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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by rjlockhart on February 21, 2007, at 0:16:34
I take Xanax, responsibly. But i was wondering....there is a tendency to want to take more i think to get some sort of relaxing effect thats why its abused.
Opiates are abused for the poppy like high they give you.
Stimulnats promote euphoric mental energy.
Just asking...
Posted by yxibow on February 21, 2007, at 0:47:14
In reply to why are benzodiazpines abused? like opiates..., posted by rjlockhart on February 21, 2007, at 0:16:34
> I take Xanax, responsibly. But i was wondering....there is a tendency to want to take more i think to get some sort of relaxing effect thats why its abused.
>
> Opiates are abused for the poppy like high they give you.
>
> Stimulnats promote euphoric mental energy.
>
> Just asking...
Well we could argue about the general abuse of non-pharmaceuticals (e.g. meth) and pharmaceuticals.
I'm sure genetics plays a role (e.g. the Bush twins and Xanax) and Bush and his past alcoholism.
Let's direct politics elsewhere, purely an example....
And yes, Xanax has the most immediacy effect of all benzodiazepines except for Versed, which is largely IV (I think, is there an oral, I forget), and you don't really hear of Versed abuse, considering it would knock you out.
Its probably to get a euphoria -- there's nothing inherently wrong with euphoria; some psychiatrists would bristle at the concept, but if a medication is helping you and it happens to make you happy, so much the better. But its to get a greater euphoria-than-used-as-directed, primarily I would think. Xanax and Valium have street value which is why there is benzophobia among some doctors. You don't really hear much about Klonopin abuse.
But eventually it is self-limiting in the morbid sense -- enough Xanax and you're going to be approaching respiratory depression. Fortunately we have the lovely substance flumazenil which reverses if in time the effects of benzodiazepine abuse and overdose, but supportive care and the whole ordeal is far less than pleasant. At least it isn't barbiturates.
And the same escalation and habituation is something dealt with prescribed benzodiazepines, and we have to deal with backing off doses -- eventually it goes down. There's no real clinical "methadone" for benzodiazepines, its just prudent reduction.
-- tidings.
Posted by kelv on February 21, 2007, at 3:44:22
In reply to why are benzodiazpines abused? like opiates..., posted by rjlockhart on February 21, 2007, at 0:16:34
> I take Xanax, responsibly.
Me too~3mgs daily-thou Valium works better!
But i was wondering....there is a tendency to want to take more i think to get some sort of relaxing effect thats why its abused.
I'v just come out of detox, and a guy i befriended was a Doc shopper, he would get a months script of Halcion (Triazolam) 0.25mcg tabs and take half~14 tabs to sleep the day away and then the next, he had lots of Docs on the go and when had a supply of Zopliclone would do 15+ at once, this guy had Doc shopping down to a lifestyle.
He convinced a Doc in another country he had spinal problems, then came here-downunder-with the paper work, and was given ~6 30mg Oxycodone suppositories daily.
The only benzo i'd take recreationally would be Valium, and then it'd be well over 100mgs to do anything noticable.
>
> Opiates are abused for the poppy like high they give you.
>
> Stimulnats promote euphoric mental energy.
>
> Just asking...
Posted by Chairman_MAO on February 21, 2007, at 5:08:30
In reply to Re: why are benzodiazpines abused? like opiates... » rjlockhart, posted by yxibow on February 21, 2007, at 0:47:14
It is _impossible_ to achieve clinically significant respiratory depression with benzodiazepines alone.
This is the main reason why barbiturates are considered "obsolete" for most applications today.Benzodiazepine dependence/withdrawal can actually be worse than the barbiturates. Seizures have been reported up to two weeks after cessation of alprazolam; this does not happen, AFAIK, with the barbiturates.
Methamphetamine is a pharmaceutical drug, and has a higher therapeutic index than d-amphetamine.
Diazepam, AFAIK, is more lipophilic than alprazolam; I may be wrong about this but I believe that sublingual diazepam would kick in faster than subligual alprazolam.
