I’ve seen a few friends and coworkers go down this path, usually as a result of work stress or hustle culture. They start on neutropics and energy drinks, then get scripts for Adderall or Vyvanse to handle the perceived insurmountable workload, stabilize on those after an initial euphoria, then build up a heroic tolerance to (dextro|meth)amphetamines. Withdrawals from that high level of addiction leads to anxiety, insomnia, delusions, mania and all sorts of craziness (I suspect the lack of sleep is the culprit).
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.
I work on hardware development, that matches pretty well the time I can spend on high-creativity design tasks. I fill the rest of the time with tasks that could be outsourced, like assembling prototypes or laying out circuit boards, but I do myself because they are more like relaxing puzzles than demanding work.
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.
> It sounds like a joke, but I probably have 4 good hours in me a day
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.
Some people moonlight other gigs (overemployed) and put unusually high levels of pressure to perform in themselves. So, 2/3x-ing that normal output is unsustainable but profitable. Context switching does take a toll when you’re putting out fires that have meetings attached. This was just an anecdotal example of a person who is running themselves into the ground. Startup culture of the 2010s fostered a lot of the myths of ultra-productivity and wealth without the backstory of drug abuse.
Why don't more people talk/blog about their drug (ab)use? As a parallel, there has been a generational change in body building where performance enhancing drug users are now much more open about it. Even a few years ago, it was a widely known secret, but almost no one talked about it publicly. For the most part, the stars in the industry have been responsible about how they share the info. They spend plenty of time telling you horror stories and negative side effects. And they stress that you need to build a plan with your doctor, even if you are using drugs that are not prescribable.
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".
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.
Your comment reminded me that a few years ago a Microsoft engineer stabbed a random guy on campus, and afterword it was discovered he had a public journal of his own drug habits
This isn’t true for everyone. I have witnessed people whose curves are more gradual. Their performance exceeded mine and the gap increased with increasing duration. The principal difference I’d say is task focus. After many hours my attention falters, but I know people whose attention diminishes more gradually.
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.
Funny how all of this changes with agentic development - once you setup your agents and the initial productivity euphoria , most of the time you spend in deep brainstorming and leave agents to “handle the details”.
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
That’s for maxxed out knowledge work. Most of running a business is simply doing mid grade knowledge/admin/management work in a responsible, cares-about-the-outcome aligned fashion, which you don’t get from some $50k/y admin person or middle manager.
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.
I have been solving this by automating anything that is done more than once. Automation can mean building a micro app or building out a prompt that can be reused later or something in between. More work up front but easier to motivate myself when I know that next time the chore takes a few mins of input and output validation
", but working 4 hours a day 3-5 (max) days a week will actually achieve peak results in my experience."
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.
> This is so wild to me because output and work quality rapidly decline at (or well before) 40 hours a week.
I see this comment regularly here. There are lots of people who can and do work for much more than 40 hours a week, and these are productive hours. Also, it is a sliding scale of productivity. It's not like hour 41 is 100% unproductive. However, I do appreciate that most normies are probably more productive if they work less than 40 hours a week, but make those hours very focused.
I am yet to see such a person rawdog it without any performance enhancing substance or "winding down" in unhealthy ways without becoming severely depressed in the process.
I mean maybe a bit of a controversial opinion but this is how I hide at my desk job to try to build my own stuff. Like I give 3-4h of focused work to my employer and 6to myself every day. Some days I need to work more for work some I can do more stuff for myself.
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.
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.
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.
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.
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.
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.
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.
Probably no surprise some (Western) European countries allow you going to the GP, telling you are exhausted/burned-out/anxious, whatever fits the extreme fatigue, and you get some time of commonly agreed off, prescribed, paid. Everyone is better off that way (except the manufacturers of stimulants. Coffee excluded here! :-) ). Also, overtime is not a trend. Preserved for exceptional circumstances, for a brief period that an otherwise balanced person can handle. Europe is economically uncompetitive, the rest of the world makes circles around it performance and money-wise, also many abuse the system, still, without people a society is nothing, economy alone is crap if it is not for the people, as much people as possible so the streets are not crawling with too much crazy. We need to have a life first. Most of my European friends would never think of living in the US or Asia prolonged, only for an energetic period to boost some aspects (financial, experience, knowledge), mostly when they are young (but not with children, no!). Those places are not liveable from a European perspective.
Depending on where you work, in Europe it can be just as bad. It doesn't matter whether Europe is economically uncompetitive (is it?), if the people themselves think they have to compete and become deprived of time and energy then they will burn out regardless. I see it happening left and right lately.
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.
> 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.
Pretty wild how common it really is. In places you wouldn't expect. I started working night shift in a warehouse when I was in my 20s, and got to know a couple of the funny yet seemingly regular guys. I asked them for advice on how to adjust to the graveyard shift. They said you gotta stay up on weekends, keep the same nightshift schedule, no exceptions. "Come out with us for a few beer sometime."
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.
I have made it abundantly clear to partners & employees health comes first, made sure they have access to a health plan, and made sure they can actually get appointments with providers. In fact that stance is probably the only reason we’re still in business and they’ve been loyal through some rough patches.
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 run sometimes in a “party” crowd and see the same thing from the other side. People take drugs on the weekend, and a benzo to come down from it, and soon find themselves hooked just on the benzo.
Is it possible you have the cause and effect backwards? These people could have highly addictive personalities and were just switching from one drug to another and it’s not the actual drug that’s the issue.
Take the adderall and benzodiazepines out of the equation and they might just as well be using cocaine and barbiturates.
Barbiturate withdrawal can absolutely kill you, as it is the same process of benzodiazepines and alcohol withdrawals. The other issue is that barbiturates themselves can easily kill you due their MOA, and low therapeutic index
There's approximately three possibilities that could lead to you believing that. Either you haven't formed close relationships with such people (unlikely), you lack the awareness to realize who they are, or you are one yourself and lack the self awareness to recognize the patterns.
