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Benzodiazepines: Our Other Prescription Drug Problem

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Re: Benzodiazepines: Our Other Prescription Drug Problem

#41
post #11

Serious question: as we make opiods and now bezos increasingly difficult to prescribe, what are the alternatives for people with chronic pain or chronic anxiety? I have friends and family members with chronic pain and, through them and their communities, have become aware of many people who use opiods on a long-term, occasional basis to manage their pain. A family member of mine who suffers from chronic migraine live…

Cannabis in both cases works well for a great many people.

With anxiety, cannabis has pretty mixed effects, and we haven't been able to create reliable medications derived from cannabis that help. I've seen cannabis exacerbate as much anxiety as I have seen it help.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#42
post #8

A friend of mine got hooked on heroin and ended up on methadone maintence. He’s since managed to get off that and is clean, but he had horror stories of people on methadone abusing benzodiazepines like crazy. Apparently mixing methadone and high doses of drugs like Xanax produce effects similar to heroin, but benzos are really hard to get off. He talked about a woman who couldn’t get her Xanax fix, and she started ha…

It is incredibly, incredibly dangerous to mix benzodiazepines (Xanax, Ativan, etc.) with Methadone. This is common knowledge amongst opiate addicts, at least everywhere I ever went in the US back in my wilder days. I have 3 close friends whom I grew up with that all died before age 30 from abusing that exact combination of narcotics, and know of countless more just in my home state alone. Benzos are a respiratory dep…

Do you have a source for this "common knowledge"? I've seen plenty of people on methadone do just fine with benzos, especially if they take prescribed doses. I'm not so sure this isn't some bullshit pushed by doctors without evidence so that they have an excuse to stop treating their patients and leave them without benzos in a state where they are forced to either go to the black market or potentially withdraw and die. I've seen a lot of this from doctors as regards to methadone patients, trying to take people who have been on benzos for years or decades off without proper tapering and without a proper reason. It's almost as if they think of methadone patients as less than human, creatures whose lives are not of value. Wait, not almost. Whatever happened to the hippocratic oath?

Re: Benzodiazepines: Our Other Prescription Drug Problem

#43

I feel for the patients that actually need a benzo to lead a normal, functioning lifestyle. Due to the actions of abusers it seems the public is starting to distrust medication.

A similar situation has already played out with people who deal with chronic pain and opiods. Stricter laws may reduce abuse but they have a chilling effect on prescribing physicians.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#44
post #34
post #23

GABAergenics (the class of drug which benzodiazepines fall under) in general are pretty much the sole class of popular recreational drug which have a very real possibility of lethal withdrawals. In the case of alcohol, it often takes years for addicts to reach a point where withdrawal becomes lethal. In the case of short acting benzodiazepines/barbiturates, this point can be reached in less than a month. Of course, b…

You have your schedules mixed up. All controlled substances have a potential for abuse. Schedule IV drugs only have a 'low' potential for abuse 'relative to the drugs or other substances in schedule III', not low overall. You could argue that it should be schedule III, but all controlled substances, regardless of their schedule, are more tightly controlled than any other unscheduled prescription-only drug. Omeprazole…

https://www.health24.com/Medical/Meds-and-you/Medication/Ome...

You're right, the website that had showed up in google that I had used for my prilosec example is either incorrect or using some non-DEA scheduling sytem. I'll use another comparatively ridiculous example and re-edit my comments with the correction.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#45
post #9

Earlier quoted context omitted.

>A study published in 2016 in the American Journal of Public Health finds that from 1996 to 2013, the number of adults in the United States filling a prescription for benzodiazepines increased 67 percent, from 8.1 million to 13.5 million. The death rate for overdoses involving benzodiazepines also increased in this time period, from 0.58 per 100,000 adults to 3.07. In the first link in the article >the quantity of be…

That's all prescribed doses, though. So, yes, the use of benzodiazepines is going up, which obviously carries with it the associated rise in side effects and drug-related deaths. It's not reasonably comparable to the narcotics epidemic, where illegal use is driving mortality rates.