Midazolam is in the same chemical class as alprazolam and triazolam, FWIW. The difference is more political than anything else, IMHO.
Posted by laima on February 21, 2007, at 6:55:02
In reply to why are benzodiazpines abused? like opiates..., posted by rjlockhart on February 21, 2007, at 0:16:34
In case of something like xanax, I think "abuse" happens if the person developes a tolerance, and then is quite desperate to get that same relaxing effect again, but requires more of the drug to do so. Or, a desire to "check out", a stress vacation of some sort.With stims, I think it has to do with chasing the euphoria which they can bring on. Or an attempt to lengthen the day to get more work done. Or, to counteract grogginess from having used too many benzos.
That's my opinion, anyway.
> I take Xanax, responsibly. But i was wondering....there is a tendency to want to take more i think to get some sort of relaxing effect thats why its abused.
>
> Opiates are abused for the poppy like high they give you.
>
> Stimulnats promote euphoric mental energy.
>
> Just asking...
Posted by laima on February 21, 2007, at 8:00:07
In reply to why are benzodiazpines abused? like opiates..., posted by rjlockhart on February 21, 2007, at 0:16:34
Well, I have a story as to how and why stims could be abused. Once upon a time, I saw a, how shall I say, "untalented" psychiatrist who had me on a very complicated and unhelpful regimine. Each week she stopped or started a new powerful med, such as effexor, with no tapering or mention of withdrawal. She wanted me to take about 8-10 meds at a time- no joke! I was very emotionally volotile and SEVERLY depressed. And I just stopped taking any of it. One day soon after, I thought, hmm, I have this bottle of ritalin- what would happen if I took a full handful? I couldn't be worse...so I did. And within a half hour I experienced euphoria. You can imagine how amazing that felt, what a relief it was! I went out and did all kinds of things: projects, books, all kinds of stuff. I felt great! Better than great! But every time it wore off, I took another handful to deal with the rebound depression-and finally a handful of klonopin to sleep. I knew this regimine wasn't a hot idea, but figured a couple days of relief was better than no relief. I thought I had no other hope to ever feel anything tolerable, so I went through an entire month supply of ritalin within about 2-3 days. I told her I lost the bottle several times, and she kept refilling it! I quickly developed a tolerance, and used even more. It was a mess, I was very unstable. When she finally cut me off, telling me I was an abuser, I really crashed. Doctors I met later were appalled by her treatments, and fully understood why I did what I did, though of course they disaproved. They put me on a much simpler regimine, and told me my depression was likely worsened by the complicated and unstable one she had me on. (Let's see, to be taken all together, a sample regimine would have included: prozac, zyprexa, neurontion, klonopin, efexor, wellbutrin, desipramine, ritalin, concerta.) They made me promise to run, not walk, from anyone who ever tried to prescribe to me this way in the future-no kidding!
I no longer have any desire to abuse stims - not worth it in any way. Not worth the extreme emotional instability, the rebound depression, and I am aware that my affect wasn't "normal". I avoided people because I knew I was acting oddly. A couple close friends told me later that I wasn't acting normally- I was jerky, jittery, and way too intense, way too busy, and speedy. (How embarressing.) I also know now that that sort of euphoria or level of activity isn't normal. I'm sure it was also dangerous, for heart, no doubt otherwise, too. Yes, like I said, not worth it, but it was so irressitable for awhile- I believed I had no other hope to ever feel anything other than very dark despair unless I did this, but fortunately I was wrong. I use a very small amount of adderall now, but haven't had any desire to abuse it-and it's working out very well. I also used reasonable amounts of ritalin shortly afte being restabilized, and it worked out alright, too. I think the key was that I was finally on a simple regimine that I understood and believed in, including a helpful antidepressent, and got a new doctor who I actually have faith in.