Obviously some people get addiction problems, and obviously some people are more vulnerable to develop them than others, but I can understand the reluctance to ascribe that to their personality.
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.
I cycled modafinil/adrafinil and caffeine. For me it was a much stronger focus effect than caffeine and a much weaker effect than amphetamine. However, I developed an intense case of the hives after use which occasionally (1/2y) recurs without use with no prior history. This is not an uncommon side effect according to the doctor who I reported this to.
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.
Modafinil is basically nothing compared to other drugs. Like you will go a longer time before feeling sleepy but it's not even on the level of caffeine for stimulation. It doesn't give you much of any wired feeling, you just are less tired when you normally would be.
For many people, modafinil stops being effective as a performance enhancer pretty quickly (days to weeks of daily usage), and withdrawal is basically a few days of excessive sleepiness, so most people don't have an issue with it. Narcoleptics take it for years, mostly without issue, so it has a decent safety profile.
Oh so that’s how people turn into drug addicts? So simple solution is not to go for a “drug” fix, performance enhancer, but to just accept that you just “can’t” and figure out a way to not burn out. Seems insane to me that there is 2 roads - one to never be a drug addict, second one is to have an extremely high chance turning into a drug addict.
What am I missing?
Well most people don't actually turn into addicts, it's just the people that do, that's how they start. Lots more people use stimulants and benzos occasionally without crossing into an addiction threshold.
this thread discusses drugs of addiction that are prescribed en masse especially in north america. so a great imaginative starting point would be to imagine being told you must consume a hard drug to cure a condition that is inherently part of you. after a while you develop a tolerance to those drugs you have been taught are your savior. then you need more drugs to achieve the same feeling you were taught is 'normal'. could you begin to see how that might feel, and how the system could possibly be seen to push people to the brink due to systematic indifference in favor of systematic interests?
Oh god, the jolts. They are horrible. They seem to get worse with screens and fluorescent office lights. The only thing that helps is going for a walk and necking some alcohol, which in turn, wrecks the sleep needed to actually fix them.
It's almost like having some sort of momentary seizure.
> The gates to hell are finally opened once a benzo is prescribed ... The amount of DGAF/YOLO these drugs give the user are very understated
... 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.
Thanks for the share. I really like these first hand accounts on HN.
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?
Parent post uses the word "doctor" throughout. People with serious addiction problems are getting their drugs elsewhere, usually from people who make money by selling them more drugs.
I'm not regularly taking them more than once a week, which is more than enough time for it to get out of my system completely. Risky profile appears to be when it's in your bloodstream for several weeks.
> Having kicked opiates cold turkey in the past, I felt nostalgic for three simple days of traditional nausea, sweatiness, and bone-deep ache.
I am one of few people stupid enough to have, at one point, been addicted to and subsequently withdrawn from, almost everything but alcohol.
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.
I did everything under the sun, got sober, did klonopin for a bit to help with anxiety and was lucky -blessedly lucky that it didn't do too much for me.
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.
It sounds a fantastic claim, but I'll read up a bit on it so thanks.
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.
I was on Ativan for acute trauma avoidance (to try to prevent PTSD) for about 6 weeks. I hate taking medicating and stopped it cold turkey. It took me another 3 weeks or so to feel "normal" again and the withdrawal period was so phenomenally physically uncomfortable and panic-inducing that I will never take it again for any reason. I spent most of that time thinking I was going to die. In the long run, I guess it helped with PTSD avoidance (which seems to be one of the things they do now), but even just thinking back to those few weeks makes my skin crawl.
14 months. (Usually) not every day, maybe 3-4 times a week. And 8 months to taper off. How long it takes to taper depends on the level of discomfort you’re willing to tolerate.
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.
About a decade ago, my doctor prescribed me Klonopin for sleepwalking. 0.5mg daily.
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'm convinced a small percent of people get addicted to anything much more easily. Ive enjoyed various things but it's like meh- though Ativan is fucking amazing (but only for fear of flying). I think it is a brain reward structure thing; I get bored very easily and i guess it takes a decent amount of danger or effort to get me very interested.
I think that's a common impression. Interestingly, while there are still a lot of questions marks around what makes someone predisposed to addiction, the few things we do know tend to run counter to the idea that people dealing with addiction are overly sensitive to feelings of reward and pleasure. Or that being less sensitive would make someone more resistant.
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.
It seems like Jordan Petersen really permanently messed himself up trying to shorten the timeline of getting off prescription benzos in a dangerous way.
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.
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 appreciate the bravery of you and others in this thread, sharing details of really horrible - and at the time likely very shameful experiences.
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. :)
How are you feeling now, and how well does your brain recover from these things? I always wonder whether these kind of things have some lasting effect on, say, your ability to focus.
Happy to say I'm in a much better place now. Recovery was/is hard, but therapy, meditation, sleep, and exercise -- plus boring old antidepressants -- keep me on much more stable ground. Also family: I have kids now, and being there for them and my wife is a bigger source of motivation than taking care of myself a good portion of the time.
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.
> before I realized that doctors would and did prescribe me meds that were actively harmful in the interest of short-term comfort
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!"
To give a different point of view: I've been taking Bromazepam for 25 years, but very occasionally when I'm very anxious or can't sleep, a few times a year, never more than 1-2 days in a row. It's been helpful, especially when I was younger as sometimes I was paralyzed by anxiety. I never had the slightest sign of addiction but was also careful not to rely on that too much (and never had any addiction problem).
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.
Seconding your experience. Used on an occasional basis, benzos can be helpful without resulting in the horror stories related here. Of course, everyone is different and YMMV, but confirming that your positive experience is not unique.
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.
>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.
No one questions if they're helpful. But the danger and the severity needs to be more commonly known.
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.
