XANAX, ATIVAN, KLONOPIN, VALIUM, great info here

[RUNVS]

Originally Posted by RUNVS

12. IF I DISCONTINUE MY BENZODIAZEPINE, WON'T THE UNDERLYING CONDITION
THAT MY DOCTOR PRESCRIBED THE BENZODIAZEPINE FOR RETURN?

It may or may not. It depends on what your underlying problem was, and
what post-withdrawal measures you take to manage the condition, if
necessary. Sometimes, the underlying problem is simply "gone" by the
time you have detoxified yourself from a benzodiazepine. Many physical
and psychological conditions are a transitory response to a temporary
condition in your life, such as a traumatic event. Often, people take
habit forming drugs such as benzodiazepines to alleviate the symptoms
of these transitory conditions, and continue taking them long after the
condition would have gone away on its own.

Other conditions are less transitory, such as chronic, long term panic
disorder (PD). However, it is important to bear in mind that there are
other treatments for these conditions, both of a pharmacological and a
non-pharmacological nature. Anxiety and stress can be managed in a
variety of different ways that are not as harmful to your body as
benzodiazepines.

There is an ongoing debate in the medical profession as to whether there
is a narrow class of individuals with long-term, chronic panic disorder
(PD) who are justified in taking benzodiazepines for life. This F.A.Q is
for informative purposes only, and will not take a position on this
controversial issue.

Often, when people complete their benzodiazepine detoxification, they
find an emergence of an underlying psychological problem that was masked
by the benzodiazepine use for many years. People also often feel the
resurfacing of emotions that may have been suppressed for a long time.
Thus, there is sometimes a period of difficult adjustment even after the
withdrawal symptoms subside. However, people often find the end result
of this period of adjustment to be very rewarding.


13. I HAVE DECIDED TO DISCONTINUE THE USE OF MY BENZODIAZEPINE.
WHAT ARE THE FIRST STEPS I SHOULD TAKE?

Your first step is to educate yourself. That means reading this F.A.Q.
and seeking out many of the resources referred to herein. Your second
step is to see a doctor who understands the seriousness of benzodiazepine
dependency, and be as well armed with information as possible going into
that visit. Your third step is to approach your detoxification with a
clear plan in mind, to set goals for yourself, and to begin the
withdrawal process with confidence. Do not listen to horror stories
from others who have had unusually bad experiences in withdrawal.
Everyone's experience is different, and many people are able to withdraw
with very manageable symptoms.

14. IS COLD TURKEY (ABRUPT, TOTAL DISCONTINUANCE OF THE DRUG) AN
ACCEPTABLE METHOD FOR DETOXING FROM A BENZODIAZEPINE?

No. There is nearly complete uniformity of opinion both in the medical
profession and in the benzodiazepine recovery community that cold turkey
is a dangerous and unacceptable method of detoxification. Cold turkey
withdrawal may cause seizures, and is also associated with a higher
probability of withdrawal psychosis. Seizures are almost non-existent
in those employing a taper method, with the limited exception of people
who have taken a benzodiazepine for a seizure disorder. Furthermore,
psychosis is rare in those who taper their benzodiazepine slowly.

There is a misconception that cold turkey withdrawal, though it may
cause more severe symptoms, will bring about a faster remission of
symptoms. This is the idea that a slow taper "prolongs the agony of
withdrawal". This notion is almost certainly false. In fact, there is
some anecdotal evidence that cold turkey withdrawal may lengthen the
course of the withdrawal syndrome, and may even cause Protracted
Withdrawal Syndrome (see below).

15. OK, IF I AM GOING TO TAPER MY BENZODIAZEPINE, HOW SHOULD I STRUCTURE
THE TAPER?

There are two very general rules, and one exception to the rule that is
discussed below. The first rule is, the slower the taper, the milder
the withdrawal symptoms. The second rule is, the smaller the cuts you
are able to make, the milder the withdrawal symptoms. These are
related, though separate, issues.

For example, you might decide to cut your dose by 1/4 mg. every month,
or in the alternative, cut your dose by 1/8 mg. every two weeks. Either
way, you are tapering at the same rate. In this author's opinion, the
second option is a far superior method of tapering. Any cut is a shock
to your brain and body. Cold turkey is the largest cut of all. It is a
spontaneous, total deprivation of your dependent substance. The shock
caused by cold turkey withdrawal is such that even after resumption of
your drug at the previous dose, it may take weeks or months to
"stabilize", and in some cases, you may never stabilize from a cold
turkey withdrawal until after you have completed your taper.

This logic further extends to the size of your cuts. The smaller the
cuts you make, the less the shock to your system, and the less
pronounced the withdrawal symptoms triggered by the cut. It is not
recommended that any individual cut represent more than 10% of your
total dose at a given time. Thus, it is preferable to make smaller and
smaller cuts as you go, though this can be very difficult as you
approach the end of your taper.

Always make the smallest cuts possible. That means taking the smallest
dose size available and splitting it into 4 pieces, which can be done
easily with or without a razor blade. For example, with Valium, you can
split the smallest (2 mg.) tablet into 4 .5 mg. pieces. With Klonopin,
you can split the smallest (.5 mg.) tablet into 4 pieces of .125 or
1/8th mg. If you are on a high dose and feel that you are able to taper
rapidly at first because you are above your tolerance point (see above),
space your cuts close together (no closer than 1 cut every 3 days), but
make the smallest cuts possible. If or when you begin to feel
withdrawal symptoms, you can start to space your cuts further apart (up
to about 4 weeks). Generally, the higher potency benzodiazepines such
as Xanax, Klonopin, and Ativan force you to make larger cuts (see
below), and therefore you must space your cuts at least 3 weeks apart
toward the end of your taper. Of course, even where you are able to make
very small cuts with lower potency benzodiazepines such as Valium, you can
make these small cuts relatively far apart if this is your most comfortable
method of detoxification.

There is a method of tapering that involves mixing the drug with either
water or a dry carrier like sugar to produce a "titration" which allows
for very minute reductions, such as 1% every other day. This method has
been employed with success by some people. In England, doctors have
created a liquid titration kit to assist users in withdrawing
comfortably. There is some promise that this method can substantially
diminish, if not eliminate, the withdrawal syndrome. Unfortunately,
these titration kits are not available in North America.

If you are unable to use a titration method, you may wish to consider
switching to Valium, assuming, of course, that you are not already using
that particular benzodiazepine. (See below) This method has been used
with success, particularly in England, for many years.

Dr. Heather Ashton has detailed taper schedules available that are based
on switching to Valium. (Also see below.)

There seems to be a limited exception to the slow taper rule where
people find that they have a "toxic" reaction to taking the
benzodiazepine (see "paradoxical symptoms" above). There is a tricky
distinction between toxic symptoms and withdrawal symptoms. The usual
way to tell the difference is to try increasing your dose. If the
symptoms reduce or stay the same, your symptoms are likely attributable
to withdrawal. If your symptoms increase, you may be experiencing
toxicity, and should probably consider a faster taper (6 to 8 weeks).
However, do not make a hasty decision to taper fast. Make certain that
you are experiencing toxicity first. Generally speaking, your symptoms
are far more likely to be related to withdrawal than toxicity.