I see how that's true on a legal level, but if we're just talking about social and public health impacts, I don't see why the distinction between prescription and illegal use matters here. A three-fold increase in a category of drugs with major health impacts seems newsworthy to me. After all, the boundaries between legal and illegal use are far from fixed. Methamphetamine was once widely prescribed by physicians for weight loss, for instance (and is indeed still legally available as a prescription medicine) [1].

Presumably we can agree that a world in which prescriptions for methamphetamine have tripled might be a cause for concern, right? It's debatable whether this class of drugs has the same abuse and health risks, but based on my own reading and anecdotal experiences, I think they're pretty comparable.

[1] https://resobscura.blogspot.com/2012/06/from-quacks-to-quaal...

Re: Benzodiazepines: Our Other Prescription Drug Problem

#46
post #7

I was taking 3mg Lorazepam nightly for almost three years. Weening off of it safely took almost an entire year of miserable work, and the final stages I had to do while I had no other significant life responsibilities because of the incredible rebound insomnia and background anxiety you experience withdrawing off benzodiazepines. The only upshot is that when you finally do manage to get yourself off of a drug like th…

I really think most Psychiatrists know how addictive Benzodiazepines are, but Americans are very stressed out.

In my case, I busted a gasket in my twenties. I went from the most capable person in the room, to the trembling guy who could barely leave his room. I can honestly say it ruined my life.

I was given a benzo with a long half life. It worked a bit, but I never fully recovered. I think we all know the drug. 40 hour half life.

I tried all kinds of medications over the years, and nothing worked except benzodiazepines , and alcohol. Yes--alcohol hits so many different parts of the brain, but is horrid on the body. I really tried to avoid alcohol, but some days the anxiety susptoms we just unbearable.

I've been on the long half life benzodiazepine for decades. I take the same dose low dose, and try not to drink.

I've never even asked my doctor, but he knows my low dose isn't going to cause physical problems. They are better than alcohol, if you're self-medicating. I belive his thinking is I need the drug. I've been on it forever. Why put him through a misserable detox, at this stage of the game?

There are a few big studies done on patients whom were on opiates, and benzodiazepines for long periods of time. They didn't necessarily need to increase their dosages. I believe the studies were done on rest home geriatric patients.

I feel at my age, what's the point of a long withdrawal. It's easy to say for myself because my doctor has reasonable rates. He is getting close to retirement, and that has me very worried. The last thing I want is a long misserable detox.

I don't like the way this drug problem is playing out. I don't like blaming doctors. All their patients are very different.

My wish is we let, especially Psychiatrists, make these hard calls concerning what's best for their patients. That's what they went to school for.

I don't know why we are even discussing it here.

I don't want to live in a world where doctors send their patients home a mess because they are afaird of being accused of some sinister reason for keeping a patient on a addictive drug.

In all reality, so many doctors just don't prescribe certain drugs. Probally, one of the main reasons why former patients go to the streets, or liquor stores.

(I would further like to see a governmental bill that would allow patients, whom have been on addictive drugs for years, the ability to authorize their own scripts. The Same dose, and any increase would require a doctor's visit. At this point my office visits are pointless. There is a bill that is in congress now I believe, but it's for drugs that aren't addictive. I doubt the AMA will ever let it pass though.)

Re: Benzodiazepines: Our Other Prescription Drug Problem

#47
I've seen plenty of doctors who prescribed benzos and not a single one had any idea how to taper off their patients properly. Nor was a single one interested in it. This is a money-making machine for them and they have no interest, regardless of what's best for the patient. On the other hand, I've gone to doctors who wanted to stop these cold-turkey risking seizures and death. Those doctors clearly never heard of the hippocratic oath. I have never seen a doctor willing to work with a patient to taper off properly. Until we get to that point, talking about reducing prescriptions is akin to signing possible death sentences for patients or pushing them to the black market / pill mills. My own withdrawal took a few months and I did it on my own. It wasn't pleasant, but it wasn't as horrible as some others' experiences. Basically, the medical establishment says 'fuck you' by putting you on these meds long-term, and another 'fuck you and die,' by not knowing how to taper you off properly or even knowing when it is appropriate. We have a long, long way before solving this problem, and reducing prescriptions by itself is an incredibly stupid and cruel way to go about this. I can see why it's being done this way. Once you become dependent on something like benzos, most doctors and most of society does not think your life is worth living and they try their hardest to make it so.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#48
post #42
post #8

Earlier quoted context omitted.