My involvement in inpatient drug abuse clinics has been benzo addiction is one of the hardest to treat and accounted for nearly half the patients, the rest split between alcohol and opioids, even during the height of the oxy crisis. It’s much less reported on because it’s widely prescribed and it’s nearly impossible to OD on. The effects aren’t as dramatic as alcohol, but are no less debilitating. Furthermore because benzos and alcohol have similar pathways they are often abused together and they amplify each others effect. You can satisfy the addiction with either - so people withdrawing from alcohol are often given benzos and people addicted to benzos often drink to relieve their addiction. People describe klonopin and similar long lasting benzos as a six pack that lasts 18 hours - which is a long time to have than level of declined inhibition. This further leads to more drinking, but also to other out of character behavior like overspending - some patients have bankrupted their families through excessive and bizarre spending.
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.
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 also take it on as needed basis. .5 mg clonzepam before bed. Sometime I’d take 2 if the day has been especially rough and I need a good night sleep. It mostly help with falling asleep and feeling more centered the day after.
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?
Some people are wired for addiction and some aren't. I knew a guy who did heroin or cocaine a few times a year when he felt like it and never got addicted. I also quickly lose interest in alcohol or marijuana but I can't stop eating sweets no matter how hard I try...
> according to the most recent study estimating total benzodiazepine use among Americans, which analyzed data from 2015 and 2016, an estimated 30.6 million American adults had taken benzodiazepines in the previous twelve months, with 25.3 million of them using them as prescribed.
I've been on fairly low dose Klonopin for about fifteen years due to persistent insomnia (I work in a black room with no windows, and hence no circadian rhythm).
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.
I helped my mother go through this after her psych decided it was time for her to cold turkey a 4x a day xanax prescription she'd been taking for 20+ years. 5 total ER trips, 3 separate hospitalizations, and a full year of absolute misery before she started getting some relief. A YEAR.
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 take Xanax when I fly. I have a prescription for a whopping 10 pills, and it usually lasts me three months. It does exactly what it's supposed to. "Banned, Period" is assuming your experience justifies taking everyone else's away, and those of us using them responsibly benefit quite a bit. 4x a day is also over recommended dosages, depending on strength - so that's more on the doctor than the drug.
People who have been taking benzos for decades with no dose escalation should be left alone. Most people develop tolerance quickly to the sedative and hypnotic and anti-convulsive effects. But not everybody develops tolerance to its anxiolytic effect, and few legitimate patients abuse the things for fun, despite what the recent zeitgeist and sob/horror stories would like us to believe.
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).
This sort of panic about people who have been on a controlled dose for long periods of time or just straight up panic discontinuations of doses is the same crap that exacerbates opioid problems too. Too many stories from family members about their loved ones who were prescribed high doses of ${addictive drug} and then suddenly some other doctor (or sometimes the same doctor) suddenly decides this was all a mistake and cuts them off completely. Soon those family members who maybe did need to come down from where they were are seeking illicit sources of their drug. And it's near impossible to get out from under a doctor if you do think they're overprescribing because of just this.
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'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 need the occasional benzo (midazolam) as a rescue medicine for my seizures a few times a year. Banning these things just makes it harder for people who actually need these life saving medicines. Most epilepsy drugs, including non-benzo, are strictly scheduled and it makes my life hell. It is very hard to get these medicines sometimes because of these rules (fuck the DEA, and your opinion), seizures can be lethal, especially compounded with withdrawal.
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.
I've been on a very long journey with mental health for many years now. It's astonishing the number of doctors who see any hint of mental health issues and then immediately claim you must be catastrophizing your symptoms. I've had a number of issues related to my ears/nose/throat, the worst being an inability to deal with pressure changes (without excruciating ER-inducing pain). The first ENT I went to walked in, scanned my file, made a small comment about my mental health issues, and then proceeded to explain there was nothing wrong with me and it was all in my head.
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 was on low-dose Ativan for a few weeks casually prescribed for anxiety. What followed is an absolute year of hell. The most unimaginably difficult time in my life. Usually they tell you that short-term low dose poses lower risk or protracted withdrawal, but it's not a purely statistical risk. There are potentially pharmacological, physiological, and other factors that govern how these drugs affect each individual and those are largely unknowable.
I was on oxycoton (among other things) for pain relief after heart surgery, and during recovery. That lasted about a month -I was worried because of my history of substance abuse but I think between being aware of that and knowing they would not be available later gave me the will power (if you can call it that) to taper off of them without much fuss.
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.
I was prescribed diazepam and it was an important part of my healing when I suffered a back injury. The doctor prescribed the 'holy trinity' for severe back pain: diclofenac for anti inflammatory, cocodamol for pain and diazepam to control muscle spasms and help me sleep. It worked like magic.
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.
It's not even an "other epidemic" - a very large proportion of opiate/opiod "overdoses" are due to taking them with benzos. At least 3/4 of overdoses I've personally witnessed involved both opiods and benzos.
Yeah, after witnessing a friend's troubles getting off theirs I wouldnt wish it upon anyone.
It convinced me to get me off my own Clonazepam PRN prescription, which thankfully was rather infrequent and had minimal issues weaning off of.
The psych had told me nothing of the nightmare that dependence on those meds can create, a situation somehow far worse than that which they're often prescribed to resolve.
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 mean, it says it right on the sheet you get with the medication
"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 psych had told me nothing of the nightmare that dependence on those meds can create"
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.
They're dealing with neurotic (not being judgment, these are a powerful class of drugs) people. Like lines of code, (saying) less is more. "oh by the way, some people get how's
hooked on them and it really sucks to get off them". then the patient doesn't take them and get the relief from the problem they saw the psychiatrist for. Any responsible psychiatrist is well aware of the problem and going to get their patient past their current crisis first, and then not give them a script for 18 months for the patient to build an addiction. Unfortunately, not all psychiatrists will do that.
Yeah, that’s a classic dilemma doctors have to face. Even my gastroenterologist stopped giving me details as soon as she convinced herself my issues were due to anxiety (they were not, but that’s another story).