One cause of toxicity may be the taking of more than one psychoactive
drug simultaneously. For example, taking a benzodiazepine with an
anti-depressant and a narcotic (pain killer).

16. SHOULD I SWITCH TO ANOTHER BENZODIAZEPINE SUCH AS VALIUM BEFORE
TAPERING?

Keep in mind that some people feel that switching to Valium is not for
everyone; and many have tapered their drug of dependency and have
recovered very well. However, if you are considering this alternative,
there are three reasons that are often cited for switching to Valium for
purposes of detoxification.

First, Valium has a far longer half-life than most other
benzodiazepines. (See above). This allows for a steady, smooth
reduction in dose over time. It also permits you to take your dose less
often. In some cases, you can take your entire daily dosage before
bedtime. This reduces problems of micro-managing your dose by taking
another pill every few hours. It also can aid in sleep, which can be a
large issue during withdrawal.

Second, Valium is low in potency relative to most other benzodiazepines
and comes in tablets of 2 mg., 5 mg. and 10 mg. As a practical matter,
you can make cuts as small as .5 mg. This is the equivalent of somewhere
between 1/20th and 1/40th mg. of Xanax or Klonopin. Given the importance
of making the smallest cuts possible, particularly as you approach the end
of your taper, this is a very large benefit.

Finally, Dr. Ashton and some others believe that the more modern, high
potency benzodiazepines such as Xanax, Klonopin, and Ativan tend to
produce more difficult withdrawal syndromes. So far the evidence of
this is anecdotal, meaning that it is based on clinical observation and
patient self-reports. There do not appear to be any studies that
conclusively correlate severity of withdrawal with type of
benzodiazepine.

If you do decide to switch to Valium, it is important that you have an
idea of what to expect. First of all, because each benzodiazepine has a
unique chemical composition, one benzodiazepine will not completely
cover the withdrawal syndrome of another. Medical literature
indicates that lower potency benzodiazepines cover fewer subclasses of
GABA-A receptors (see above) than the modern, high potency
benzodiazepines such as Xanax and Klonopin. This is why it is important
to observe the proper dose equivalencies. (See above.) These are
special equivalencies for purposes of switching to Valium, and are
sometimes called "loading doses" or "suppression doses." The consequence
of taking a loading dose is that although your withdrawal symptoms may be
suppressed very well, you might also experience the side effect of over
sedation. This is particularly so as Valium is a more potent sleep
agent than most high potency benzodiazepines even at the equivalent
therapeutic dose, and these equivalencies are probably well above the
therapeutic dose equivalencies. However, most benzodiazepine users
rapidly develop a tolerance to the sleep inducing (hypnotic) effects of
benzodiazepines, so that it is likely that this over-sedation will
recede within the first few weeks.

Because it is important to manage this problem of over sedation and to
avoid cross-over withdrawal symptoms, it is a very good practice to use
a gradual dose substitution method rather than simply discontinue your
drug of dependency and begin taking Valium at the full equivalency dose.
Depending on the size of your dose, the period of dose substitution may
be anywhere from 3 weeks to about 3 months.

During this period of dose substitution, sometimes cuts to your total
dose are made, and other times, slight increases are made. If you
experience extreme over-sedation and no withdrawal symptoms, that is a
sign that the equivalency dose is too high for you, and you may wish
make a small cut in your total dose as you cross-over. If, on the other
hand, you begin to experience heightened withdrawal symptoms during
cross-over, you may wish to make a small increase in your dose during
cross-over. Because the proper equivalencies vary from person to
person, the cross-over process can be a matter of trial and error.
However, it is important to understand that the end result of switching
to Valium should be that you are relatively stable after the switch is
complete, meaning that you are experiencing either no withdrawal or very
mild withdrawal symptoms.

Dr. Ashton has circulated detailed protocols based upon switching to
Valium and explaining the method in detail. (See above and below.)

Librium is another long acting benzodiazepine that is sometimes (but
rarely) used as a substitute. This author has insufficient information
regarding the effectiveness of Librium substitution to provide a
meaningful comment at this time. It is not necessary to switch from
Librium to Valium. Librium should be tapered directly, although there
is a problem in that it comes only in 5 mg. capsules in North America.
Ideally, for Librium detoxification, the capsule should be opened and
the contents halved to make 2.5 mg. cuts. Of course, if it possible
to make even smaller cuts, that is most preferable.

17. MY DOCTOR HAS ASKED ME TO SWITCH TO A DRUG CALLED "PHENOBARBITOL"
FOR DETOX? IS THIS A GOOD IDEA?

Some doctors, particularly in the United States, use a detoxification
method of switching the patient to phenobarbitol, then tapering the
phenobarbitol, usually over a period of 2 to 6 weeks. Phenobarbitol is
a long acting barbiturate (another class of sedatives). It acts upon
many of the same GABA-A receptors as benzodiazepines, but binds to the
receptors at a different location. Phenobarbitol is very cross-tolerant
with the benzodiazepine class, and if taken in a proper "loading dose"
(see above) will probably suppress withdrawal symptoms fairly well.
Phenobarbitol detoxification is "medically safe," in that Phenobarbitol
is a potent anti-seizure agent so that you will likely not have any risk
of seizures with this method.

Phenobarbitol also has a very long half-life, similar to that of Valium,
and can be broken down into very small cuts. The equivalency is 3 mg.
of Phenobarbitol to 1 mg. of Valium.

Reported results from Phenobarbitol substitution are mixed but
inconclusive due to the small number of people at benzo@egroups.com who
have experienced this method. Doctors using this method generally
observe the practice of using a heavy "loading dose," but they usually
do not employ a gradual dose substitution method. More importantly,
when this method is used, the detoxification is usually done very
rapidly (e.g. 4-6 weeks). The problem with Phenobarbitol detoxification
may not be so much the use of Phenobarbitol itself as the rapidity of the
taper that is usually employed. Where information is discovered related
to the effectiveness of Phenobarbitol using a slow taper method, this F.A.Q.
will be revised to reflect that information.

.

[RUNVS]

Originally Posted by RUNVS

18. SHOULD I CONSIDER GOING INTO AN IN-PATIENT DRUG REHABILITATION
FACILITY OR DETOX CENTER TO GET OFF MY BENZODIAZEPINE?

Only in a relatively small percentage of cases do people have successful
experiences detoxing from benzodiazepines on an in-patient basis. The
problems with detoxification centers are multi-fold. First and
foremost, detox facilities are geared towards treating drug abuse
behaviors, not providing support for withdrawal. The facilities often
do not understand the necessity of tapering your benzodiazepine slowly.
Often, they will require you to taper over a 3-6 week period. Some will
even take you off your benzodiazepine over a one week period with a
Valium or phenobarbitol substitute. These facilities usually will not
keep you in-patient for more than about 6 weeks. The result is that you
may end up being detoxed in an overly rapid fashion, while receiving
classes on drug abuse but no specific support for managing withdrawal.
The experience after leaving the facility can often be very rough, as you
may be left in a state of fairly intense withdrawal that can persist for
a long while. In short, people with benzodiazepine dependencies often
feel worse after they leave these facilities than before then entered.

