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!!!
This is so wild to me because output and work quality rapidly decline at (or well before) 40 hours a week. It sounds like a joke, but I probably have 4 good hours in me a day. Sure, more if I'm really into something, but working 4 hours a day 3-5 (max) days a week will actually achieve peak results in my experience.
I work on hardware development, that matches pretty well the time I can spend on high-creativity design tasks. I fill the rest of the time with tasks that could be outsourced, like assembling prototypes or laying out circuit boards, but I do myself because they are more like relaxing puzzles than demanding work.
When I have to work on single a software-only project, after about two weeks of sitting at a desk for eight hours a day, I absolutely have to do something else.
Some people moonlight other gigs (overemployed) and put unusually high levels of pressure to perform in themselves. So, 2/3x-ing that normal output is unsustainable but profitable. Context switching does take a toll when you’re putting out fires that have meetings attached. This was just an anecdotal example of a person who is running themselves into the ground. Startup culture of the 2010s fostered a lot of the myths of ultra-productivity and wealth without the backstory of drug abuse.
That’s for maxxed out knowledge work. Most of running a business is simply doing mid grade knowledge/admin/management work in a responsible, cares-about-the-outcome aligned fashion, which you don’t get from some $50k/y admin person or middle manager.
I would say that less than 25% of a startup CEO’s workload requires the “well-rested, highest quality thinking” that you describe. A lot of it is simply quantity and determination. The output of “having grit” is not that you are suddenly smarter - it’s that you are less willing to stop.
To be honest, I really think some people use the “I'm so productive“ as an excuse for why they’re doing drugs and cover for addiction (even if mild). A lot of this so-called productivity is spinning wheels and jumping around.
One of the subreddits I used to read religiously (sorry, offensive name incoming...) was /r/bartards. It was diary-like entries from people who were addicted Benzodiazapines. I've never used them, but wow is it easy to see the lessons there. Here's a few things you should know about these drugs, all of which were very easy to learn if you read 2 or 3 stories on this subreddit:
1: Benzo's, as they call them, reduce inhibitions greatly, and also reduce short-term memory. If you take a 1 MG Xanax with no tolerance, and you have a bottle of 10 more pills, somewhere within the next 12 hours, you will take all 10 of those extra pills. The "High" has a very "I don't feel it" quality, because all that's really happening is your inhibitions are vanishing. So, geez, I don't feel it, I'll take more! Keep in mind, a 1 mg Xanax is usually supposed to be cut into 4 doses.
2: Driving on Benzo's almost always results in a "Americas Most Dangerous Police Chases" type behavior. The driver will likely have taken, now, 11 mgs of Xanax, and will awaken in a jail cell 2 to 3 days after the car incident, completely unaware of what has transpired. Guaranteed they fought the cops 100% of the way to that cell, too, so they don't know where the bruises came from.
3: A real Benzo fiend "blacks out" all the time. A common theme in this subreddit would be "I took 1 MG, had a 100 pills left. Woke up 1 week later with pictures on my phone of myself and 3 other people having an orgy. No pills left. I don't remember any of this." It's astonishing how much people can down in such a binge. Seems it's hard to OD. HOWEVER.....
4: If you are addicted to benzos and you quit cold turkey, you can die. Seizures, blackouts, flu-like symptoms. Its BAD. This is not Heroin. You have to slowly taper off of them, like you were decompressing from a deep ocean dive, over weeks, if not months. Or else you DIE!
5: You can go online right now and get a prescription for this stuff from some disgraced doctor through a startup like those Viagra, ADHD, or GLP1 pharma mills.
6: DON'T EVER TAKE A BENZO, EVER. Maybe 1 before eye surgery where they can't anesthetize you and you leave without any more pills.... Something like that. Otherwise, avoid.
The timing of dose reductions increase as one does down. And the amounts one can drop each time decrease a lot. Separately that lack of inhibition is the secret sauce for high power executives to deliver deceptive or outright false speeches and do horrible things like lie under oath or do mass firings.
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.
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.
> 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.
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.
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 sounds a fantastic claim, but I'll read up a bit on it so thanks.
Must admit though I've not had any drug - prescribed or illicit - that had a more immediate and powerful effect on my anxiety than a benzodiazepine (granted I've not tried heroin before!).
Thankfully they are incredibly hard to get prescribed where I live due too all the above associated dangers.
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.
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.
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.
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.
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.
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...
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.
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?
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 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'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, and few legitimate patients abuse the things for fun, 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 pills per month".
That way the doctor can monitor the patient needs more closely and effectively prevent both addiction and tolerance from developing (to preempt: no, most people cannot in fact easily source it from the black market, and doctor shopping is no longer a thing for controlled drugs thanks to the opiod crisis).
