The Other Epidemic: Trying to get off benzodiazepines

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.

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.

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.

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.

... 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.

It's almost like having some sort of momentary seizure.

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?

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.

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.

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.

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.

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 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.

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.

Was told by the doctor it was a much safer alternative to most other treatments. Could be worth asking about.

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'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).

I was out of options for anti-seizure drugs outside of the benzo class, which I refused to take on a daily basis (clobazam). I have had to taper and switch many AEDs in the past, none were too hard (2-4 weeks) but I didn’t want to be stuck on this one and have to taper it for months should I have needed to.

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?

There’s definitely a lot of factors

"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.

If you make the switch be sure to manage the "cross taper" carefully.

I remember him touting a substance he called “chaperon”, about ten years back, as an alcohol alternative. But it wasn’t a benzo, it was somewhere in the phenethlyamine superfamily IIRC (the internet tells me it was MEAI, a substituted, cyclized PEA).

He now has a company selling non-alcoholic spirit substitutes based on herbal ingredients, called Sentia, and is trying to get approval for something called “alcarelle” but I have no idea what class of substance that is and it hasn’t yet made it to market so saying it didn’t catch on seems a touch premature.

I don’t agree with the characterisation of him as naive, in fact I think his book delves into the societal and social effects of drugs quite well. The only way he could be considered naive IMHO is that he seems to have expected politicians to listen to reason.

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

(Not to say I agree with Parvini about everything, like I'd have to pick Starhawk over Evola and I think second-wave feminism had something to say, no matter how hard it might be to live with, when it was countercultural in the 1970s -- but Parvini has a basic integrity which Peterson lacks.)