The Other Epidemic: Trying to get off benzodiazepines
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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.
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.
My personal experience with Xanax was that a psychiatrist prescribed 0.25mg pills for daily use, but out of caution I decided to only take it during episodes of high anxiety. I was going through a very emotionally volatile time in my life and was diagnosed with an anxiety disorder.
I would take 1-2 pills occasionally to this end and it worked to stabilize my mood. Initially once or twice a week.
When I told the psychiatrist about this he shrugged his shoulders and the next prescription was "take 1 as needed."
I simultaneously did cognitive behavioral therapy. Life also got better.
Over time the frequency with which I took the pills went down. Eventually I went about 2 months without taking any and decided there was no need to refill the prescription or see the guy again.
I still keep some hydroxyzine on hand. It's an antihistamine with mild anxiolytic effects that tends to induce drowsiness. Occasionally if I'm really stressed out and anxiety is hitting hard I'll pop one of those at bedtime to ensure I get a good sleep, that's usually all it takes for me to set things right and do my best the next day. They're not as strong as benzos nor do they have the infamous downsides.
All this to say, I don't doubt the Reddit stories are real but I think there's a bit of Internet effect going on there, I wouldn't agree with #6 and I think tightly controlled use of benzos can be helpful.
But it does mean you can't just stop cold turkey without risk of harm. This is true of benzos, and also many antidepressants (which are very different from benzos) and other psychiatric meds. Often a long period of tapering is required, with "hyperbolic" dosing reduction (each reduction is a small percentage of the previous dosage). This is called a "hyperbolic taper."
As an example, for some benzos, you drop the dosage by 5-10% reduction (from the previous dose, not the original) every 2 to 4 weeks. So D = D0*(1-X)^n where D0 is original dose, X is fraction reduced per period, N is the period number. This should be done under medical supervision.
I bit of a harsh take. I started having out of nowhere physical panic attacks (GAD) in my early thirties and they worked wonders. 0.25mg did it. Taken when needed, not daily or as a party drug. I don't use them anymore, for a long time, but they were a crutch that I needed at the time. Breathing into a brown bag wasn't it.
You can absolutely take them responsibly.
https://web.archive.org/web/20230224010752/https://josephcan...
It also totally torpedoes the carefully crafted Linkedin narrative of one as a superior hustler if it turns out that the one weird trick to hustling more is just benzos.
> People don't talk about it because it's often illegal and definitely something you will be shamed for. And in many contexts it's "cheating".
> the one weird trick to hustling more is just benzos.
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.
Especially if it's a known-working design assembling the second or third prototype. Feels like gardening.
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.
I’d be a far more successful startup CEO if I were cracked out Vyvanse right now because I’d be getting g done mind numbing but necessary tasks with deadlines.
As it is I made a decision a while ago to prioritise personal health over greater business success.
At least for me, the fatigue snowballs hard. I don't take it on the weekends and saturday is hell for me unless I have something to distract me for many hours.
At my dosage, 6ish hours after taking it, my brain still fights tooth and nail doing the mind numbing administrative stuff.
Basically becoming a candle that burns the brightest, but fastest.
The dosages are never mentioned though.
There's a lot of danger to it. My friend who'd give me them would regularly take two, at 120mg. He's extremely successful, has since stopped, but a doctor let him know he had some scarring on his heart from a minor heart attack.
Really amazing albeit dangerous drug. he took them since he was 8 or 9 and had no issue with stopping. It doesn't have remotely the same crash as straight adderall(dextroamphetamine). After over a year I still forget to take it. At my current dose it helps me through really rough ruts. When taking breaks, the withdrawal lasts about 1-2 days and then I'm back to "normal".
All this being said, I really wish these rise-n-grinders would cut this abuse out before it gets further restricted. It's been life changing for me in my normal therapeutic dose.
The adhd brain that sees results on 60mg would become able to focus "normally" for a "normal" amount of time, get tired as usual, then go to bed at a regular hour.
A lot of hyper productivity people take more than the therapeutic dose but the truth is more complex. Medication that can "fix" the executive function in a lot of adhd brains for a brief period will do crazy things for a non-adhd brain for a longer time, because the non-adhd brain doesn't require fixing or support in that way.
