Posted by Elizabeth on June 25, 2001, at 3:30:29
In reply to Re: Addictive meds in general, posted by gilbert on June 22, 2001, at 10:30:37
Gil,
Like you, most people taking doses within the accepted therapeutic range can taper off benzos without suffering significant withdrawal symptoms. With appropriately cautious tapering, seizures are almost unheard of. The discontinuation process often has to be an extremely slow one, though, especially with short-acting benzos such as Xanax or if the person has been taking the benzos for a very long time.
I've encountered 12-steppers who express the sort of attitude you mention, that the use of benzodiazepines (or even, sometimes, of antidepressants!) jeopardises the sobriety of a recovering addict. Although addiction history should be considered, my own opinion is that alcoholism and other addictions should *never* be seen as absolute contraindications for the use of benzos in the treatment of anxiety disorders.
Although people who are currently abusing other drugs are the most likely to abuse prescribed benzos (otherwise, abuse is almost unheard of), many people originally *became* addicts (alcoholics in particular) when they realised that they could use drugs to "self-medicate" lifelong anxiety disorders. Denying these people BZDs may actually put them at *increased* risk of relapse. Such patients should be carefully monitored, of course, but benzos are extremely safe and effective for anxiety, while alcohol carries all sorts of health risks as well as the general risk of addiction associated with unmonitored self-medication.
SSRIs have been touted for anxiety disorders, but many anxiety patients find the side effects *very* hard to tolerate. Benzos, in contrast, are almost invariably well-tolerated. Personally I have never experienced any adverse side effects from my intermittent use of benzos or for the month or so that I took Klonopin daily.)
> I also have never wanted to take them to get high in fact I don't feel high at all from taking them...they just get rid of the panics and make me feel normal.
Same here. I have a hard time believing that *anyone* would find benzos a "high." I suspect that, more often, people who use unprescribed benzos are using them to stave off withdrawal symptoms from other drugs such as heroin and alcohol.
> Even though tolerance may appear after the initial dose most people can maintenace dose with the same amount year after year.
Tolerance to the anxiolytic effects is the exception, not the rule, with benzos. (People do grow tolerant to side effects like sedation, dizziness, and appetite stimulation, though.)
> I will tell you all drugs cause dependence at some level.
Yes, this is just what I was getting at ("physical" or "pharmacologic" dependence). Unfortunately, even many mental health professionals do not understand the difference. As a result, many non-drug-abusing anxiety patients are pressured to stop taking benzos, and some are even pushed into "rehab" programs where they don't belong at all!
> Even blood pressure drug removal causes rebound.
Very true. Clonidine, an antihypertensive often used for ADD-associated hyperactivity, is particularly notorious for this (something which child psychiatrists too often fail to mention to the parents!). People who take glucocorticoids (cortisol-like steroids such as prednisone, dexamethasone, etc.) can suffer severe, even fatal, withdrawal reactions if the drug is suddenly discontinued. And benzos and barbiturates aren't the only anticonvulsants that can cause rebound seizures; all anticonvulsants have this potential (which makes me rather concerned about the extremely liberal use of these drugs in off-label conditions).
> I have never thought wow why don't I take a bunch of xanax and go hang out downtown and party. They just don't feel or work that way. I have been able to take xanax and do things I was always afraid to do ....
I know exactly what you mean; buprenorphine is similar for me. When used responsibly, these two drugs (which generally have low potentials for abuse anyway) are, as you say, life-savers. There are many people out there like us who can function on a day-to-day basis because of these medications.
-elizabeth
poster:Elizabeth
thread:1356
URL: http://www.dr-bob.org/babble/20010618/msgs/67775.html