My high school years were plagued by anxiety. My cousin knew a psychiatrist and convinced my family to at least see what he had to say. After diagnosing me, the doctor prescribed lorazepam and an SSRI. According to the doctor, it was just like having a small cold and would eventually go away after a while. At his office, he also told me that lorazepam should only be taken as needed because it can lead to psychological dependence.
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.
Benzodiazepines are really gnarly stuff. Like alcohol, withdrawal from a benzodiazepine can be fatal. IIRC, some post-acute withdrawal symptoms can last indefinitely for some people. Benzos have their utility but they can be really, really awful stuff to become dependent upon.
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.
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.
Funny, I tried beta blockers before xanax for flying. They didn't seem to do anything, and the xanax I take a dozen times a year works wonders. Everyone's different.
Curious if anyone with epilepsy has experienced this. Dosing can be a bit heavier. Ativan had terrible withdrawal for me.
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.
I had a strong reaction to Covid and that was the only time in my life I ever took what you might call mine drugs. I took Ativan for a while, but I read up on it and I was very careful not to take larger amounts. I was cutting the pills and halves or quarters and just using them for some mild relief, but I did have severe anxiety for a while. I think there could be a place for them but unfortunately, the way drug companies are they allow people to get too much and they profit from the addiction.
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
The only cure for anxiety is, ultimately deconditioning.Meds definitely can help smoothen that process , but that needs to be addressed carefully, as PRN /SOS will reinforce the maladaptive conditioning. Ultimately the simplest analogy is to not respond to the false fire alarm - and the brain eventually stops treating it as emergency. Easier said than done , but that’s the hard facts. Most suffer from Somatic symptoms, but keep the noise peripheral, never central- by returning to whatever you are doing, however badly. As for anxiolytics- Fixed time dosing for a finite period prevents maladaptive conditioning and makes exposure therapeutic. Ultimately, for a panic attack emergency- creating a threshold rule is better, and even then hydroxyzine like antihistamines serve better than to messing with Benzos.
Agree. It’s radical exposure to the anxiety and trigger, and full acceptance of every feeling and symptom it brings, that’s the only true way out. The issue I myself encounter is that if one has built up enough anxiety over a long time, there is soo much to be processed, that the exposure and radical acceptance process requires a lot of time and deliberate action (even if action only means sitting with it). Possibly weeks or longer. Hard to find that time.
Remember David Nutt suggesting his own heavily branded benzos as a "replacement" for alcohol?
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.
Which benzos was he peddling? I don’t recall that.
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, but 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 in my book is that he seems to have expected politicians to listen to reason.
I was on klonopin for years but apparently not at those levels. It was by far the most effective anti anxiety med I had found. I feel like I dodged a bullet: my prescribing psychiatrist (requires) never mentioned the symptoms described by OP. Ironically after being off it for over 10 years my life has taken a turn that has made me want to go back on it. But I will absolutely be sharing this story with my Rx. Yikes.
I had a friend who got hooked on these and it really messed up his life. He had issues before but one he was hooked to those he became unbearable to even be around.
doesn't seem like great advice to take someone who is "feeling unstable" off a decade plus of benzodiazepine therapy to make them more stable. also, that was probably too aggressive of a taper for that long of use.
There is such a thing as too much of a good thing. These pharmaceuticals were originally based off valerian root, which works too, and is cheaper, and easy to obtain. You can always try going back to the roots. I find it helps me sleep every now and then.
A pill of Valerian is enough to make it hard for me to wake up after eight hours of sleep. I can’t imagine how powerful benzos are or what he’ll are the people taking them going through
I'm not a big believer in valerian, based on my experience. It's certainly not a stand-in when it comes to treating panic attacks. For sleep, it could work but I generally tend to prefer melatonin.
The prescription of benzos to help with things like sleep is wild to me. There are certainly use cases where they are extremely helpful but just like anything the lack of nuance is where things get shitty.
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.
This also just reminds me of the sensible things to ask your doctor when they try to prescribe a drug. Can I simply stop taking this drug? For two people I know in the last year this would have been a nice question to ask.
I just saw a YouTube video about a Soviet era benzo that became somewhat popular in the West as a research chemical. It really sounds like a nightmare:
Jordan Peterson has talked at length about his issues with benzodiazepine withdrawals. I know he is a controversial figure, but I wouldn’t wish that on anyone.
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.
I've always found it wild that governments are happy to dish out benzos to the populace. I'm quite liberal when it comes to drugs, but don't really like the idea of trusted medical professionals handing out shit to the general population. Powerful drugs should be difficult to get :/
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'm not sure if it's just the US and Canada, but doctors here (in my experience) are absolutely atrocious and not properly trained when it comes to getting off benzos (but in fairness my experience was from the mid/late 00s).
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.
I’ve seen a few friends and coworkers go down this path, usually as a result of work stress or hustle culture. They start on neutropics and energy drinks, then get scripts for Adderall or Vyvanse to handle the perceived insurmountable workload, stabilize on those after an initial euphoria, then build up a heroic tolerance to (dextro|meth)amphetamines. Withdrawals from that high level of addiction leads to anxiety, insomnia, delusions, mania and all sorts of craziness (I suspect the lack of sleep is the culprit).
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!!!
> handle the perceived insurmountable workload
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.
I work on hardware development, that matches pretty well the time I can spend on high-creativity design tasks. I fill the rest of the time with tasks that could be outsourced, like assembling prototypes or laying out circuit boards, but I do myself because they are more like relaxing puzzles than demanding work.
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.
> It sounds like a joke, but I probably have 4 good hours in me a day
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.
Some people moonlight other gigs (overemployed) and put unusually high levels of pressure to perform in themselves. So, 2/3x-ing that normal output is unsustainable but profitable. Context switching does take a toll when you’re putting out fires that have meetings attached. This was just an anecdotal example of a person who is running themselves into the ground. Startup culture of the 2010s fostered a lot of the myths of ultra-productivity and wealth without the backstory of drug abuse.
