miss all of them: the notional reason that certain drugs are prohibited isn't that they are addictive and dangerous, but that they are addicted and dangerous and lack therapeutic use.

Drugs which are as addictive and dangerous as prohibited drugs but which have therapeutic uses for which there is not a superior substitute are supposed, by the logic of the system, to be legal. This "Fun fact!" neither points to any problem in the overt logic in the system, nor a way in which the effect of the system conflicts with the overt logic (there's plenty of both to be found, just not here.)

mrsteveman12• 11 years ago

As the article mentions we're largely favoring SSRIs over benzodiazepines now as "first line" medications for anxiety related disorders, but they're being overprescribed too, perhaps even more due to not being controlled substances. And patients are just as uninformed about what they're being given.

I could probably pick up my phone, scroll through my contacts and blindly pick a name, and that person is quite likely to know what the phrase "brain zaps" means, and have a horror story about being prescribed SSRIs, or especially SNRIs, without being warned about the potential downsides and indeed the withdrawal symptoms.

task_queue• 11 years ago

Having been on both, SSRI withdrawal is terrible but benzo withdrawal is a miserable experience like nothing else. It's completely disabling.

stuxnet792• 11 years ago

I tried a cocktail of SSRIs for 3 months each and none ever worked for my anxiety. I'm not a fan of benzos given what I've read here and heard in other places. Also, I doubt I'd be able to easily obtain them. Nevertheless, my anxiety is slowly killing me and I'd like to get a handle on it - what other options are there? I recently discovered that MAOIs are great, if you can deal with the dietary restrictions - anybody have experience with them?

mrsteveman12• 11 years ago

Yea, SSRIs actually made things worse for me (and they can be quite dangerous if taken alongside other medications that aren't "obviously" problematic, including some that merely affect liver enzyme levels).

You might look at magnesium/calcium/D3 in combination, specifically one of the chelated forms of magnesium.

arikrak• 11 years ago

It sounds like these medicines are great for occasional use but bad for long-term use. So these pills would be good for people who have trouble sleeping when anxious about something, but usually sleep OK. For example, people who get nervous before a test and the like could get such pills to help.

jaryd• 11 years ago

Anyone else think it's interesting that this is functionally a cross-promotional blog by the mattress startup Casper.

joesmo• 11 years ago

First things first. It is possible to get off this shit. I was on kolonopin for almost 7 years, never at doses lower than 2mg as well as Xanax. The Ashton manual is invaluable. So is the Benzo Buddies forum. Be aware that most doctors don't know anything about benzos. In my experience, in the US at least, you're on your own. Even psychiatrists have no idea how to taper. Most have no interest in helping their patients taper because they also do therapy and hate to lose clients, especially on the west coast where these things are typically combined.

General practitioners or even psychiatrists have no business prescribing this for longer than a week without fully discussing the inevitable dependence and taper plans. Any doctor who does not do that is akin to a murder on my mind and should be treated as such. This has been my experience with over a dozen doctors in two different states in both coasts.

It's a horrible situation this, but it is possible to escape. Best of luck to everyone who is struggling with this. I was able to taper off in a few months with few side effects. That was incredibly rapid for benzo withdrawal. I'd definitely budget at least three to six months at a minimum with the idea that it could be a lot longer. There are some scary stories out there but it's possible, given time, to do it gradually enough that it's not horrible. It's now been almost a year and a half and I haven't looked back since. The one blessing is that after the taper I've had no cravings. I had to give up a life I had spent seven years building and return home with no money and no savings and no job to taper, but it was worth it to get my life back.

The "doctors" who prescribed that shit, I will forever wish they lose their job. In my opinion, jail would be the only proper place for them. But it's big pharma. Never going to happen while the profits roll on. After all, they are indeed the most ruthless drug kingpins out there.

Source: seven years of hell on benzos under a dozen so called "doctors."

Is It Bedtime for Benzodiazepines?

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