The major physiological consequences didn’t rear their heads until years later, after I had not touched it for 5+ years. I was lucky.
Vyvanse didn't do anything for me after day 1.
Like whatever else you say about the POTUS it's shocking how many hours he must be working at 80 years of age with or without "help"
I can’t imagine he actually works that much. His output isn’t really there. We already know he doesn’t read the daily briefing (reports suggest he never reads anything at all) and it’s pretty clear 99% of what his admin does is the result of legwork from people who are not him.
If he is diving into low level details that is a different story.
Basically all his waking hours will be counted as working.
You can’t reliably do more than 5 hours of heavy concentration work per day.
Which is both liberating - a lot less punishing mentally and not requiring so much flow focus, but on the other hand you have to keep more loosely held context in your head.
And agents need you attention constantly throughout the day, you leave them working overnight. While you are not in the office etc, and it’s hard to justify when an agent just needs “a quick look” or some confirmation and direction. You leave being paged all the time so you never really relax.
I think a lot of developers will end up feeling what founders actually go through, for better or worse, but also without actually getting the golden ticket option founders usually hold.
It’s just a very different mindset for work, though maybe requiring less chemicals to actually make work
> This is so wild to me because output and work quality rapidly decline at (or well before) 40 hours a week.
Meh. It's competetive enough. Productivity per hour worked is about the same (sometimes higher) than in US. We just work reasonable hours.
> Those places are not liveable from a European perspective.
If the sacrifices these people make were at least for something that was obviously good - I could maybe understand that. But it's mostly making the world worse (either through financial schemes, addictive social media, marketing, AI, or other pointless bullshit).
Imagine wasting your life slaving away at making better ways to get people addicted to nicotine. That's IT now.
The only thing here is that there generally is a fairly robust social net ready to catch you if you do, as you mention. But my honest opinion is that this is not a solution, it's a bandaid for the real problem: why do people feel like they have to work themselves into the ground in order to be able to live?
You are right though, many here including myself cannot imagine living in those circumstances in other continents. I think that is another problem in itself, that people are becoming complacent here due to the low risk. That might even be part of the reason why people are so careless with their work-life balance, because they can't really lose it all like in other places, so maybe people stop paying attention to things that are actually important. Just guessing.
Don't buy the propaganda. You're talking about the second-richest part of Earth, with undeniably the world's highest average quality of life. It's also a big place with massive differences.
You have to understand that when Germans are being dramatic over the economic state of their country, they are describing issues that the vast majority of countries would absolutely love to have. Economic growth of only 0.9% is very bad if you have a lot of catching up to do, but Germany doesn't, so it just amounts to being slightly behind other rich countries.
"Deteriorating Europe" is a Russo-American psyop. Luckily we have better memory - we've heard this song for at least 100 years by now, and yet here we are. That's not to say that there aren't issues, but Europeans are largely unbothered by things like the GDP growth difference between the Eurozone and the US, because it's quite clearly driven by a runaway stock market and unfathomable inequality. You can't eat GDP figures.
Really? The last time I checked, Germany was sitting well in the middle of Europe
* contrary to many countries it has had export/import surplus since decades. Not a single year with a deficit since 1952. Compare this e.g. with the USA, which had the last surplus in 1975.
* it's tiny, look at it on a globe. And yet it's number 3 worldwide on economic power. Two years surpassed Japan that is larger by size and has double the people
* in June it had the highest exports ever in it's history
And that is just ONE of the European countries. Others, like Switzerland and Netherlands aren't shabby either, especially normalized to inhabitants or country size.
I could see someone like that using more hours productively. In a sense, someone who is awake 18 hours lives 12% more life than the 16 h me.
Yes, we max out on focus time ...
... but no, you're not a concert violinist. The rest of you time is all the other stuff - meetings, light reading, sales reps, catching up with professional colleagues, filling out forms, HR stuff, all the inquires from he newbies, returning emails, etc. etc..