Why don't more people talk/blog about their drug (ab)use? As a parallel, there has been a generational change in body building where performance enhancing drug users are now much more open about it. Even a few years ago, it was a widely known secret, but almost no one talked about it publicly. For the most part, the stars in the industry have been responsible about how they share the info. They spend plenty of time telling you horror stories and negative side effects. And they stress that you need to build a plan with your doctor, even if you are using drugs that are not prescribable.
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".
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.
Your comment reminded me that a few years ago a Microsoft engineer stabbed a random guy on campus, and afterword it was discovered he had a public journal of his own drug habits
https://web.archive.org/web/20230224010752/https://josephcan...
This isn’t true for everyone. I have witnessed people whose curves are more gradual. Their performance exceeded mine and the gap increased with increasing duration. The principal difference I’d say is task focus. After many hours my attention falters, but I know people whose attention diminishes more gradually.
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.
[delayed]
Funny how all of this changes with agentic development - once you setup your agents and the initial productivity euphoria , most of the time you spend in deep brainstorming and leave agents to “handle the details”.
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
100% correct and this resembles my experiences and countless anecdotes.
You can’t reliably do more than 5 hours of heavy concentration work per day.
That’s for maxxed out knowledge work. Most of running a business is simply doing mid grade knowledge/admin/management work in a responsible, cares-about-the-outcome aligned fashion, which you don’t get from some $50k/y admin person or middle manager.
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.
We like to talk about startups here cos it's HN but when I watch the news it's clear that world leaders clearly don't work 40 hour weeks.
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"
Well said.
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.
I have been solving this by automating anything that is done more than once. Automation can mean building a micro app or building out a prompt that can be reused later or something in between. More work up front but easier to motivate myself when I know that next time the chore takes a few mins of input and output validation
", but working 4 hours a day 3-5 (max) days a week will actually achieve peak results in my experience."
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.
Organizations get in their own way when it comes to quality, almost every time.
I am yet to see such a person rawdog it without any performance enhancing substance or "winding down" in unhealthy ways without becoming severely depressed in the process.
I mean maybe a bit of a controversial opinion but this is how I hide at my desk job to try to build my own stuff. Like I give 3-4h of focused work to my employer and 6to myself every day. Some days I need to work more for work some I can do more stuff for myself.
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.
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.
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.
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
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.
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.
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.
The problem is it's hard to realize that is indeed the case.
Probably no surprise some (Western) European countries allow you going to the GP, telling you are exhausted/burned-out/anxious, whatever fits the extreme fatigue, and you get some time of commonly agreed off, prescribed, paid. Everyone is better off that way (except the manufacturers of stimulants. Coffee excluded here! :-) ). Also, overtime is not a trend. Preserved for exceptional circumstances, for a brief period that an otherwise balanced person can handle. Europe is economically uncompetitive, the rest of the world makes circles around it performance and money-wise, also many abuse the system, still, without people a society is nothing, economy alone is crap if it is not for the people, as much people as possible so the streets are not crawling with too much crazy. We need to have a life first. Most of my European friends would never think of living in the US or Asia prolonged, only for an energetic period to boost some aspects (financial, experience, knowledge), mostly when they are young (but not with children, no!). Those places are not liveable from a European perspective.
Depending on where you work, in Europe it can be just as bad. It doesn't matter whether Europe is economically uncompetitive (is it?), if the people themselves think they have to compete and become deprived of time and energy then they will burn out regardless. I see it happening left and right lately.
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.
> Europe is economically uncompetitive
Meh. It's competetive enough.
> 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.
Agreed.
^this
Pretty wild how common it really is. In places you wouldn't expect. I started working night shift in a warehouse when I was in my 20s, and got to know a couple of the funny yet seemingly regular guys. I asked them for advice on how to adjust to the graveyard shift. They said you gotta stay up on weekends, keep the same nightshift schedule, no exceptions. "Come out with us for a few beer sometime."
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.
I have made it abundantly clear to partners & employees health comes first, made sure they have access to a health plan, and made sure they can actually get appointments with providers. In fact that stance is probably the only reason we’re still in business and they’ve been loyal through some rough patches.
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.
A pub in Britain? Yeah, pretty much everyone is on the bag
New West, Vancouver, Canada, so same deal pretty much. As I found out
I run sometimes in a “party” crowd and see the same thing from the other side. People take drugs on the weekend, and a benzo to come down from it, and soon find themselves hooked just on the benzo.
Is it possible you have the cause and effect backwards? These people could have highly addictive personalities and were just switching from one drug to another and it’s not the actual drug that’s the issue.
Take the adderall and benzodiazepines out of the equation and they might just as well be using cocaine and barbiturates.
Barbituate withdrawal won’t kill you.
Benzodiazepines, and alcohol, can actually induce death if you withdraw too quickly
Barbiturate withdrawal can absolutely kill you, as it is the same process of benzodiazepines and alcohol withdrawals. The other issue is that barbiturates themselves can easily kill you due their MOA, and low therapeutic index
There is no such thing as an addictive personality.
There's approximately three possibilities that could lead to you believing that. Either you haven't formed close relationships with such people (unlikely), you lack the awareness to realize who they are, or you are one yourself and lack the self awareness to recognize the patterns.
Obviously some people get addiction problems, and obviously some people are more vulnerable to develop them than others, but I can understand the reluctance to ascribe that to their personality.
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.
What are you seeing with Modafinil (Provigil)? It seems to be popular among the same crowd.
I cycled modafinil/adrafinil and caffeine. For me it was a much stronger focus effect than caffeine and a much weaker effect than amphetamine. However, I developed an intense case of the hives after use which occasionally (1/2y) recurs without use with no prior history. This is not an uncommon side effect according to the doctor who I reported this to.
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.