Posted by kelv on February 21, 2007, at 8:13:31
In reply to Re: why are stims abused?, posted by laima on February 21, 2007, at 8:00:07
> Well, I have a story as to how and why stims could be abused. Once upon a time, I saw a, how shall I say, "untalented" psychiatrist who had me on a very complicated and unhelpful regimine. Each week she stopped or started a new powerful med, such as effexor, with no tapering or mention of withdrawal. She wanted me to take about 8-10 meds at a time- no joke! I was very emotionally volotile and SEVERLY depressed. And I just stopped taking any of it. One day soon after, I thought, hmm, I have this bottle of ritalin- what would happen if I took a full handful? I couldn't be worse...so I did. And within a half hour I experienced euphoria. You can imagine how amazing that felt, what a relief it was! I went out and did all kinds of things: projects, books, all kinds of stuff. I felt great! Better than great! But every time it wore off, I took another handful to deal with the rebound depression-and finally a handful of klonopin to sleep. I knew this regimine wasn't a hot idea, but figured a couple days of relief was better than no relief. I thought I had no other hope to ever feel anything tolerable, so I went through an entire month supply of ritalin within about 2-3 days. I told her I lost the bottle several times, and she kept refilling it! I quickly developed a tolerance, and used even more. It was a mess, I was very unstable. When she finally cut me off, telling me I was an abuser, I really crashed. Doctors I met later were appalled by her treatments, and fully understood why I did what I did, though of course they disaproved. They put me on a much simpler regimine, and told me my depression was likely worsened by the complicated and unstable one she had me on. (Let's see, to be taken all together, a sample regimine would have included: prozac, zyprexa, neurontion, klonopin, efexor, wellbutrin, desipramine, ritalin, concerta.) They made me promise to run, not walk, from anyone who ever tried to prescribe to me this way in the future-no kidding!
>
> I no longer have any desire to abuse stims - not worth it in any way. Not worth the extreme emotional instability, the rebound depression, and I am aware that my affect wasn't "normal". I avoided people because I knew I was acting oddly. A couple close friends told me later that I wasn't acting normally- I was jerky, jittery, and way too intense, way too busy, and speedy. (How embarressing.) I also know now that that sort of euphoria or level of activity isn't normal. I'm sure it was also dangerous, for heart, no doubt otherwise, too. Yes, like I said, not worth it, but it was so irressitable for awhile- I believed I had no other hope to ever feel anything other than very dark despair unless I did this, but fortunately I was wrong. I use a very small amount of adderall now, but haven't had any desire to abuse it-and it's working out very well. I also used reasonable amounts of ritalin shortly afte being restabilized, and it worked out alright, too. I think the key was that I was finally on a simple regimine that I understood and believed in, including a helpful antidepressent, and got a new doctor who I actually have faith in.You must have taken a lot of Ritalin!
Kinda reminds me of Judy Garland who was taking~40 Ritalin tabs in 1968, vodka to conttrol the anxiety it caused, and instead of K, she took Seconal to sleep, which was to kill her.
Posted by yxibow on February 21, 2007, at 9:24:35
In reply to Re: why are benzodiazpines abused? like opiates... » yxibow, posted by Chairman_MAO on February 21, 2007, at 5:08:30
> It is _impossible_ to achieve clinically significant respiratory depression with benzodiazepines alone.
It's not impossible, just somewhat implausible with normal to medium high amounts. I was referring to whole jars of substances. I'm not going to say how much Valium you'd have to take for obvious reasons but thats what I meant by self-limiting in a sense. There is always an LD50 for any substance. You can be comatose on benzodiazepines. I'm well aware of the difference between the LD50 of barbiturates and benzodiazepines.
> This is the main reason why barbiturates are considered "obsolete" for most applications today.
>
> Benzodiazepine dependence/withdrawal can actually be worse than the barbiturates. Seizures have been reported up to two weeks after cessation of alprazolam; this does not happen, AFAIK, with the barbiturates.
>
> Methamphetamine is a pharmaceutical drug, and has a higher therapeutic index than d-amphetamine.