The 3hrs focus/day is one kind of work, all that non-focus time is the 'work part of work'.
Literally most jobs is like that, it's 100% that kind of thing, there is no 'peak performance' it's just putting one foot in front of the next.
No joke at all. I eventually decided to never open email until lunchtime so that I could get four hours of productive work done while I was still fresh. Then lunch, then email, then plan what I'd do the next morning. I had to do the seriously difficult stuff in the morning or I'd be too worn out to do it right.
I think this is the point of the stimulants - they make you really into whatever you're currently doing.
For reference, I'm in my late 60's, and I don't inject anything. I've had a wide range of life-long health issues, but partly because I've optimized to be acceptably focused and productive while living with those issues (that I've been resolving one-by-one), I can have some pretty long periods of focus.
Four hours? Woah. I'd say in a given week I probably only do about fifteen minutes of real, actual, work. The rest of the time I just stare at my desk; but to Lumbergh, my boss, it looks like I'm working.
Take the adderall and benzodiazepines out of the equation and they might just as well be using cocaine and barbiturates.
Benzodiazepines, and alcohol, can actually induce death if you withdraw too quickly
Why can't it be the situation? Even to call it the internal situation if you find no obvious external reasons, is probably healthier than to ascribe to the essence of who you are.
In my case I experienced no physical dependency on any of the drugs and chose to stop because I wanted to perform other experiments. I’d say it’s about half a decade now since.
I do know others who get weakened impulse control but I just get hyper focus of various degrees.
So there we are in a regular pub, about 11pm. One guy starts dialing on his phone and says, "I'm gonna pick up. You want in?" I kind of smirked and said, "uhhh I don't smoke weed dude. Thanks." And he looked at me like I was an innocent deer and said, "umm, we're going skiing dude. this is how we stay up."
Oh boy. I was never addicted to it thank god, but what a wild couple of years that was.
Right before my cofounder and I wrote down our values, when we were done, I said, okay, now we’re both going to schedule the labs and checkups I know we’ve both been procrastinating.
Let’s just say that was the difference between stage 1 and stage 4… by a few months. It has been probably our defining corporate value ever since. And yeah I don’t ever expect an outside investor to like that.
I have a feeling this means something else than in Scandinavia. I am so innocent. I would take it literally "Where?" if someone said that to me. And probably ask if I could join.
All substance abuse is painkilling, in a manner of speaking.
... let's dial this back a little here. I've been a (prescribed) benzo user for ~15 years, across xanax, valium, and klonopin. I regularly go for weeks at a time without taking them or thinking about them. I have taken some very, very large doses before (as part of a now-resolved fear of flying).
Firstly, yes, obviously, they are addictive. This is compounded by the fact that people are generally prescribed them when they really need them, and they are highly short-term effective. If you have acute mental distress and someone gives you a drug that switches that off in the short term, you are going to really want more of it when that distress comes back. Many people seem to have at least some low-level mental distress, and so many people respond really well to benzos. They also cause physical dependence, so cessation if you've taken them chronically for as little as a few weeks is going to be somewhere between annoying and extremely rough, quite aside from the addiction.
Secondly, the "amount of DGAF/YOLO". Some users experience dose-dependent impaired judgement, probably similar to alcohol? If you've taken a serious dose, you'll know you've taken something psychoactive. This isn't something that needs to factor in to your risk profile for taking 5mg of valium. A very small number (1%?) experience severe impaired judgement. Test one first.
Overall, they are a drug to approach with a lot of caution, and with the help of a doctor who you think understands the risks, like opiates. But like opiates, they are a miracle solution to a very difficult problem. If your doctor thinks you need to carry some Xanax around in your wallet for panic attacks, don't assume all hell will break loose. If your doctor wants you to take klonopin for five days while you switch SSRI, that's probably OK. If you're terrified of flying, but need to make your once-a-decade flight, gladly accept a dose of valium. On the other hand, if your doctor is prescribing a four-week once-a-day schedule, urgently seek out a second opinion unless they sit you down and are very clear on the risks with you first, and even then do some of your own research.