Modafinil is basically nothing compared to other drugs. Like you will go a longer time before feeling sleepy but it's not even on the level of caffeine for stimulation. It doesn't give you much of any wired feeling, you just are less tired when you normally would be.
For many people, modafinil stops being effective as a performance enhancer pretty quickly (days to weeks of daily usage), and withdrawal is basically a few days of excessive sleepiness, so most people don't have an issue with it. Narcoleptics take it for years, mostly without issue, so it has a decent safety profile.
Oh so that’s how people turn into drug addicts? So simple solution is not to go for a “drug” fix, performance enhancer, but to just accept that you just “can’t” and figure out a way to not burn out. Seems insane to me that there is 2 roads - one to never be a drug addict, second one is to have an extremely high chance turning into a drug addict. What am I missing?
Well most people don't actually turn into addicts, it's just the people that do, that's how they start. Lots more people use stimulants and benzos occasionally without crossing into an addiction threshold.
this thread discusses drugs of addiction that are prescribed en masse especially in north america. so a great imaginative starting point would be to imagine being told you must consume a hard drug to cure a condition that is inherently part of you. after a while you develop a tolerance to those drugs you have been taught are your savior. then you need more drugs to achieve the same feeling you were taught is 'normal'. could you begin to see how that might feel, and how the system could possibly be seen to push people to the brink due to systematic indifference in favor of systematic interests?
I don't know why this reminded me of that Palantir guy.
Oh god, the jolts. They are horrible. They seem to get worse with screens and fluorescent office lights. The only thing that helps is going for a walk and necking some alcohol, which in turn, wrecks the sleep needed to actually fix them.
It's almost like having some sort of momentary seizure.
> The gates to hell are finally opened once a benzo is prescribed ... The amount of DGAF/YOLO these drugs give the user are very understated
... 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.
Thanks for the share. I really like these first hand accounts on HN.
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?
Parent post uses the word "doctor" throughout. People with serious addiction problems are getting their drugs elsewhere, usually from people who make money by selling them more drugs.
I'm not regularly taking them more than once a week, which is more than enough time for it to get out of my system completely. Risky profile appears to be when it's in your bloodstream for several weeks.
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.
I did everything under the sun, got sober, did klonopin for a bit to help with anxiety and was lucky -blessedly lucky that it didn't do too much for me.
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.
Lavender extract is about as effective as klonopin according to a study.
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.
It sounds a fantastic claim, but I'll read up a bit on it so thanks.
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.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12500767/ - this is the study the GP is talking about.
Also: https://pubmed.ncbi.nlm.nih.gov/19962288/
FYI: CalmAid a brand name for Silexan, and Ativan is a brand name for Lorazepam.I was on Ativan for acute trauma avoidance (to try to prevent PTSD) for about 6 weeks. I hate taking medicating and stopped it cold turkey. It took me another 3 weeks or so to feel "normal" again and the withdrawal period was so phenomenally physically uncomfortable and panic-inducing that I will never take it again for any reason. I spent most of that time thinking I was going to die. In the long run, I guess it helped with PTSD avoidance (which seems to be one of the things they do now), but even just thinking back to those few weeks makes my skin crawl.
> weeks/months rather than days.
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.
how long were you taking them?
14 months. (Usually) not every day, maybe 3-4 times a week. And 8 months to taper off. How long it takes to taper depends on the level of discomfort you’re willing to tolerate.
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
> Diazepam half life is so long
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.
About a decade ago, my doctor prescribed me Klonopin for sleepwalking. 0.5mg daily.
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.
Just curious, why not alcohol? With it being so common and easy to get...
I'm convinced a small percent of people get addicted to anything much more easily. Ive enjoyed various things but it's like meh- though Ativan is fucking amazing (but only for fear of flying). I think it is a brain reward structure thing; I get bored very easily and i guess it takes a decent amount of danger or effort to get me very interested.
I think that's a common impression. Interestingly, while there are still a lot of questions marks around what makes someone predisposed to addiction, the few things we do know tend to run counter to the idea that people dealing with addiction are overly sensitive to feelings of reward and pleasure. Or that being less sensitive would make someone more resistant.
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.
It seems like Jordan Petersen really permanently messed himself up trying to shorten the timeline of getting off prescription benzos in a dangerous way.
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.
Fun story time:
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 appreciate the bravery of you and others in this thread, sharing details of really horrible - and at the time likely very shameful experiences.
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.
Thank you for the kind words.
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. :)
How are you feeling now, and how well does your brain recover from these things? I always wonder whether these kind of things have some lasting effect on, say, your ability to focus.
Happy to say I'm in a much better place now. Recovery was/is hard, but therapy, meditation, sleep, and exercise -- plus boring old antidepressants -- keep me on much more stable ground. Also family: I have kids now, and being there for them and my wife is a bigger source of motivation than taking care of myself a good portion of the time.
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.
> before I realized that doctors would and did prescribe me meds that were actively harmful in the interest of short-term comfort
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!"
To give a different point of view: I've been taking Bromazepam for 25 years, but very occasionally when I'm very anxious or can't sleep, a few times a year, never more than 1-2 days in a row. It's been helpful, especially when I was younger as sometimes I was paralyzed by anxiety. I never had the slightest sign of addiction but was also careful not to rely on that too much (and never had any addiction problem).
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.
Seconding your experience. Used on an occasional basis, benzos can be helpful without resulting in the horror stories related here. Of course, everyone is different and YMMV, but confirming that your positive experience is not unique.
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.
>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.
No one questions if they're helpful. But the danger and the severity needs to be more commonly known.
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.
My involvement in inpatient drug abuse clinics has been benzo addiction is one of the hardest to treat and accounted for nearly half the patients, the rest split between alcohol and opioids, even during the height of the oxy crisis. It’s much less reported on because it’s widely prescribed and it’s nearly impossible to OD on. The effects aren’t as dramatic as alcohol, but are no less debilitating. Furthermore because benzos and alcohol have similar pathways they are often abused together and they amplify each others effect. You can satisfy the addiction with either - so people withdrawing from alcohol are often given benzos and people addicted to benzos often drink to relieve their addiction. People describe klonopin and similar long lasting benzos as a six pack that lasts 18 hours - which is a long time to have than level of declined inhibition. This further leads to more drinking, but also to other out of character behavior like overspending - some patients have bankrupted their families through excessive and bizarre spending.