Clinical experience suggests that benzodiazepine detoxification works
best where the patient controls his or her own taper schedule in
conjunction with the advise of a physician knowledgeable about
benzodiazepine dependency. Detoxification centers, even where they
might permit a relatively slow taper, will usually take the control
of the process away from the patient and force the patient into a
rigid protocol.

However, detox centers should be considered in two circumstances.
First, if you have a problem abusing benzodiazepines either alone or in
combination with other drugs, an in-patient setting is often appropriate
to enforce the discipline of tapering the drug, and to educate you on
how to avoid drug abuse. (But see the discussion on 12 step programs
below.) If you feel that you lack the necessary self-discipline to
taper yourself slowly and gradually and have no spouse or other
caretaker who will manage your taper for you, you may wish to consider a
facility.

Second, in the rare circumstance where your withdrawal syndrome is so
severe that you are unable to take care of yourself and you have no
live-in spouse or other caretaker, you may wish to consider the
in-patient option.

Before choosing a detox facility, you should call at least five
different facilities and make, at a minimum, the following inquiries:

a. Will they permit you to taper your benzodiazepine slowly?

b. Do they have staff who have direct experience with patients in
benzodiazepine withdrawal?

c. Do they have an in-house psychiatrist and/or psychologist to provide
support?

If the answer to these questions is yes, yes, and yes, the chances are
that you have found the best possible detox facility. However, it is
still inadvisable to detox yourself on an in-patient basis unless you
are in either of the two circumstances discussed above.

19. WHAT IS THE LENGTH OF THE WITHDRAWAL PROCESS?

It varies tremendously. For people with mild dependencies, the
withdrawal process typically encompasses 1-4 weeks of symptoms. This
generally applies to most, but not all, people who have used a benzodiazepine
for less than six months. It also applies to a percentage of people
who have used a benzodiazepine for more than one year. For people with severe
dependencies, 6 to 18 months total recovery time, including the taper
process, is typical. Generally, one may expect 6 months to a year of
diminishing symptoms after a taper is complete.

There is also an uncommon phenomenon called Protracted Withdrawal
Syndrome (see below).

20. IS IT OK FOR ME TO SOMETIMES "CHEAT" DURING MY TAPER AND TAKE A
LITTLE MORE OF MY BENZODIAZEPINE IF I HAVE TO GO THROUGH A STRESSFUL
EVENT?

This is strictly a matter of opinion. In the opinion of this author,
anyone detoxing from benzodiazepines who has a history of abuse should
avoid the temptation to temporarily increase the dose at all costs,
unless it is to avoid seizures or psychosis. If one has poor
self-discipline, giving in on a single occasion to increase the dose in
order to better cope with some stressful event may lead to a pattern of
"giving in" which will ultimately lead to total relapse. If confronted
with a stressful event, my advice is avoid the stressful event if
possible. If not, make sure a supportive individual is there with you
and tough it out.

If, however, you are among the majority who have no history of abuse and
have never abused your benzodiazepine, it is probably not harmful to do
this on rare occasions, e.g. if you must attend a wedding or funeral or
are forced to attend a function in a crowded public place where you have
some fear of crowds and/or public places. If you have demonstrated
self-discipline in your taper, you can probably get away with increasing
your dose for one day on rare occasions, e.g. a few times during your
taper.

As clarification, it is always acceptable to "go sideways," (stay at
the same dose as opposed to cutting) for a while in order to stabilize
where your symptoms are particularly severe. This is different than the
issue of increasing your dose to cope with stressful events.

Finally, if you feel that you must increase your dose a little to
stabilize yourself because you have tapered too quickly, do so.
However, the better solution is to avoid tapering too quickly in the
first place. (See above.)

21. WILL I NEED TO QUIT WORK OR GIVE UP OTHER IMPORTANT ASPECTS OF MY
LIFE DURING BENZODIAZEPINE WITHDRAWAL?

Going through withdrawal while managing the demands of everyday life is
a difficult balancing act. It cannot be emphasized strongly enough the
extent to which stress can worsen your withdrawal symptoms. That means
stress related to jobs, relationships, or anything else. The key is
that you need to understand going into your withdrawal process is that
you will have to make adjustments in your life, including your level of
activity and the types of activities in which you engage. The amount of
adjustment will depend on the severity of your withdrawal on the one hand,
and the stress level brought on by the activities on the other. Some people
can work through withdrawal; others cannot. Some people quit their jobs,
some take leaves of absence, some work through it with considerable
difficulty, and still others work through it with mild difficulty. While
in withdrawal, the best advice is to reduce your stress by the maximum
amount that is feasible given the demands of your life. What that means
will vary tremendously from one case to the next.

22. MY DOCTOR HAS PRESCRIBED AN ANTI-DEPRESSANT TO TAKE DURING MY
WITHDRAWAL. IS THAT A GOOD THING TO DO?

Maybe. Most doctors who prescribe anti-depressants for benzodiazepine
withdrawal, or for any other purpose, will prescribe one of the modern
class of SSRIs (Selective Serotonin Reuptake Inhibitors) that includes
Prozac, Paxil, Zoloft, Celexa, and Serzone. Or they sometimes prescribe
one of two even more recently developed drugs: Effexor and Wellbutrin.
Doctors often prescribe these particular drugs because, in addition to
their anti-depressant properties, they are recognized as anxiolytics
(anti-anxiety agents). Ironically, all of these drugs are known to
heighten anxiety and agitation, though this side effect often diminishes
after the first few weeks of use. Even the SSRI's such as Paxil and
Zoloft which are thought to have a primary sedative effect often cause
heightened anxiety when you are in withdrawal. This heightened anxiety
may be one reason that people in benzodiazepine withdrawal often
discontinue the use of these drugs after a short period of time.

Among those who have taken anti-depressants for long periods of time
during withdrawal, the experiences are mixed. Some seem to benefit,
others do not. Still others feel that their symptoms are worsened.
Generally, due to the potential for creating complications of your other
withdrawal symptoms, anti-depressants should only be taken where you are
suicidally depressed. That does not mean that you are simply pondering
or even obsessing about suicide. It means that you feel that, barring
some kind of pharmacological intervention, you *will* do something
self-destructive. Otherwise, anti-depressants should generally be
avoided during withdrawal.

Another issue is that most anti-depressants are documented to be addictive
to varying degrees and, in fact, there is some evidence that the withdrawal
syndrome can be very pronounced and similar to benzodiazepine withdrawal
(though not nearly as protracted) in some cases of long term use.