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.
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'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. I did have one crazy symptom: in the middle of the night, if I woke up, I could close my eyes and watch my visual cortex go haywire. It was like a fireworks show. That eventually went way, but man, it took months.
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.
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.
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."
"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.
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.
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 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:
doesn't seem like great advice to take someone who is "feeling unstable" off a decade plus of benzodiazepine therapy to make them more stable. also, that was probably too aggressive of a taper for that long of use.
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 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.
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.
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.
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.
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) in the context of some clips of Peterson and his daughter talking about his experience. [1]
Definitely something that it’s good to raise public awareness about, because they are very widely prescribed (10% of women over the age of 50, for example) and a lot of people being prescribed these drugs likely don’t fully understand the risks.
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!!!
This is so wild to me because output and work quality rapidly decline at (or well before) 40 hours a week. It sounds like a joke, but I probably have 4 good hours in me a day. Sure, more if I'm really into something, but working 4 hours a day 3-5 (max) days a week will actually achieve peak results in my experience.
When I have to work on single a software-only project, after about two weeks of sitting at a desk for eight hours a day, I absolutely have to do something else.
I would say that less than 25% of a startup CEO’s workload requires the “well-rested, highest quality thinking” that you describe. A lot of it is simply quantity and determination. The output of “having grit” is not that you are suddenly smarter - it’s that you are less willing to stop.
1: Benzo's, as they call them, reduce inhibitions greatly, and also reduce short-term memory. If you take a 1 MG Xanax with no tolerance, and you have a bottle of 10 more pills, somewhere within the next 12 hours, you will take all 10 of those extra pills. The "High" has a very "I don't feel it" quality, because all that's really happening is your inhibitions are vanishing. So, geez, I don't feel it, I'll take more! Keep in mind, a 1 mg Xanax is usually supposed to be cut into 4 doses.
2: Driving on Benzo's almost always results in a "Americas Most Dangerous Police Chases" type behavior. The driver will likely have taken, now, 11 mgs of Xanax, and will awaken in a jail cell 2 to 3 days after the car incident, completely unaware of what has transpired. Guaranteed they fought the cops 100% of the way to that cell, too, so they don't know where the bruises came from.
3: A real Benzo fiend "blacks out" all the time. A common theme in this subreddit would be "I took 1 MG, had a 100 pills left. Woke up 1 week later with pictures on my phone of myself and 3 other people having an orgy. No pills left. I don't remember any of this." It's astonishing how much people can down in such a binge. Seems it's hard to OD. HOWEVER.....
4: If you are addicted to benzos and you quit cold turkey, you can die. Seizures, blackouts, flu-like symptoms. Its BAD. This is not Heroin. You have to slowly taper off of them, like you were decompressing from a deep ocean dive, over weeks, if not months. Or else you DIE!
5: You can go online right now and get a prescription for this stuff from some disgraced doctor through a startup like those Viagra, ADHD, or GLP1 pharma mills.
6: DON'T EVER TAKE A BENZO, EVER. Maybe 1 before eye surgery where they can't anesthetize you and you leave without any more pills.... Something like that. Otherwise, avoid.
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.
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
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.
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.
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.
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 use it to deal with my anxiety.
I don’t trust benzos in the slightest. Especially so after reading the horrors of this thread.
Must admit though I've not had any drug - prescribed or illicit - that had a more immediate and powerful effect on my anxiety than a benzodiazepine (granted I've not tried heroin before!).
Thankfully they are incredibly hard to get prescribed where I live due too all the above associated dangers.
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'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.
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.
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.
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.
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?
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 pills per month".
That way the doctor can monitor the patient needs more closely and effectively prevent both addiction and tolerance from developing (to preempt: no, most people cannot in fact easily source it from the black market, and doctor shopping is no longer a thing for controlled drugs thanks to the opiod crisis).
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.
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.
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. I did have one crazy symptom: in the middle of the night, if I woke up, I could close my eyes and watch my visual cortex go haywire. It was like a fireworks show. That eventually went way, but man, it took months.
Was told by the doctor it was a much safer alternative to most other treatments. Could be worth asking about.
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.
"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 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.
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.
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.
https://youtu.be/CAm_L6CTnD4?is=o1UjxkDQwFloZ8VM
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
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.
Here’s a video of a doctor talking about the dangers of BIND (Benzodiazepine-Induced Neurological Dysfunction) in the context of some clips of Peterson and his daughter talking about his experience. [1]
Definitely something that it’s good to raise public awareness about, because they are very widely prescribed (10% of women over the age of 50, for example) and a lot of people being prescribed these drugs likely don’t fully understand the risks.
[1] https://youtu.be/_q44phEpFjA