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.
> a few times a year, never more than 1-2 days in a row
It takes at least a few weeks to a few months of daily use to develop dependence.
I also take it on as needed basis. .5 mg clonzepam before bed. Sometime I’d take 2 if the day has been especially rough and I need a good night sleep. It mostly help with falling asleep and feeling more centered the day after.
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?
Some people are wired for addiction and some aren't. I knew a guy who did heroin or cocaine a few times a year when he felt like it and never got addicted. I also quickly lose interest in alcohol or marijuana but I can't stop eating sweets no matter how hard I try...
> according to the most recent study estimating total benzodiazepine use among Americans, which analyzed data from 2015 and 2016, an estimated 30.6 million American adults had taken benzodiazepines in the previous twelve months, with 25.3 million of them using them as prescribed.
That's much more than I would have expected
I've been on fairly low dose Klonopin for about fifteen years due to persistent insomnia (I work in a black room with no windows, and hence no circadian rhythm).
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.
I was given promethazine to help with sleep, an antihistamine with sedating properties.
Was told by the doctor it was a much safer alternative to most other treatments. Could be worth asking about.
Just for kicks, what do you do? Radiology?
Space robotics
Why does this need a black room with no windows?
Cool!
I helped my mother go through this after her psych decided it was time for her to cold turkey a 4x a day xanax prescription she'd been taking for 20+ years. 5 total ER trips, 3 separate hospitalizations, and a full year of absolute misery before she started getting some relief. A YEAR.
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 take Xanax when I fly. I have a prescription for a whopping 10 pills, and it usually lasts me three months. It does exactly what it's supposed to. "Banned, Period" is assuming your experience justifies taking everyone else's away, and those of us using them responsibly benefit quite a bit. 4x a day is also over recommended dosages, depending on strength - so that's more on the doctor than the drug.
People who have been taking benzos for decades with no dose escalation should be left alone. Most people develop tolerance quickly to the sedative and hypnotic and anti-convulsive effects. But not everybody develops tolerance to its anxiolytic effect, and few legitimate patients abuse the things for fun, despite what the recent zeitgeist and sob/horror stories would like us to believe.
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).
This sort of panic about people who have been on a controlled dose for long periods of time or just straight up panic discontinuations of doses is the same crap that exacerbates opioid problems too. Too many stories from family members about their loved ones who were prescribed high doses of ${addictive drug} and then suddenly some other doctor (or sometimes the same doctor) suddenly decides this was all a mistake and cuts them off completely. Soon those family members who maybe did need to come down from where they were are seeking illicit sources of their drug. And it's near impossible to get out from under a doctor if you do think they're overprescribing because of just this.
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".
>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).
I need the occasional benzo (midazolam) as a rescue medicine for my seizures a few times a year. Banning these things just makes it harder for people who actually need these life saving medicines. Most epilepsy drugs, including non-benzo, are strictly scheduled and it makes my life hell. It is very hard to get these medicines sometimes because of these rules (fuck the DEA, and your opinion), seizures can be lethal, especially compounded with withdrawal.
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 need to be banned. Period.
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.
How is forcing her to cold turkey that not malpractice?
I've been on a very long journey with mental health for many years now. It's astonishing the number of doctors who see any hint of mental health issues and then immediately claim you must be catastrophizing your symptoms. I've had a number of issues related to my ears/nose/throat, the worst being an inability to deal with pressure changes (without excruciating ER-inducing pain). The first ENT I went to walked in, scanned my file, made a small comment about my mental health issues, and then proceeded to explain there was nothing wrong with me and it was all in my head.
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 was on low-dose Ativan for a few weeks casually prescribed for anxiety. What followed is an absolute year of hell. The most unimaginably difficult time in my life. Usually they tell you that short-term low dose poses lower risk or protracted withdrawal, but it's not a purely statistical risk. There are potentially pharmacological, physiological, and other factors that govern how these drugs affect each individual and those are largely unknowable.
On the other hand I took Valium 5mg daily for 2 weeks, and had no issues getting off them.
There’s definitely a lot of factors
I was on oxycoton (among other things) for pain relief after heart surgery, and during recovery. That lasted about a month -I was worried because of my history of substance abuse but I think between being aware of that and knowing they would not be available later gave me the will power (if you can call it that) to taper off of them without much fuss.
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.
I was prescribed diazepam and it was an important part of my healing when I suffered a back injury. The doctor prescribed the 'holy trinity' for severe back pain: diclofenac for anti inflammatory, cocodamol for pain and diazepam to control muscle spasms and help me sleep. It worked like magic.
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.
It's not even an "other epidemic" - a very large proportion of opiate/opiod "overdoses" are due to taking them with benzos. At least 3/4 of overdoses I've personally witnessed involved both opiods and benzos.
Yeah, after witnessing a friend's troubles getting off theirs I wouldnt wish it upon anyone. It convinced me to get me off my own Clonazepam PRN prescription, which thankfully was rather infrequent and had minimal issues weaning off of. The psych had told me nothing of the nightmare that dependence on those meds can create, a situation somehow far worse than that which they're often prescribed to resolve.
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 mean, it says it right on the sheet you get with the medication
"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
"The psych had told me nothing of the nightmare that dependence on those meds can create"
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.
They're dealing with neurotic (not being judgment, these are a powerful class of drugs) people. Like lines of code, (saying) less is more. "oh by the way, some people get how's hooked on them and it really sucks to get off them". then the patient doesn't take them and get the relief from the problem they saw the psychiatrist for. Any responsible psychiatrist is well aware of the problem and going to get their patient past their current crisis first, and then not give them a script for 18 months for the patient to build an addiction. Unfortunately, not all psychiatrists will do that.