But be aware that they are highly effective at removing your acute mental distress, and if that's an issue for you anyway, you might be about to feel better than you've felt in years, and you need to be sure you're not going to reach for them when you don't actually need them, and kick off an addiction that will be very, very hard to shake.
Bottom line: miracle drug, but be as skeptical of them as doctor-prescribed opiates.
Can you theorise on why you are not (less?) affected by the addictive elements of benzos? I'm not here to doubt, rather to ask: What are you doing differently? Are you someone with (insanely) high self-control... so you can back off if you feel the pressure of addiction?
I don't think self control has anything to do with it. Part of it is probably genetic -- I don't have a family history of addiction but a lot of people do.
The other part is I use them for a reason, I like having them available for that reason, and honestly I don't find them that fun to take outside of those reasons. I just feel kinda drunk.
But they definitely create "dependence," which is very different and comes with proper user of them.
The meds can change one's life for the better and do so for millions. But they have to be used to treat a problem, not to get high.
Edit: Granted, falling asleep is not really conducive to being able to work. So I imagine there a number of people where "it made me fall asleep, but I can't do my job like that" is a non-starter, and short-term benzos is the only way forward.
Dependence is about having problems when quitting after using for a bit. It is an issue with proper use of benzos, antidepressants, etc. A person who is dependent on, say, Xanax may be just taking it regularly in a low dose. But when they quit, unpleasant symptoms can arise - beyond just a return of whatever they were being treated for. So quitting these often requires a long tapering process - see my post on "hyperbolic taper" above.
That person is not addicted, is not an addict, but rather is the usual responsible user of the medication.
It's almost like having some sort of momentary seizure.
We didn't do drugs other than redbull and some of the other guys smoked tobacco. I am really glad there wasn't a hustle culture of taking amphetamines.
Not at all. From amphetamines to benzos, pretty much every doctor tells you what the fuck can and likely will happen if but you are zoned out and either desperate or want to avoid that despair at all costs.
It's why parents let their kids have/start amphetamines pre- to mid puberty and why some give them shots to boost sexual development. They can't handle and have zero desire to build the skill or patience to parent the whiny little bitches they create. But the consequences are always the same.
The extremes you described are just the most cinematic ones.
The extremes you don't see are worse and much much more prevalent. The damage and bullshit these peeps cause outweigh any function they perform in society by crazy high factors. But they get to fake the fun without effort and doubt. And while doubt is imperative for a healthy, growing brain, it's extra painful when your meds' dosage is too low or you are currently off them. Ante up!
Been there, stopped taking them asap and fought for better alternatives that might come with their own price downstream. Side effects have to be mitigated actively, and not just with Magnesium and Electrolytes and eye drops ... ... ... it's a mental effort, a matter of character ... but sure, opt in for that work and that ugly behavior you now don't have a feeling/intuition/instinct for anymore ... it certainly makes for a good recurring story in a YOLO kind of world and if it's the only way you can handle it, why beware?
The stimulant over-prescribing problem can be self-limiting for many when they discover that the initial euphoria and feeling of being super productive disappear. It's wild how common the "my Adderall isn't working any more" complaints roll in from people who thought they were signing up for the pill from the Limitless movie instead of a concentration-enhancing pill that isn't fun or enjoyable in the long term.
But not everyone stabilizes on a boring dose or gives up on the medication when tolerance takes away the fun part. It's the people who start stacking crazy supplements or even illicit drugs on top to go deeper. Some of these people wouldn't normally see themselves as drug users or abusers, but something about prescription treatment opens a blind spot in certain personalities. I knew a few people who got all the way to rock bottom and into rehab programs while fully believing that they were "self-medicating" a medical condition, despite using drugs and doses that were not helpful for concentration in any way.
Those who go from unmedicated to being prescribed high doses of amphetamine and a benzo within a year or two are the craziest stories. Now they'll often have a ketamine prescription for depression as well. I don't know where these doctors are that prescribe these regimens so quickly to patients, but they go out and find them. I've heard so many stories of about patients trying to establish care with my friends and then showing up with crazy combinations of scheduled medications and a request for more prescriptions. Many of them haven't realized yet that controlled substances are tracked in a shared database that providers can read, and they can even see if you've been getting prescriptions in neighboring states too.