There are a few scattered reports of people who have benefited from the
use of an earlier class of anti-depressants known as "tricyclics." One
of these is Doxepin, which has a primary sedative effect as opposed to
the stimulant effect of the SSRIs. Tricyclics also have their own set
of complications and side effects. Consult your physician and check the
written warnings for tricyclics to make sure that you do not have any of
a number of medical conditions that may be complicated by the use of
tricyclics. As with SSRI's, some are known to cause primarily sedation,
where others are known to have stimulant properties.

The best advice with anti-depressants or any other prescribed adjunct
drug is to proceed with caution. If you decide to take an
anti-depressant, you may want to start at a very low dose to see how
well you tolerate the drug before increasing to the dose recommended by
your physician.


23. ARE THERE ANY OTHER DRUGS BESIDES ANTI-DEPRESSANTS TO CONSIDER USING
DURING BENZODIAZEPINE WITHDRAWAL?

Yes. There are several. And your doctor may suggest one or more.
Again, the best advice is to proceed with caution and carefully research
any new drug you are considering. A few are mentioned below.

Tegretol (carbomazepine): an anti-seizure drug. Some studies have shown
this drug to be effective in reducing certain physical withdrawal
symptoms. Others have shown it to be ineffective. Testimonials
regarding the use of Tegretol are mixed.

Neurontin: primarily a pain medication, neurontin has been implicated as
alleviating certain physical withdrawal symptoms. Testimonials are
mixed and too few for reliable generalization.

Beta blockers (e.g. Inderal): beta blockers help with heart palpitations,
hypertension, as well as shakes/tremors. Some beta blockers cross the
blood/brain barrier, and may be mildly addictive, though the official
medical literature states that they are non-addictive. However, that
same literature also recommends that they not be discontinued abruptly.
Do not take a beta blocker unless you are seriously troubled by any of
the above-mentioned symptoms. Even then, you should either take them at
the lowest dose possible, or take them situationally (as the symptom
emerges). Beta blockers do not directly reduce anxiety, but they can
alleviate some of the physical symptoms associated with panic attacks,
which may indirectly help to reduce the associated anxiety level.

24. ARE THERE ANY PARTICULAR DRUGS A DOCTOR MIGHT PRESCRIBE THAT
DEFINITELY DO NOT HELP WITHDRAWAL?

Yes. Buspar, a commonly prescribed anti-anxiety agent, is virtually
certain to be totally ineffective in alleviating withdrawal symptoms.
This conclusion is supported by studies. Furthermore, this
author has never heard a single testimonial from anyone who claims to
have benefited from this particular drug in withdrawal.

25. WHAT ABOUT HERBS AND OTHER HOMEOPATHIC REMEDIES - DO ANY OF THOSE
HELP THE WITHDRAWAL SYMPTOMS?

Maybe. Everyone's experience is different. Acupuncture, massage
therapy and chiropractic have been commented on, but there is little
conclusive data as to their effectiveness in relieving withdrawal
symptoms. As for herbal remedies, all of the following have been
mentioned as helpful to one person or another: valerian, kava kava,
st. john's wort, 5htp, SAMe, melatonin, GABA, chamomile, and Rescue
Remedy****.

With very few exceptions, the majority of these have been found to be
helpful in only a few cases, and several people have felt that their
withdrawal symptoms were heightened by taking one or more of
these substances. Of the entire group mentioned, only two have been
singled out by a fairly large number of people as especially helpful:
chamomile tea and Rescue Remedy****. Keep in mind that even those
herbal substances which you find helpful may only work where your
symptoms are relatively mild. For example, chamomile tea might
relieve mild agitation, but is very unlikely to bring you out of a full
blown panic attack. However, there are breathing and relaxation methods
that can help to alleviate panic attacks.

Kava is noted as creating more adverse reactions than some of these
other substances, and is probably the least recommended of the group
for experimentation. However, all herbal drugs have been noted by one
person or another as producing unpleasant side effects or as simply being
ineffective. Herbal drugs are generally not regulated and there are
occasional reports of these substances containing toxins, though these
occurrences are becoming particularly rare in industrialized countries
in recent years due to heightened media scrutiny of homeopathic drugs.

It is also important to understand that herbal medicines are drugs.
These plants contain organic, bioactive substances that cross the blood
brain barrier and act upon your brain just as synthetic drugs do. In fact,
many pharmaceuticals are synthesized versions of bioactive substances
naturally occurring in plants and animals. The only difference is, you get
a much higher purity of the substance in synthetic form than you would
in organic form.

Because herbs are drugs, they can also have toxic and deleterious
effects. Fortunately, most herbal medicines are low enough in potency
that they are well tolerated and non-addictive.

However, it is important to start at a low dose and pay close attention to
your body's reaction to the use of an herbal medicine just as it is with a
synthetic one. Generally speaking, you will have a strong sense of how well
you are tolerating a particular substance shortly after you beginning taking
it, often after the very first dose.

This FAQ does not recommend, negatively or positively, the use of herbal
remedies for anxiety disorders such as GAD or PD. This FAQ is about
benzodiazepine dependency and withdrawal, not about alternative treatments
for anxiety disorders. The only opinion intimated herein is that some
people may experience some relief from certain herbal remedies during the
withdrawal process. Many, if not most, others, experience no relief at all.

In general, herbal medicines are safer to experiment with during
withdrawal than are synthetic ones. Therefore, you may wish to consider
these possibilities before trying another potentially addictive
synthetic drug. However, keep in mind that even if you experience some
form of relief from an herbal remedy, there are no panaceas for
benzodiazepine withdrawal syndrome, and only time will ultimately
produce total recovery.

26. WHAT ABOUT USING CAFFEINE DURING WITHDRAWAL?

You should *totally* abstain from the use of caffeine during
benzodiazepine withdrawal. It is a stimulant and is known to worsen
withdrawal symptoms. If you use caffeine to ward off migraine
headaches, try to find another remedy that does not contain caffeine.
You should refrain from the use of all other stimulants as well. For
example, do not use "non drowsy decongestants" that contain the drug
"pseudophedrine." That is a stimulant that will likely cause heightened
agitation, which is the last thing you need during withdrawal.




27. WHAT ABOUT EATING SUGAR DURING WITHDRAWAL?

There is considerable anecdotal evidence in the form of testimonials
from people in withdrawal that sugar can exacerbate withdrawal symptoms.
Shirley Trickett, in her book Freeing Yourself From Tranquilizers,
indicates that benzodiazepine withdrawal causes hypoglycemia. This is
one theory as to why sugar may cause problems during withdrawal.
Another is that sugar may stimulate the production of adrenaline. In
much the same way that it may cause hyperactivity in children, it can
cause heightened agitation during withdrawal.

Whatever the reason, there is substantial anecdotal evidence that
consuming sweets, particularly in large quantities, can greatly
complicate withdrawal.

