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Comment by exmadscientist | Hacker News Reader

They really are extremely effective drugs when used correctly. That's why the calls to ban them (as seen elsewhere in this thread) are not terribly compelling. There's no replacement for what they do.

That said: do not abuse benzos. They will fuck you up.

I was prescribed temazepam for insomnia. It was the only sleep medication that worked, and it was the best sleep I've had in my life. It stopped being effective after around 30 days (or maybe 60, I forget). That was the end of that. I could have argued for a higher dose or a refill or whatever, but... you don't fuck with benzos.

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Benzos can fuck you up good and proper without abuse. I was prescribed some for panic attacks. Take as needed, up to every 4 hours.

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.

I wonder if there’s a way to predict how someone might react to them. This isn’t my experience.

An yet, I've been on and off them for decades. No problem.

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.

>They really are extremely effective drugs when used correctly. That's why the calls to ban them (as seen elsewhere in this thread) are not terribly compelling. There's no replacement for what they do.

>That said: do not abuse benzos. They will fuck you up.

This is pretty much my perspective, except I'd say that it doesn't even necessarily require abuse per se. I'd say just be very careful when using them, and get off of them ASAP. Myself, I only take them if there's a procedure of some sort they're called for.

I'd say awareness is more called for than a total ban. A total ban would be messed up because there is zero replacement for them for what they do -none.

It depends what they're being taken for. There are certain conditions where low doses of benzos are fine for years or decades.

I don't think that the likelihood of dependence is correlated to the disorder being treated. The GABA receptors will do what they will.

There seems to be a reduction in psychological dependence in people treated with benzos and barbiturates for seizure disorders compared to people who don't have seizure disorders.

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.

Makes sense.

This needs the caveat that following the maxim "do not abuse benzos" means telling well meaning doctors no if they suggest taking benzos consistently for even a few days. Which is a bit of a stretch of the definition of abuse.

It seems that you got lucky, which is wonderful but not necessarily actionable for others.

Not quite luck, there was a bit more to it than that. Temazepam has a bit different risk profile than some of the others. And the stop signal was developing tolerance; increasing dose would have been the exact thing to do if I wanted to get addicted. So I didn't ask for that!

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