I know I'm more exposed to these stories than normal by proximity to people who see them a lot, but it's getting really sad. I'm also worried that we're headed for an opioid-style backlash where prescribing medications to people who really need them becomes difficult due to the rampant abuse.
> Having kicked opiates cold turkey in the past, I felt nostalgic for three simple days of traditional nausea, sweatiness, and bone-deep ache.
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.
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.
> A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder
I have had clinically significant anxiety since I was a young child, and in the end, treating other mental illnesses effectively (I developed bipolar 1 in my late teens) and exercising very regularly seems to pull my baseline level of neuroticism down to within the normal range. If I get good cardio in, usually an outdoor run, 3 days a week, I feel normal.
I had no issues getting off of it; not to say that other people don't either -they very well might.
One of the most well studied genetic risk factors for addiction vulnerability is the DRD2 gene, which encodes the dopamine receptor D_2. People who are particularly vulnerable to addiction commonly have a deficiency here, meaning getting bored very easily and feeling under stimulated/rewarded by typical things is in part what makes riskier sources of pleasure (i.e. drugs) so appealing.
Disclaimer: Not a medical professional, just like reading about addiction and genetics.
A couple of the people I knew who ultimately ended up in rehab would describe themselves as not having addictive personalities. One even bragged about how boring drugs had become to himself.
This is the hubris that opened the window to their addiction. They thought it was a thing that happened to other people, so it was safe to dabble. Then dabbling became a little more frequent, then they decided the drugs were actually helping them and therefore it was logical to do more, then they took little breaks to prove that they could stop but came right back to the drugs as soon as their life got a little hard again.
After two or three months I discontinued it. He suggested to just stop, but I thought better of that, tapering through 0.25mg and 0.125mg. What followed was weeks of unrelenting insomnia and headache.
I wouldn't recommend.
I always feel awful when I hear people making fun of him for this. It seems like it's one of the most horrible and difficult things out there.
Good job 'choosing life,' as they say.
Almost a decade ago now, I was a happy, high-functioning alcoholic. Winery tours, Scotch tastings, workplace drinks, etc.
It was all "fine" until I started struggling to get to sleep without a little "nudge"; then it was getting back to sleep in the wee hours; then it was every hour or two, 24x7.
Then I decided to go cold turkey while on vacation in Hawaii with my family, because who wants to be the drunk asshole in search of a cocktail while everyone else is having a good, sober time at the beach?
Boom: detox seizures, ER visit, and the ever-so-helpful prescription of Ativan so I wouldn't seize again. I was discharged with the instructions to "take as needed, up to every four hours." Since I was an addict in pain, I took that to mean, "take them every four hours, or maybe more often."
Cut forward 3-4 days, and the scrip ran out. Boom: more DTs, this time from the benzos.
It wasn't long after that when I went through my first inpatient psych visit b/c I was in no way equipped to handle withdrawals from two highly-addictive drugs at the same time.
Sadly it took another couple of years and another trip through the ER + inpatient care before I realized that doctors would and did prescribe me meds that were actively harmful in the interest of short-term comfort.
It's been six years since the last big episode and I'm genuinely grateful I only threatened myself with my shitty brain chemistry (however aggravated by poor medical intervention) rather than putting other people at risk. It could have been much worse if, say, I routinely drove people around or did any kind of safety-critical work.
Regardless: benzos are not "lightweight" drugs, and giving them to people with any kind of history of substance abuse disorders is a Bad Idea.
I'm glad to hear you (all) made it to the other side, and hope your stories give others who are struggling with addiction courage to seek help and free themselves.
Honestly, having gone through recovery and grappling with all the shit I didn’t want to acknowledge has been a gift.
Learning to not hate myself for bad decisions I made in the past creates a lot of space to be compassionate and (hopefully) skillful in helping other people who are struggling. (Not to mention myself, when I fuck up…which is often.)