28. WHAT ABOUT CONSUMING ALCOHOL DURING WITHDRAWAL?

Alcohol consumption, even in relatively small amounts, is not advised
during benzodiazepine withdrawal. Many people report that alcohol, a
sedative that should cause a reduction in anxiety, actually heightens
withdrawal symptoms, particularly those of derealization and
depersonalization.

Even if you find that alcohol has a calming effect on withdrawal
symptoms, regular alcohol use creates a toxicity that will almost
certainly prolong your recovery process. And even if you are able to
successfully withdraw from benzodiazepines while consuming alcohol on a
regular basis, which is unlikely, you will have probably substituted one
addiction for another.

29. WHAT FOODS SHOULD I EAT (OR AVOID) DURING WITHDRAWAL?

First of all, you should probably drink lots of liquid, perhaps double
your ordinary intake. Some people feel that this may hasten the
recovery process. The evidence of this is inconclusive. However,
drinking large quantities of liquids helps to flush toxins from your
system and is a generally good for digestion. Even if it provides no
specific relief in withdrawal, it is generally a healthy practice.

As for food, there are various theories about what should and should not
be consumed. Some people develop fixations about their diets during
withdrawal, associating a new withdrawal symptom with whatever food they
consumed most recently, and concluding that this food is something to be
avoided during withdrawal.

Shirley Trickett (see above), in her book Freeing Yourself From
Tranquilizers, recommends a hypoglycemic diet. This consists of eating
three small meals per day, and having at least 2-3 snacks spaced out
between the meals. The regimen consists of roughly equal parts complex
carbohydrates, protein, and fat, with very little or no sugar intake.

Whatever diet you decide is appropriate, the most important
consideration during withdrawal is that it is a healthy diet. While the
evidence regarding the effect of one particular food versus another is
not conclusive, there is strong evidence that a healthy diet makes for
an easier withdrawal. Another way of looking at it is in the converse:
when you eat junk, your body rebels and causes you to experience
discomfort. While this is true even when you are not in withdrawal, it
is true more so in withdrawal because your body is already in a state of
trauma. That trauma is virtually certain to be compounded by an
unhealthy diet.

There are a wide variety of opinions about proper diet and nutrition
during withdrawal, and to discuss all of them is outside the scope of
this F.A.Q. If you are interested in eliciting opinions on this
subject, inquire to benzo@egroups.com wherein you will find no shortage
of ideas on the subject.

30. I SMOKE CIGARETTES. SHOULD I QUIT DURING WITHDRAWAL?

Nicotine, the primary drug contained in tobacco, is an addictive sedative
drug like benzodiazepines, although it is vastly different in its chemical
structure and mechanism of action. Unlike benzodiazepines, the primary
symptom of Nicotine withdrawal is a craving for the drug. However, other
symptoms, especially agitation and insomnia, have been noted as Nicotine
withdrawal symptoms. Therefore, it is inadvisable to withdraw from Nicotine
while you are in the process of benzodiazepine detoxification. If you plan
to quit smoking (which is always a good idea for health reasons), it is
preferable that you accomplish this before you begin benzodiazepine
detoxification. Failing that, you should wait until you have fully recovered
from benzodiazepine withdrawal before discontinuing cigarettes.

The only exception to this guideline is where you are carrying a child. In
that circumstance, it is critical that you quit smoking immediately.
Benzodiazepine detoxification should also be accomplished during pregnancy,
as there is clear medical evidence that a child born of a benzodiazepine
dependent parent may experience symptoms consistent with benzodiazepine
withdrawal. Where you are dependent on a benzodiazepine and carrying a
child, a more rapid taper schedule that is generally desirable may be
advisable. Detoxification during pregnancy, as in all other situations,
should be done with close consultation with a physician who is
knowledgeable regarding benzodiazepine dependency.

31. SHOULD I EXERCISE DURING BENZODIAZEPINE WITHDRAWAL?

Yes. Aerobic exercise has consistently been found in studies to reduce
both anxiety and depression. Some people believe that aerobic exercise
may even shorten the course of withdrawal.

Strenuous aerobic exercise is often difficult for people in withdrawal,
as it causes an influx of adrenaline that can heighten withdrawal
symptoms. In some cases, people have reported experiencing panic
attacks after intensive exercise. Where you are unable to engage in
vigorous exercise, it is recommended that you engage in as much low
impact aerobic exercise as possible. Brisk walking is a good form of
aerobic exercise that some people have reported as having an immediate,
calming effect. Relatively non-strenuous swimming is also a good
option.

32. I HAVE TERRIBLE INSOMNIA DURING MY WITHDRAWAL. SHOULD I TAKE
SOMETHING TO HELP ME SLEEP?

Opinions vary on the subject. While it should not slow your recovery
process to take an over-the-counter drug with sedative properties, some
people feel that taking virtually any other drug makes their withdrawal
symptoms worse. Many others, however, have found that various synthetic
and organic drugs are helpful as sleep aids. These include, but are not
limited to, antihistamines (such as Benadryl), Dramamine, valerian root,
5Htp, chamomile, warm milk, and melatonin.

It is important to be cautious regarding your decision to ingest any
psychoactive chemicals, be they organic or synthetic, during withdrawal.
Therefore, it is prudent to avoid taking sleep aids if you are suffering
from only mild insomnia. If, however, your insomnia is severe, as it
often can be during certain stages of withdrawal, you may wish to
consider taking one or more sleeping aids, particularly as serious sleep
deprivation may worsen withdrawal symptoms.

It should go without saying that you cannot take a different benzodiazepine
for sleep. That might be effective in inducing sleep, but it is the
equivalent of increasing your dose and reversing your recovery process.
The same holds true to varying degrees for barbiturates, alcohol, opiates
and narcotics.

You should also avoid the drug Ambien, a sedative not technically in the
benzodiazepine class, but very similar chemically.

Any of the above-mentioned over-the-counter sleep aids or herbal
sedatives may be useful. However, it has often been observed that
tolerance to the sleep effects of these substances, including for
example melatonin, can develop rapidly. It is therefore recommended
that you alternate more than one sleep remedy, so that no one remedy is
employed more than 2 or 3 times per week.

It is important to note that virtually all tranquillizers, including
antihistamines, can produce paradoxical symptoms of agitation and heightened
insomnia for some users. If you feel that any substance you are consuming
as a sleep aid is making your withdrawal symptoms worse, discontinue that
substance immediately.

32. WHAT CAN I TAKE FOR PAIN MANAGEMENT DURING WITHDRAWAL?

Many people experience muscle and joint pain during withdrawal. This
can occur to varying degrees. Only a very small fraction of people have
reported bad reactions to over-the-counter pain relievers. These should
be used as a first resort. Do not use prescription pain relievers
unless your pain is extremely debilitating.

34. ARE THERE ANY PARTICULAR DRUGS THAT ARE KNOWN TO COMPLICATE
WITHDRAWAL?

There is some evidence that antibiotics can complicate withdrawal.
However, it is not recommended that you refrain from taking antibiotics
where they are prescribed by a doctor for a potentially serious
condition. Some people have actually refused to take antibiotics for
pneumonia while in withdrawal. Be advised that if you choose to make
this kind of decision, you do so at your own risk.