Yeah, that’s a classic dilemma doctors have to face. Even my gastroenterologist stopped giving me details as soon as she convinced herself my issues were due to anxiety (they were not, but that’s another story).
My high school years were plagued by anxiety. My cousin knew a psychiatrist and convinced my family to at least see what he had to say. After diagnosing me, the doctor prescribed lorazepam and an SSRI. According to the doctor, it was just like having a small cold and would eventually go away after a while. At his office, he also told me that lorazepam should only be taken as needed because it can lead to psychological dependence.
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.
Benzodiazepines are really gnarly stuff. Like alcohol, withdrawal from a benzodiazepine can be fatal. IIRC, some post-acute withdrawal symptoms can last indefinitely for some people. Benzos have their utility but they can be really, really awful stuff to become dependent upon.
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.
Funny, I tried beta blockers before xanax for flying. They didn't seem to do anything, and the xanax I take a dozen times a year works wonders. Everyone's different.
Indeed. Every drug has its non-responders and super-responders, it seems!
Curious if anyone with epilepsy has experienced this. Dosing can be a bit heavier. Ativan had terrible withdrawal for me.
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.
I had a strong reaction to Covid and that was the only time in my life I ever took what you might call mine drugs. I took Ativan for a while, but I read up on it and I was very careful not to take larger amounts. I was cutting the pills and halves or quarters and just using them for some mild relief, but I did have severe anxiety for a while. I think there could be a place for them but unfortunately, the way drug companies are they allow people to get too much and they profit from the addiction.
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
The only cure for anxiety is, ultimately deconditioning.Meds definitely can help smoothen that process , but that needs to be addressed carefully, as PRN /SOS will reinforce the maladaptive conditioning. Ultimately the simplest analogy is to not respond to the false fire alarm - and the brain eventually stops treating it as emergency. Easier said than done , but that’s the hard facts. Most suffer from Somatic symptoms, but keep the noise peripheral, never central- by returning to whatever you are doing, however badly. As for anxiolytics- Fixed time dosing for a finite period prevents maladaptive conditioning and makes exposure therapeutic. Ultimately, for a panic attack emergency- creating a threshold rule is better, and even then hydroxyzine like antihistamines serve better than to messing with Benzos.
Agree. It’s radical exposure to the anxiety and trigger, and full acceptance of every feeling and symptom it brings, that’s the only true way out. The issue I myself encounter is that if one has built up enough anxiety over a long time, there is soo much to be processed, that the exposure and radical acceptance process requires a lot of time and deliberate action (even if action only means sitting with it). Possibly weeks or longer. Hard to find that time.
Maybe some people respond very well to hydroxyzine but it would not be typical for it to stop a panic attack. It is very mild.
Remember David Nutt suggesting his own heavily branded benzos as a "replacement" for alcohol?
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.
Which benzos was he peddling? I don’t recall that.
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, but 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 in my book is that he seems to have expected politicians to listen to reason.
I was on klonopin for years but apparently not at those levels. It was by far the most effective anti anxiety med I had found. I feel like I dodged a bullet: my prescribing psychiatrist (requires) never mentioned the symptoms described by OP. Ironically after being off it for over 10 years my life has taken a turn that has made me want to go back on it. But I will absolutely be sharing this story with my Rx. Yikes.
Site seems down. Here's archive: https://archive.ph/Tb1SZ
When you are tapering down over MONTHS and you find yourself dividing the tiny tablets into 8ths, yeah that's a benzo.
I had a friend who got hooked on these and it really messed up his life. He had issues before but one he was hooked to those he became unbearable to even be around.
doesn't seem like great advice to take someone who is "feeling unstable" off a decade plus of benzodiazepine therapy to make them more stable. also, that was probably too aggressive of a taper for that long of use.
There is some evidence that Gabapentin can assist with benzodiazepine withdrawal https://ispub.com/IJPHARM/4/2/3283#
There is such a thing as too much of a good thing. These pharmaceuticals were originally based off valerian root, which works too, and is cheaper, and easy to obtain. You can always try going back to the roots. I find it helps me sleep every now and then.
A pill of Valerian is enough to make it hard for me to wake up after eight hours of sleep. I can’t imagine how powerful benzos are or what he’ll are the people taking them going through
I'm not a big believer in valerian, based on my experience. It's certainly not a stand-in when it comes to treating panic attacks. For sleep, it could work but I generally tend to prefer melatonin.
The prescription of benzos to help with things like sleep is wild to me. There are certainly use cases where they are extremely helpful but just like anything the lack of nuance is where things get shitty.
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.
This also just reminds me of the sensible things to ask your doctor when they try to prescribe a drug. Can I simply stop taking this drug? For two people I know in the last year this would have been a nice question to ask.
I just saw a YouTube video about a Soviet era benzo that became somewhat popular in the West as a research chemical. It really sounds like a nightmare:
https://youtu.be/CAm_L6CTnD4?is=o1UjxkDQwFloZ8VM
Dont jump on the cymbalta train. It is one of the harder ones to taper off and will make you miserable again.
I’d be super careful taking any drug which messes with your brain chemistry.
Jordan Peterson has talked at length about his issues with benzodiazepine withdrawals. I know he is a controversial figure, but I wouldn’t wish that on anyone.
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.
[1] https://youtu.be/_q44phEpFjA
I've always found it wild that governments are happy to dish out benzos to the populace. I'm quite liberal when it comes to drugs, but don't really like the idea of trusted medical professionals handing out shit to the general population. Powerful drugs should be difficult to get :/
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'm not sure if it's just the US and Canada, but doctors here (in my experience) are absolutely atrocious and not properly trained when it comes to getting off benzos (but in fairness my experience was from the mid/late 00s).
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.
Lithium Orotate for anxiety. You're welcome.