>
> Diazepam, AFAIK, is more lipophilic than alprazolam; I may be wrong about this but I believe that sublingual diazepam would kick in faster than subligual alprazolam.
>
> Midazolam is in the same chemical class as alprazolam and triazolam, FWIW. The difference is more political than anything else, IMHO.
Posted by Chairman_MAO on February 21, 2007, at 12:59:07
In reply to Re: why are benzodiazpines abused? like opiates... » Chairman_MAO, posted by yxibow on February 21, 2007, at 9:24:35
No, it is _IMPOSSIBLE_ in virtue of its mechanism of action. The BZD receptor complex can only potentiate GABA-A activity so much; there is a ceiling effect. There's a joke in pharmacology that the only way to kill a rat with alprazolam is to bury it alive in it. Sure, there's always an LD50. The LD50 of alprazolam in rats is 331-2171mg/kg! How could someone ever consume that much? You'd have to give yourself a bolus! Sure, you can be comatose, but that doesn't imply dangerous respiratory depression. You will eventually be un-comatose with only a lack of pharmacological savvy to show for it.
There was a politician years ago who tried to off himself with diazepam in the face of a scandal; it didn't work. I've met people who've downed hundreds of pills of clonazepam and survived without any issues except sleeping a very long time.
Posted by laima on February 21, 2007, at 16:40:36
In reply to Re: why are stims abused? » laima, posted by kelv on February 21, 2007, at 8:13:31
Yes- and the ridiculous part is I thought that this practice was my only possible hope to experience any despair-free moments at all. I did develop quite a tolerance at the time.
> You must have taken a lot of Ritalin!
>
> Kinda reminds me of Judy Garland who was taking~40 Ritalin tabs in 1968, vodka to conttrol the anxiety it caused, and instead of K, she took Seconal to sleep, which was to kill her.
Posted by Klavot on February 21, 2007, at 16:50:43
In reply to Re: why are benzodiazpines abused? like opiates... » yxibow, posted by Chairman_MAO on February 21, 2007, at 12:59:07
Does that mean there is an upper limit to effective benzodiazepine dose, i.e. a dose beyond which no further benefits are to be derived by virtue of GABA activity being maximally potentiated?
I once read - I suspect it might have been on Sheldon Preskorn's website - that at 200 mg per day Zoloft, serotonin reuptake is inhibited 100 % and consequently there are no additional benefits to be realised beyond a 200 mg per day dose of Zoloft.
Klavot
-----
Chairman said:
> No, it is _IMPOSSIBLE_ in virtue of its mechanism of action. The BZD receptor complex can only potentiate GABA-A activity so much; there is a ceiling effect. There's a joke in pharmacology that the only way to kill a rat with alprazolam is to bury it alive in it. Sure, there's always an LD50. The LD50 of alprazolam in rats is 331-2171mg/kg! How could someone ever consume that much? You'd have to give yourself a bolus! Sure, you can be comatose, but that doesn't imply dangerous respiratory depression. You will eventually be un-comatose with only a lack of pharmacological savvy to show for it.
>
> There was a politician years ago who tried to off himself with diazepam in the face of a scandal; it didn't work. I've met people who've downed hundreds of pills of clonazepam and survived without any issues except sleeping a very long time.
Posted by yxibow on February 21, 2007, at 19:13:03
In reply to Re: why are benzodiazpines abused? like opiates... » yxibow, posted by Chairman_MAO on February 21, 2007, at 12:59:07
> No, it is _IMPOSSIBLE_ in virtue of its mechanism of action. The BZD receptor complex can only potentiate GABA-A activity so much; there is a ceiling effect. There's a joke in pharmacology that the only way to kill a rat with alprazolam is to bury it alive in it. Sure, there's always an LD50. The LD50 of alprazolam in rats is 331-2171mg/kg! How could someone ever consume that much? You'd have to give yourself a bolus! Sure, you can be comatose, but that doesn't imply dangerous respiratory depression. You will eventually be un-comatose with only a lack of pharmacological savvy to show for it.
