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Comment by gedy | Hacker News Reader

To be honest, I really think some people use the “I'm so productive“ as an excuse for why they’re doing drugs and cover for addiction (even if mild). A lot of this so-called productivity is spinning wheels and jumping around.

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One of the subreddits I used to read religiously (sorry, offensive name incoming...) was /r/bartards. It was diary-like entries from people who were addicted Benzodiazapines. I've never used them, but wow is it easy to see the lessons there. Here's a few things you should know about these drugs, all of which were very easy to learn if you read 2 or 3 stories on this subreddit:

1: Benzo's, as they call them, reduce inhibitions greatly, and also reduce short-term memory. If you take a 1 MG Xanax with no tolerance, and you have a bottle of 10 more pills, somewhere within the next 12 hours, you will take all 10 of those extra pills. The "High" has a very "I don't feel it" quality, because all that's really happening is your inhibitions are vanishing. So, geez, I don't feel it, I'll take more! Keep in mind, a 1 mg Xanax is usually supposed to be cut into 4 doses.

2: Driving on Benzo's almost always results in a "Americas Most Dangerous Police Chases" type behavior. The driver will likely have taken, now, 11 mgs of Xanax, and will awaken in a jail cell 2 to 3 days after the car incident, completely unaware of what has transpired. Guaranteed they fought the cops 100% of the way to that cell, too, so they don't know where the bruises came from.

3: A real Benzo fiend "blacks out" all the time. A common theme in this subreddit would be "I took 1 MG, had a 100 pills left. Woke up 1 week later with pictures on my phone of myself and 3 other people having an orgy. No pills left. I don't remember any of this." It's astonishing how much people can down in such a binge. Seems it's hard to OD. HOWEVER.....

4: If you are addicted to benzos and you quit cold turkey, you can die. Seizures, blackouts, flu-like symptoms. Its BAD. This is not Heroin. You have to slowly taper off of them, like you were decompressing from a deep ocean dive, over weeks, if not months. Or else you DIE!

5: You can go online right now and get a prescription for this stuff from some disgraced doctor through a startup like those Viagra, ADHD, or GLP1 pharma mills.

6: DON'T EVER TAKE A BENZO, EVER. Maybe 1 before eye surgery where they can't anesthetize you and you leave without any more pills.... Something like that. Otherwise, avoid.

The timing of dose reductions increase as one does down. And the amounts one can drop each time decrease a lot. Separately that lack of inhibition is the secret sauce for high power executives to deliver deceptive or outright false speeches and do horrible things like lie under oath or do mass firings.

Benzo blackouts are the most clear cut blackouts ever. No feeling of time lost, no amount of cues can bring back any memories, you just wake up and the pills are gone. It doesn't always mean you did something crazy though, you can very well have just had a normal week. And you can learn stuff, you just won't remember learning it. Like if you watch a show you can know what happened on the show a week later but just have no memory of watching it.

SWIM and other users they knew would call this tolerance dependant dosage threshold xanesia

Hunh.

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.

One of the characteristic diagnostics for ADHD conditions is that "uppers", substances that would normally make someone more jittery and excitable, have a calming effect on ADHD sufferers when taken in theraputic doses.

Is this some kind of AI generated karma farm? I didn't mention uppers and have never been diagnosed with ADHD.

These are rather extreme cases. Very few of those who use benzos, tens of millions in US alone per TFA, will go on binges ever. Most problems are from the dependence caused by long-term prescription-level dosing.

Feels like a bit of a Reddit LARP. These extreme stories are a good reminder to not abuse the drugs, but the nuanced take here is that your average person is not going to chug the whole bottle in one sitting the moment they get their first prescription. Like many drugs, they can be useful when used responsibly and under the supervision of a _good_ doctor (which can be a bit of challenge in some cases, I know). A blanket statement to completely dismiss a class of drugs is not useful.

That’s a model of addiction as a “habit” with a loss of self-control. But the other definition of addiction is really more like “continued use of the substance is required to eliminate a syndrome which only occurs when use of the substance is reduced or discontinued.” I think the latter model is more useful because there are tons of medications out there where responsibly using them leads to addiction. Even SSRIs could be addictive under that definition.

What you describe is called physical dependence, which differs from addiction because it does not involve getting high, does not involve increasing doses to chase the feeling.

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.

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.

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.

Yeah, I use them, like, one or two days in a row every six months. They're a godsend for getting out of a bad state or for getting through something difficult. Sometimes you just need to function and do the thing.

You can absolutely take them responsibly.

My cousin quit benzos cold turkey. Dead at 45 from a stroke.

I look at it from a close but slightly different angle. I think the spinning wheels and jumping around that you describe is an aesthetic of being productive as opposed to actual productivity and that the drugs can genuinely fuel it. So many people (here I refer to other topics in addition to productivity) think they're doing A when really they're doing B which merely has a strong aesthetic that resembles A.

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