There are undoubtedly other drugs that may complicate withdrawal as
well. Be cautious, but also be sensible about health problems you may
have that are unrelated to withdrawal.

35. I AM WELL INTO MY TAPER, AND MY SYMPTOMS ARE EITHER NO BETTER OR ARE
WORSE. WHEN CAN I EXPECT MY SYMPTOMS TO GET BETTER?

There is no way to tell. Sometimes, people's symptoms begin to diminish
before their taper is complete; sometimes shortly after the taper is
complete; sometimes quite a while after the taper is complete. The
important thing to remember is that in all cases the healing process is
moving forward, whether it is immediately apparent or not, and that you
will eventually begin to feel better.

36. I HAVE COMPLETED MY TAPER, AND HAVE FELT MUCH BETTER FOR A WHILE,
BUT NOW I FEEL WORSE AGAIN. WHY?

This is a typical experience. Benzodiazepine withdrawal recovery occurs
in fits and starts. The fact that you have experienced relief for a
time means that you will experience it again. As time goes on,
generally these recurring episodes are spaced further apart, and are
less in intensity. Benzodiazepine withdrawal leaves you vulnerable to
stress for quite a long time even after you are almost totally healed.
It is often reported that people who have felt withdrawal free for six
months have had sudden, intense withdrawal episodes brought on by
traumatic or stressful events. It is probably helpful to get counseling
if you continue to have ongoing anxiety issues long after your taper is
complete. This does not mean that you are not still experiencing
withdrawal. It means that the purpose of detoxifying yourself in the
first place was to find alternative, less toxic methods of managing
anxiety problems.

.

[RUNVS]

Originally Posted by RUNVS

37. WHAT IS PROTRACTED WITHDRAWAL SYNDROME?

Protracted With Syndrome (PWS) is not a phenomenon with a single,
unitary definition. Many people who have no experience with
benzodiazepine dependency, which includes almost half of the medical
community, do not recognize any form of withdrawal syndrome as
persisting beyond about 30 days. Part of the problem is that the
average physician sees very few people with serious benzodiazepine
dependency, and when they do, the symptoms are often misinterpreted or
misdiagnosed. Another problem is that statistics actually show that,
indeed, about 70% of people with a benzodiazepine dependency are able to
complete withdrawal in less than a month. However, it is important to
understand that this statistic takes into account large numbers of
people who have used a benzodiazepine for only a few weeks or months.
For people who have used benzodiazepines for years, a 6 to 18 month
course of withdrawal is actually the norm. For doctors who have not
seen significant numbers of people in this circumstance, that scenario
is viewed as "protracted," because withdrawal syndromes rarely persist
more than 30 days for virtually every other class of drug.

What those few doctors and recovering victims who truly understand
benzodiazepine dependence know is that the 6 to 18 month scenario is
just a typical outcome for any serious dependency. In those circles,
PWS is roughly defined as significant, debilitating, and continuous (not
minor or occasionally occurring) symptoms persisting beyond about one
year after total cessation of the drug. One of the true ironies here is
that just as there is debate among the truly ignorant as to whether the
very common 6 to 18 month scenario exists, there is also a debate among
people in recovery and addiction medicine circles as to whether true PWS
(beyond about 18 months) is a real phenomenon. Most people in these circles
believe it is. However, some would attribute symptoms several years
out to a re-emergence of an underlying condition, to some other
undiagnosed medical or psychiatric condition, or to psychosomatic
complaints.

Dr. Ashton and others believe that PWS is a real phenomenon. What
causes it is at this point is unknown. However, there are two things to
keep in mind about PWS. First, even if you are in the category of
people with a serious dependency, the statistical likelihood of you
experiencing PWS is quite small, probably less than 1 in 10. If you are
two years out and have occasional, mild symptoms, that is not PWS. It
is typical. If you have significant, debilitating symptoms beyond a
year, that is PWS and it is atypical but not unheard of. However, the
second thing to keep in mind is that there is no evidence that
benzodiazepine withdrawal syndrome can ever be permanent. Even in the
rare cases that symptoms persist for years, they gradually diminish over
time until they are gone.

As you taper, do not concern yourself with whether or not you will
experience PWS. You probably will not. And even if you do, that is
something to manage if or when you get there.

38. SHOULD I USE A 12 STEP PROGRAM LIKE NARCOTICS ANONYMOUS TO HELP ME
RECOVER FROM MY BENZODIAZEPINE ADDICTION?

This is a personal choice, and opinions vary considerably in the
benzodiazepine recovery community. In fact, the issue has been debated
on the benzo@egroups.com (see below) more than once. Some feel that
most people who have a benzodiazepine dependency are not drug abusers.
Rather, they are people who have taken a medication according to their
doctor's instructions for a specific medical and/or psychological
condition, have never exceeded the recommended dosage, have never
experienced a "high" or intoxication from the drug, and have never
experienced a specific craving for the drug. This is where the term
"accidental addict" is rooted. Often, people who fit this mold feel
that 12 step programs such as NA are not a proper fit for them, because
those programs are aimed at conditioning people to avoid abuse type
behaviors. People with a benzodiazepine dependency are often seeking
support and guidance on how to manage their withdrawal syndrome, not
training on how to avoid drug abuse.

Still others not only feel that these types of programs have helped
them, but feel that they would not be alive today without them. It is
important to note that a sizable percentage of benzodiazepine dependents
do exhibit patterns of abuse. The clearest sign is taking dosages far
in excess of what your doctor has prescribed, and/or having a history of
abusing other drugs in the past or simultaneously with your
benzodiazepine. 12 step programs may be a better fit for people in that
category.

One factor that many have found helpful in the withdrawal process is
spirituality, e.g. a connection with some form of Higher Power(s). Some
have found that 12 step programs help them understand the importance of
spirituality. Others have found their own spirituality without the
assistance of any such program.

39. WHO IS DR. HEATHER ASHTON?

Dr. C. Heather Ashton D.M. is a British psycho-pharmacologist (an expert on
psychiatric drugs) who ran a benzodiazepine detoxification clinic in Newcastle,
England between 1982 and 1994. During that time, she detoxified over 300
patients,
with a high rate of success. Her DM degree is a Doctorate in Medicine.
One of her papers is an observation of the outcome of her first 50 cases.
In that study, only three patients relapsed, and the others made it through
with varying long term outcomes - mostly positive. Dr. Ashton is undoubtedly
one
of the world's foremost authorities on benzodiazepine addiction and recovery.

Dr. Ashton always switches her patients to Valium (see above) unless, of course,
Valium is their drug of dependency. She also recommends a very slow taper.

She has written a manual for consumption by the general public. It is
available for purchase at
http://members.dencity.com/ashtonpapers/index.html. This manual is an
excellent resource for anyone beginning the process of detoxification.
Dr. Ashton is not the only expert on the subject, but she is one of the
more knowledgeable ones. She is far more knowledgeable than this
author.