It can always be worse, and I’ve lived through enough “bad” to be grateful for how much easier mundane shit like taxes, politics, and argumentative kids are by comparison. :)
With regards to focus: I've struggled with that for my entire life, starting long before I ever took a drink or anything harder. Perhaps unsurprisingly, bipolar (which I 100% am) and ADHD (~95% sure; just not medicating for it b/c, y'know, "fun" drugs are a problem) are very common dual-diagnoses with substance disorders.
So it's not so much that the substance abuse made me less able to focus; it's more that I've _always_ struggled with slowing down and staying put. Alcohol and other downers were always a form of self-medication.
The number of times I've read about celebrities and random people in deep addiction (or eventual death), whose starting point was just pain relief from a run of the mill injury. Makes me wonder what idiocy has overtaken these doctors. "Here, take these so you don't have to suffer a sore back for the two next weeks. And btw, you may become deeply addicted and it might cost you your life. Good luck!"
I've been on klonopin for sleep and prescribed xanax or ativan for acute anxiety at a couple points over the years, and never had any trouble getting off them. I usually stayed at the lowest dose and often skipped doses, and I'm searching my brain for any memories of withdrawal symptoms, and I don't remember ever having any.
I would bet that more patients have my experience with these drugs than have the long term addiction and severe withdrawal, and doctors have often passed people on before the consequences start stacking up.
I still think they should be prescribed extremely sparingly, because even in my experience with them, they didn't really do too much that some running and yoga didn't do, and they come with much bigger risks.
I've also seen friends or family members who used and stop these drugs without much difficulty.
This isn't medical advice obviously, but I wouldn't rely on anecdotal experience to form an opinion on this. These drugs can certainly be helpful to some people.
That said: do not abuse benzos. They will fuck you up.
I was prescribed temazepam for insomnia. It was the only sleep medication that worked, and it was the best sleep I've had in my life. It stopped being effective after around 30 days (or maybe 60, I forget). That was the end of that. I could have argued for a higher dose or a refill or whatever, but... you don't fuck with benzos.
>That said: do not abuse benzos. They will fuck you up.
This is pretty much my perspective, except I'd say that it doesn't even necessarily require abuse per se. I'd say just be very careful when using them, and get off of them ASAP. Myself, I only take them if there's a procedure of some sort they're called for.
I'd say awareness is more called for than a total ban. A total ban would be messed up because there is zero replacement for them for what they do -none.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6494026/
I think other disorders in gaba/glutamate functioning (or in an adjacent disorder that affects these systems) could be similar.
My guess is that low doses of benzos used to treat neurological disorders have a lower risk because GABA/Glutamate/related systems in that population are pathologically dysfunctional and benefit more directly from these medications.
I took one a day for 4 days, as the panic would flare up right before I tried to sleep. I figured, I could be taking 6 a day, so 1 a day shouldn't hurt. And it was only 4 days in a row. No problem.
Day 5. Bang. Dt's. Immediate anxiety attack. Suicidal thoughts. Brain zaps. High blood pressure. Vertigo.
They are no joke, but doctors throw them around like they used to with opiates.
But many people have trouble and I am still at risk.
Benzos are miracle drugs for many including myself, but have to be taken carefully, and discontinued slowly (hyperbolic taper) if withdrawal symptoms are too bad.
It seems that you got lucky, which is wonderful but not necessarily actionable for others.
It takes at least a few weeks to a few months of daily use to develop dependence.
During a crisis I took it for a month. Then stopped. Stupid as it may be, I only fairly recently learned that this drug can cause hell but for the life of me I couldn’t understand how. All it did for me is help me sleep. I didn’t understand how it can be abused or what’s the recreational part of it. When my doc told me about the dependence, and how it may creep stopped even my occasional use and the bottle I got last Jan still sits in my meds canbinet.
Could it be that different people have different reactions or may be more susceptible to addiction to it?
For example, if I take some sort of sleep aid (e.g. US OTC antihistamines, Ambien, or low-dose benzos) then after ~2 nights my subsequent ability to fall asleep without help is noticeably impaired. That’s already the start of a physiological change that, if not reversed, would continue to a dependency (albeit not necessarily an ‘addiction’.)