It is incredibly, incredibly dangerous to mix benzodiazepines (Xanax, Ativan, etc.) with Methadone. This is common knowledge amongst opiate addicts, at least everywhere I ever went in the US back in my wilder days. I have 3 close friends whom I grew up with that all died before age 30 from abusing that exact combination of narcotics, and know of countless more just in my home state alone. Benzos are a respiratory dep…

Do you have a source for this "common knowledge"? I've seen plenty of people on methadone do just fine with benzos, especially if they take prescribed doses. I'm not so sure this isn't some bullshit pushed by doctors without evidence so that they have an excuse to stop treating their patients and leave them without benzos in a state where they are forced to either go to the black market or potentially withdraw and di…

I mean I cannot link you to a direct source, it was just something everyone knew, ya know 'common knowledge'. This was on both coasts as well as the midwest.

And it was explained to me at 3 different clinics in 3 different areas of the country that it was really about #1) liability -- particularly at clinics that accepted insurance for payment but not exclusively, there were cash-only ones with the same rule: No Benzos full-stop. If you had a legit prescription for xanax or ativan then they would send a letter to the prescribing doctor and would not dose you until they got an affirmative, positive response -- and to a somewhat lesser extent #2) they know it has the real potential to be fatal, and they're not monsters they don't want to kill all the junkies. Despite what you might think, some of them actually do give a shit and got into substance abuse medicine trying to help. Sure, for some it's just a job, and if you own the clinic it's a gold-shitting goose, but there are a lot of them who are genuinely trying to do good.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#49
post #40
post #23

GABAergenics (the class of drug which benzodiazepines fall under) in general are pretty much the sole class of popular recreational drug which have a very real possibility of lethal withdrawals. In the case of alcohol, it often takes years for addicts to reach a point where withdrawal becomes lethal. In the case of short acting benzodiazepines/barbiturates, this point can be reached in less than a month. Of course, b…

The DEA drug schedule is a hot mess. https://www.dea.gov/drug-scheduling There's no planet where Ritalin has a higher potential for abuse and addiction than Xanax. Not to mention all the lower-risk drugs that have been categorized schedule I for political reasons. Under the current system rohypnol is schedule IV but has special date rape laws passed to make possession of it punishable like a schedule I drug as a work…

>There's no planet where Ritalin has a higher potential for abuse and addiction than Xanax.

Most of the prescription opiates such as Hydromorphone, Oxycodone, etc are schedule II as well.

>Not to mention all the lower-risk drugs that have been categorized schedule I for political reasons.

Not just for political reasons (clonazolam would be FAR superior than anything currently scheduled as a 'date-rape' drug, thanks for keeping us safe politicians), but also anything 'new' is often placed in schedule I by default, without any consideration as to the actual properties of the drug.

A great recent example of this is whenever the DEA moved to schedule kratom as schedule I. Kratom. The DEA, in an age where it gets constant flack for classifying marijuana as a schedule 1 drug, attempted to classify kratom as having more potential for abuse than Hydromorphone.

It's an absolute fucking sham, but goodluck seeking a political career while being seen as anything other than 'TOUGH ON DRUGS!'.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#50
Taking 1/4 pill of Xanax occasionally together with 1200 mg piracetam + 3 mg sunifiram + another 1200 mg piracetam pill some hours later is amazing for concentration (but that's my personal experience, just sharing it, I don't recommend this to anybody, also neither piracetam nor sunifiram are approved by the FDA). Almost cures my ADHD and anxiety altogether and makes me happy and super productive (as compared to my baseline which is severely hindered by untreated ADHD and anxiety). And no addiction ever (perhaps people that take higher doses get addicted but I don't). God save the black market and the grannies who don't mind sharing a pill. I really believe people should stop this witch hunt and embrace the BLTC (better life through chemistry) philosophy and start developing ways to fight the bad effects (physiological addiction, withdrawal syndromes, tolerance development, liver/kidney harm, receptors disregulation etc) instead of outlawing substances that improve quality of life. A person mood/attitude and performance is 99% chemistry and demonizing the very idea of seeking to improve it (even above what is considered a norm) is madness.
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