39. WHAT IS BENZO@EGROUPS.COM?

Benzo@egroups.com (aka benzo@onelist.com) is a listserver (an e-mail
message board) that consists of people who are at various stages of
benzodiazepine dependency and recovery. Some have not even begun a
taper, others are tapering, others have completed their taper and are
still experiencing withdrawal. Still others are completely recovered
and post to the group to support those still in the recovery process.
Benzo@egroups.com is a tremendous source of both support and information
regarding all aspects of benzodiazepine dependency. You can sign up for
the listserver by going to www.egroups.com. There are other listservers
on a variety of different topics at the egroups site, including
benzofree@egroups.com. This group is for people who have completely
discontinued their benzodiazepine. It is a forum for celebrating
freedom from dependency and tends to be oriented towards the 12 step
philosophy more so than benzo@egroups.com. There is, however,
considerable cross-membership between the groups.

40. ARE THERE ANY OTHER RESOURCES THAT WOULD BE HELPFUL TO ME IN
UNDERSTANDING BENZODIAZEPINE DEPENDENCY AND WITHDRAWAL?

Yes. There are lots.

Get the Ashton manual with detailed detoxification protocols here:
http://members.dencity.com/ashtonpapers/index.html.

Here is perhaps the single best website regarding benzodiazepine
dependency and withdrawal: http://homepage.ntlworld.com/raymond.nimmo/or
http://www.benzo.org.uk This is growing very fast and should be consulted
frequently for updated information on this issue.

Here again is the extremely comprehensive list of possible withdrawal
symptoms mentioned above: members.dencity.com/BenzoBusters/index.html.

Here is an excellent site that contains references to hundreds of
articles and books on benzodiazepines: www.benzodiazepines.net.

Here is a good site that addresses the issue of managing and recovering
from panic disorder without the use of benzodiazepines. It contains
many helpful links and references. http://home1.gte.net/panicdoc/

The "Benzodiazepine Angst Webring" contains these sites and many other
helpful ones. You can start here:
http://www.slipperysquid.simplenet.com/benzo.html or at any of the
individual sites.

Here are some other websites of interest:

Detoxification: Principles and Protocols
http://www.asam.org/publ/detoxification.htm
(This is the website for the American Society of Addiction Medicine.
There is some valuable information here, but you have to separate the
wheat from the chaff. For example, there is a benzodiazepine
equivalency chart here that is extremely inaccurate.)

KLONOPIN: Little Known Facts
http://neuro-www.mgh.harvard.edu/for...MKLONOPIN.Lit\
tleKn

Bristol and District Tranquilliser Project
http://www.epost.co.uk/charities/bdtranq.html

HYPNOTICS, SEDATIVES AND ANXIOLYTICS
http://www.mssm.edu/pharmacology/Pha...-57/56-57.html

ICFDA Klonopin
http://www.drugawareness.org/klonopin.html

Roche's latest Klonopin Monograph:
http://www.rocheusa.com/products/klonopin/pi.html
(This is the pharmaceutical company's own information. There is
detailed pharmacological information here. However, bear in mind that
Roche and other companies who manufacture benzodiazepines offer slanted
views on the severity of withdrawal for long time users, for obvious
reasons.)

The Merck Manual - Home Edition, Sec. 7, Ch. 92, Drug Dependence and
Addiction:
http://www.merck.com/pubs/mmanual_home/sec7/92.htm
(Again, you need to separate the wheat from the chaff here. For
example, the Merck Manual, a mainstream publication, takes the position
that barbiturate withdrawal is more severe than benzodiazepine
withdrawal. This is almost certainly false. Although the symptom
profile is very similar, barbiturate withdrawal typically passes in no
more than 30 days after discontinuance, and usually less time than
that.)

Management of Withdrawal Symptoms and Relapse in Drug and Alcohol
Dependence:
http://www.aafp.org/afp/980700ap/miller.html

American Family Physician: Addiction - Part I Benzodiazepines:
http://www.aafp.org/afp/20000401/2121.html

Classification of Tremor and Update on Treatment - American Academy of
Family Physicians:
http://www.aafp.org/afp/990315ap/1565.html

Two particularly excellent books on benzodiazepine dependence and recovery:

The Accidental Addict by Porritt and Russell. This one is essentially
out of print, but can be ordered here:
http://members.dencity.com/BenzoBusters/index.html. Copies are running
out, so get it while you can. It is excellent.

Freeing Yourself From Tranquillizers, by Shirley Trickett. This one is
in general circulation and can be ordered from www.amazon.com or on
special order through any reputable book store. The title of this book
in the UK is "Coming off Tranquillizers, Sleeping Pills &
Anti-depressants." It is an odd title, because the book has very little
to do with coming off of anti-depressants. It is basically a book about
benzodiazepine dependency and withdrawal.

Council for Involuntary Tranquilizer Addiction: C I T A
Cavendish House, Brighton Road, Waterloo, Liverpool L22, ENGLAND 5NG
Tel: 0151 474 9626, FAX 0151 284 8324, Helpline: 0151 949 0102

It is rumored that there will be other books on the subject published soon.

The above list of references, along with the entire archived history of
posts at benzo@egroups.com, also serves as the bibliography for this
F.A.Q. It is this body of information that this author has used as a
basis for the facts and opinions stated herein.

The reader is encouraged to do his or her own research, as there are
undoubtedly more resources both on the Internet and in print which are
relevant to this topic. Any reader who uncovers such information is
encouraged to bring it to benzo@egroups.com.





****Rescue Remedy is a product name. This FAQ neither promotes nor
discourages the use of any specific product.

End of F.A.Q. version 1.1.

This F.A.Q. is expressly placed into the public domain, and may be
freely disseminated by any who come into its possession. The identity
of its authors is irrelevant. It is a product of the effort of a few
among a community known as benzo@egroups.com (aka, benzo@onelist.com.)
It is also a product of the spirit of that entire community. It is both
a gift from its authors to that community, and a gift from that
community to anyone in the world whose life has been touched by
benzodiazepine dependency.

.

[windysan]

Accidental addict.

I've heard that one before.

[woops]

Yep - take as prescribed by the doc - never abusing - and end up addicted thro no fault of your own.
"Addiction by prescription" or "accidental addict"
Esp true of the benzos..........

[windysan]

I'm just an addict.

Dang!

[Arpeggioh]

Thank Goodness for "open" forums...anyone is welcome to reply, yes?

Please cast my vote firmly in FAVOR of benzo-addiction, based entirely on my own experience: lowest dosage, longest-term usage...

You'll pry my .25 mg. B.I.D. Xanax bottle out of my cold, dead hands before I'll give it up willingly. This low-dose benzo has allowed me to hold a job, avoid public humiliation, talk myself out of having an immediate stroke, and function in society long-term; I have no intention of "tapering" away from something this cheap and effective.

Blegghh,
Michael (Arp)

[Buzz Kilowatt]

Originally Posted by Arpeggioh

Thank Goodness for "open" forums...anyone is welcome to reply, yes?