It’s a process of analogue change, not binary, and individuals’ pace of change will vary.
Many people receive opioid treatment and do not become addicted. In fact most do. Most people can drink alcohol without becoming an alcoholic. This isn’t a proof that “anecdotal experience” that opioid addiction and alcoholism aren’t serious problems. In fact it is a demonstration that they are insidious for that exact reason - it’s fairly easy to slip through the cracks in the system into a serious problem that is life altering and extraordinarily difficult to emerge from.
Finally, the hardest withdrawals I’ve seen are benzo withdrawals. Relapse is also extremely high because the profound anxiety that led to the addiction is amplified in the years of subsequent withdrawal with very little as effective as a benzo to mitigate it. Paralyzing irrational fear is in many ways worse than pain, and pain is often a symptom to boot.
I feel that perhaps saying “well not everyone, take my anecdotal experience” isn’t the most empathetic response, and the statistics bear this out. The prevalence of benzodiazepine dependency is roughly on par with alcoholism in the US and several times that of opioids. The distinction is that crisis level addiction is roughly the same as opioid, while alcohol is roughly 7x worse. This likely because acute alcoholic behavior is rapid and very readily observable, while opioid and benzo dependency can be masked behind an otherwise normalish appearing life. The decline is fairly slow often unless you trip over into fentanyl. Further the prevalence of common use of both opioids and alcohol is much higher because surgery and recreational alcohol use is fairly prevalent while anxiety disorders less so.
Stevie Nicks is a popular icon who has been very public about how hard her withdrawal from Klonopin was, including how her skin sloughed off among other horrible effects. She lost a large part of her life span to it. But otherwise it’s also a relatively under reported dependency given its prevalence.
https://time.com/3482462/rolling-stone-stevie-nicks-drugs-mu...
I’d also note in many countries benzodiazepines are highly controlled with much higher bars than US, including the UK, where they’re only allowed in crisis, not general anxiety disorders less.
I certainly wouldn't want them removed -particularly after spending 4 months going through different surgical procedures where benzos were medically indicated. But awareness of the down-side is thin on the ground (from my perspective) and it's good to get out there.
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.
The end result of this is that, especially in the winter, it’s really easy for me to drive to work in daylight, and then that’s literally the only time I see the sun. I leave work after dark. Totally screws with my circadian rhythm.
Was told by the doctor it was a much safer alternative to most other treatments. Could be worth asking about.
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 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).
My own family had a similar problem. The family member was way over-prescribed a drug by a doctor who clearly wasn't helping treat the underlying issues and frankly barely remembered the patient from month to month (for a person they were seeing every month). It still took us nearly a year to find a doctor we could switch to because everyone we called was so freaked out by the dosing the prior doctor had prescribed that half of them wouldn't even touch the case at all, and the others wanted to just stop everything cold and start all over again. The problem with that being that the underlying reason they were getting prescribed these medications was still an issue. Asking someone who does need the medication in question (or similar treatment) to not only suffer without it for a few months but also just stop their escalated doses cold turkey is just needlessly cruel and harmful. We were lucky to finally get a doctor who accepted helping us get things under control, with a pre-made plan of action and a "sole-prescriber" contract, both of which was fine, we just needed someone whose plan didn't start with "and now you stop everything you're taking to treat your condition and we wait until you're detoxed before we try anything else".
I don't think so. It should be drilled into doctors' heads to prescribe them very cautiously and always warn about the addiction potential. But they have their legitimate uses and in some cases are irreplaceable.
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.
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
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.
More recently another friend mentioned getting prescribed a rather hefty dose for his anxiety. I convinced him otherwise with science backed evidence and accounts like what OP linked, given his personality type I'm certain it would have ended him.
I hear this all the time and never get it. Didn't these people go to school? People talk about this every day on the internet. It's right there on Wikipedia, even.
"MISUSE OF CLONAZEPAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Never share clonazepam with another person. Selling or giving away this medicine is against the law.
Some people have thoughts about suicide while taking clonazepam. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.
Get medical help right away if you stop using clonazepam and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide.
