
Is It Bedtime for Benzodiazepines? - LesZedCB
https://vanwinkles.com/bedtime-for-benzodiazepines-addicted-drug-most-popular-sleeping-pills
======
fapjacks
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.

~~~
omgitstom
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.

~~~
fapjacks
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.

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pc2g4d
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.

------
tsotha
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.

~~~
DanBC
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.

~~~
tsotha
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.

~~~
DanBC
But people with long term pain mostly should not have opiods -- they should
have rapid access to skilled pain management clinics (and if that clinic
recommends opiods then fair enough). Many people in pain end up addicted to
opiods, and don't have adaquate pain relief.

~~~
MichaelGG
Surely this is something each individual should decide for themselves. Why
should you or anyone else decide that _I_ cannot use morphine and friends?

~~~
DanBC
If you want to manage your long term pain morphine and other opiates are
probably the wrong choice.

The patient will develop a tolerance to the meds; requiring higher and higher
doses; and eventually they'll be taking dangerously high levels of those meds
_and their pain will not be controlled_ , and so now they have an opiate
addiction and they still have the pain.

~~~
MichaelGG
What's dangerously high? All accounts and experiences I've seen show people
can adapt to very high doses without extra danger. It'd be lethal to an opiate
naive person, but not particularly dangerous to the patient. And with a bit of
effort, depending on the underlying problem, this ever-increasing usage isn't
a _given_. That is, is possible to avoid escalating while still reaping much
of the benefit.

~~~
DanBC
But you're just arguing for careful and managed use of opiates, which is what
I'm asking for.

We know that opiates are widely misused by clinicians and we know that this
misuse does not help treat the pain and causes considerable other problems.

------
rifung
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.

------
stordoff
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).

------
throw_away9999
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.

------
fishingpurple
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.

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3pt14159
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.

------
beat
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.

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

Why is this a problem?

~~~
beat
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.

~~~
MichaelGG
Your comment said it was a problem that people liked being addicted. If
someone wants to quit but can't, they aren't liking being addicted. But for
patients that are OK with being addicted (and have the means, like many people
on HN do), why is addiction a problem?

~~~
beat
I have a bandmate who is an alcoholic. She mostly keeps it under control, but
it's a worry. We have a great friendship and make wonderful music together,
but I always knew that it ever got to where I had to tell her that it's the
bottle or me, she'd choose the bottle.

Luckily, she has decided it's a real problem and is sobering up a lot - not
completely, but better and more conscious. I've seen others who weren't so
lucky.. failed marriages and parenting, car crashes, even worse things.

------
CyberDildonics
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.

~~~
DanBC
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.

------
univalent
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.

------
mrsteveman1
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.

~~~
stuxnet79
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?

~~~
mrsteveman1
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.

~~~
stuxnet79
Thanks, I will look into that. Incidentally, I just booked an appointment with
my psychiatrist in two weeks - I intend to bring this entire issue up.

------
chejazi
"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.

------
Nursie
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.

~~~
ac29
> 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.

~~~
Nursie
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.

------
arikrak
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.

------
palosanto
"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
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_.)

------
PaulHoule
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.

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

------
joesmo
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."