>
> There was a politician years ago who tried to off himself with diazepam in the face of a scandal; it didn't work. I've met people who've downed hundreds of pills of clonazepam and survived without any issues except sleeping a very long time.
I'd still prefer not to give people ideas on here of ways to... anyhow. That's why I didn't go there. Comatose isn't exactly much better than respiratory depression. Not everyone comes out of a coma. I can see your point, but I'd like to keep people on here alive, even if its not due to saturation of the GABA receptor.
Posted by TheMeanReds on February 22, 2007, at 10:20:46
In reply to why are benzodiazpines abused? like opiates..., posted by rjlockhart on February 21, 2007, at 0:16:34
I noticed xanax gives me a euphoria to want to paint, and alot of energy to do it...even though no stimulant is taken. So it gives me euphoric and energetic states at once. Pretty fantastic.
Posted by Cynthia_Greene on February 22, 2007, at 20:13:56
In reply to why are benzodiazpines abused? like opiates..., posted by rjlockhart on February 21, 2007, at 0:16:34
> I take Xanax, responsibly. But i was wondering....there is a tendency to want to take more i think to get some sort of relaxing effect thats why its abused.
>
> Opiates are abused for the poppy like high they give you.
>
> Stimulnats promote euphoric mental energy.
>
> Just asking...
Different people have different brain chemistry so maybe that's why some people claim to get high off of opiates, others prefer amphetamines, and some even benzos.I take Xanax as needed to sleep at night (occasionally Valium during the day) and I can't say they give me a traditional high as in a lot of energy and euphoria. But when I'm stressed out, they make me sort of not care, which is a nice feeling.
Posted by rjlockhart on February 23, 2007, at 0:31:56
In reply to Re: why are benzodiazpines abused? like opiates..., posted by Cynthia_Greene on February 22, 2007, at 20:13:56
Like GABA (which benzodiapines target)
What in me actaully since i have ADHD, is psychostimulants such as Dextrostat, Adderall, Ritlin. Stimulants i prefer to use because i can operate more functionally on. But my doctor doesnt want me on stimulants. Even though i take Xanax 2mg if needed daily. Xanax doesnt make me euphoric at all, it just causes ease and relaxation.
Opiates....if there used for pain, other wise i think there abused. Opiates have long history of being misused, all the way back to the civil war.
So if a person doesnt maybe have enought dopamine transmission..... stimulants is what that person may benefit from. Same with GABA receptors.
rj
Posted by kelv on February 23, 2007, at 1:33:22
In reply to Re: Well it depends on what is the brain lacks, posted by rjlockhart on February 23, 2007, at 0:31:56
> Like GABA (which benzodiapines target)
>
> "What in me actaully since i have ADHD, is psychostimulants such as Dextrostat, Adderall, Ritlin. Stimulants i prefer to use because i can operate more functionally on"me too, i prefer to be awake and on track
. "But my doctor doesnt want me on stimulants. Even though i take Xanax 2mg if needed daily. Xanax doesnt make me euphoric at all, it just causes ease and relaxation."
Xanax doesn't do much for me either-it did early on, but now at 3mgs does stuff all, give me Valium any day!
>
> Opiates....if there used for pain, other wise i think there abused. Opiates have long history of being misused, all the way back to the civil war.Yep, they called it 'soldiers disease' due to massive Morphine acdiction, the hypodermic syringe was invented around this time.
>
> So if a person doesnt maybe have enought dopamine transmission..... stimulants is what that person may benefit from. Same with GABA receptors.
>
> rj
Posted by laima on February 23, 2007, at 8:13:21
In reply to Re: why are benzodiazpines abused? like opiates..., posted by Cynthia_Greene on February 22, 2007, at 20:13:56
But abusing benzos or stims isn't necessarily about looking for a "high". That's never been the case for me- more like desperation, a last-ditch effort to avoid blackest depression in the case of stims, a desire to avoid withdrawal with benzos, after developing a tolerance. Hardly recreational.
This is the end of the thread.
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