Do not stop using clonazepam without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Some withdrawal symptoms may last up to 12 months or longer."
The doctor gave me the minimum amount of pills to get me through the initial chronic period, 7 days, and I was very grateful to be made comfortable.
I was lucky that my back healed quickly, even after a few days on the drugs I detected a feeling of dependency creeping up.
And by the way to get off of them, I read that the most successful people statistically with the ones who did a very gradually. So again I took the scissors and I was cutting small amounts off of pills so that I was sometimes taking some multiple of 1/8 of a pill And when I made adjustments I might go down by 1/8 or 1/4 per week.
My anxiety problem actually played a role in me being afraid to take too much anxiety medication ha ha and that probably saved me
Such misery coming off them. Crying like a bitch, as if your parents and dog all died yesterday... every single morning. Overstimulation lurking around every corner that provokes palpitations and flop sweats. Your skin goes "on fire" when you're worried. For months and months and months. Maybe forever? You don't know if there's light at the end of the tunnel.
Mental health issues are an invisible hell. I have so much more empathy after being out the other end of bzd bs.
That's much more than I would have expected
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.
Many years have passed. Every time I feel I’m losing control because of anxiety, I imagine taking a lorazepam pill or having one within reach. Even these imaginings bring me some peace. But I still know it’s a bit dangerous, even though it’s not technically addictive.
That’s how “good” the stuff is. And you should be careful with it.
Currently on maximum strength of clobazam. Missing a dose by more than an hour wakes me from sleep. Miss one entirely and I'm sobbing for the next 3 days.
The "taper with Valium" path sounds promising, but I'm not sure my neurologist would agree. Or if it is even effective in the same way clobazam is. Something to ask.
If you make the switch be sure to manage the "cross taper" carefully.
Today marks a week since I've totally stopped. It's been interesting to see the relatively low-stakes rollercoaster that getting off it has been. The bigger roller coaster was how sedated I was last month, because before stopping I started another epiplepsy drug that increased how much of this benzo I metabolized. While I see how this experience has ranged from euphoria to insomnia to exhaustion, it's certainly been nothing like this author (so far).
When I started this benzo, my psych said something to me I'll never forget: "oh, there's nothing wrong with taking benzos daily... as long as you take them every day at exactly the same time for the rest of your life." My epileptologist swore that wasn't the case and seems to have been right, but that advice still lingers with me about benzos in general.
A note about patients having taken a benzo due to stress and then complain they became worse after stopping it: you don't know if you were even worse without taking it in the first place.
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.
He was technically absolutely right that alcohol was worse than most illegal drugs (what he was unfairly fired for saying), but man, he had major white coat blinders. Terribly naive and oblivious to what science besides neuroscience could say about drug use. Good thing his "synthetic alcohol" benzos didn't catch on.
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.
GHB gets a bad rep because it's extremely potent (imagine the same intoxication level as a shot of liquor from 1/3ml of GHB), so it gets used to drug people surreptitiously, and most people aren't good at controlling dosages of liquids like that. Sold pre-diluted, it really wouldn't be much different safety-wise than alcohol.
I lost a friend to benzos. Over Covid, ended up buying RCs from the darkweb. I think it was clonazolam or some derivative. He said he had to dose toothpick amounts, which was utterly insane. He said he needed it just to function and get by.
Amazing guy, etc. I've always wondered what the 'true' cost of lockdowns were after this time.
I wonder how many anxiety sufferers would jump on the option to be completely free of their misery in exchange for a 1 hr mandatory daily exercise routine that can be done entirely indoors. I was a complete shitshow until I started rowing at least 10km every morning (365 days per year).
There was a time when this level of exertion sounded insane to me. The unfortunate reality is that this is the bare minimum my particular physiology requires to achieve the desired outcomes. I suspect the threshold isnt that far off for some others. It took me half a lifetime to get used to the idea of exerting myself like this for at least an hour every single day.
There are days where it feels very hard to get going, but then I recall the alternative options and their consequences. That's all it takes for me now. I've been to the bottom of a few rabbit holes. I know how those stories end.
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.
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.)