Please cast my vote firmly in FAVOR of benzo-addiction, based entirely on my own experience: lowest dosage, longest-term usage...

You'll pry my .25 mg. B.I.D. Xanax bottle out of my cold, dead hands before I'll give it up willingly. This low-dose benzo has allowed me to hold a job, avoid public humiliation, talk myself out of having an immediate stroke, and function in society long-term; I have no intention of "tapering" away from something this cheap and effective.

Blegghh,
Michael (Arp)

There are good uses for any medication and each patient's use must be evaluated in terms of risk / benefit.

This forum is for people who are struggling with their drug and medication usage -- situations where meds have made their life worse, not better as you claim.

I tend to take a "libertarian" view of many things and if Xanax is working for you well great, it's no one else's business.

But I've got to wonder, if you are content or even enthusiatic about your own drug use, why would you be compelled to join an addiction forum?

Best regards,

Buzz

[windysan]

Originally Posted by Arpeggioh

Thank Goodness for "open" forums...anyone is welcome to reply, yes?

Please cast my vote firmly in FAVOR of benzo-addiction, based entirely on my own experience: lowest dosage, longest-term usage...

You'll pry my .25 mg. B.I.D. Xanax bottle out of my cold, dead hands before I'll give it up willingly. This low-dose benzo has allowed me to hold a job, avoid public humiliation, talk myself out of having an immediate stroke, and function in society long-term; I have no intention of "tapering" away from something this cheap and effective.

Blegghh,
Michael (Arp)

Hey dude....whatever works for ya.

I can't stop at .25 though. That bottle would be gone in a couple of days in my house.

[ccgirl]

Hi, I'm new here and I am having a hydrocodone withdrawal issue. Just to let you know why I found this place to start with. I also posted on the anti depressant thread because I'm bipolar. Now I'll post here because I have Generalized anxiety disorder.

I have been on klonopin for about 9 years and I honestly can tell you that addiction has never and continues to not be a problem. My doctor prescribed it to take as needed for anxiety. I have a range of .5mg per day to 1.5 mg per day. I have never run out of my prescription; in fact sometimes it's expired before I refilled it all. I only take it during excruciatingly anxious times and I am grateful for this medication because without it I would worry all day, every day. I realize addiction potential is strong, and it is not for everyone, but for someone like me whose gene pool in the mental illness department sucks, it, along with lexapro and lamictil have been lifesavers. And a good therapist, too.

[RUNVS]

This thread is to inform others that benzos can lead to problems and there is hope.

Just make sure you do not let your prescription run out. Because cold turkey on 9 years of klonipin use could be real tough. Even the manufactors of klonopin do not recommend taking benzos for more then 4 weeks at most. Remeber this is a sober recovery board and not a board for the promotion of drugs.

BENZODIAZEPINE WITHDRAWAL SYMPTOMS

PSYCHOLOGICAL SYMPTOMS
Excitability (jumpiness, restlessness)
Insomnia, nightmares, other sleep disturbances
Increased anxiety, panic attacks
Agoraphobia, social phobia
Perceptual distortions
Depersonalisation, derealisation
Hallucinations, misperceptions
Depression
Obsessions
Paranoid thoughts
Rage, aggression, irritability
Poor memory and concentration
Intrusive memories
Craving

PHYSICAL SYMPTOMS
Headache
Pain/stiffness - (limbs, back, neck, teeth, jaw)
Tingling, numbness, altered sensation - (limbs, face, trunk)
Weakness ("jelly-legs")
Fatigue, influenza-like symptoms
Muscle twitches, jerks, tics, "electric shocks"
Tremor
Dizziness, light-headedness, poor balance
Blurred/double vision, sore or dry eyes
Tinnitus
Hypersensitivity - (light, sound, touch, taste, smell)
Gastrointestinal symptoms - (nausea, vomiting, diarrhoea,
constipation, pain, distension, difficulty swallowing)
Appetite/weight change
Dry mouth, metallic taste, unusual smell
Flushing/sweating/palpitations
Overbreathing
Urinary difficulties/menstrual difficulties
Skin rashes, itching
Fits, convulsions




Different strokes for different folks. I choose now to be completely drug and alcohol free.

Take good care
RUNVS

[RUNVS]

Dependence. Benzodiazepines are potentially addictive drugs: psychological and physical dependence can develop within a few weeks or months of regular or repeated use. There are several overlapping types of benzodiazepine dependence.

Therapeutic dose dependence. People who have become dependent on therapeutic doses of benzodiazepines usually have several of the following characteristics.

1. They have taken benzodiazepines in prescribed "therapeutic" (usually low) doses for months or years.

2. They have gradually become to "need" benzodiazepines to carry out normal, day-to-day activities.

3. They have continued to take benzodiazepines although the original indication for prescription has disappeared.

4. They have difficulty in stopping the drug, or reducing dosage, because of withdrawal symptoms.

5. If on short-acting benzodiazepines (Table 1) they develop anxiety symptoms between doses, or get craving for the next dose.

6. They contact their doctor regularly to obtain repeat prescriptions.

7. They become anxious if the next prescription is not readily available; they may carry their tablets around with them and may take an extra dose before an anticipated stressful event or a night in a strange bed.

8. They may have increased the dosage since the original prescription.

9. They may have anxiety symptoms, panics, agoraphobia, insomnia, depression and increasing physical symptoms despite continuing to take benzodiazepines.

http://www.benzo.org.uk/manual/bzcha01.htm

[VictoryLee]

I am new here. Today is my first day on this forum. I have been on xanax for over 20 years. My highest dose, which was prescribed by my doctor was 10mgs a day. I have tapered down to 6mgs. by slowly reducing the dosage, but now I am in tolerance w/d and having a very hard time tapering. I am aware of the Ashton method, but have seen and read so many horror stories that I am afraid to try the valium. I am in my 60's and would like to get this drug thing sorted out before Altzheimers kicks in I don't have a problem with a small amount of xanax...I would take that gladly, but 6mgs is way too much. I feel terribly anxious, have a pounding heart, and have insomnia, even on this large a dose. The more I taper, the worse my insomnia gets.
Would anyone have any suggestions about what I should be doing? Should I give the valium a try and see if I can just knock off a couple of xanax? I am totally confused right now. I thought for sure I would do the Ashton taper, but my best friend did it and she is now 2 years drug free and can't get out of bed. I don't have time for that...plus I don't want to go through all of that. It is too hard .
Thanking you in advance for any help you can give me.

Victory

[windysan]

Do the valium taper....much easier on you.

[VictoryLee]

Windysan, do you think the valium would work on someone my age who has been on such a high dose? Like I said, my friend tapered off of klonopin to valium and she has been drug free for 2 years. She can't walk, has terrible vertigo, severe tinnitus, she passed out a couple of times, she is totally non-functional. Do you think her situation is unusual or not? I have been on Benzo Island and from what I read these people are spending 5 or 6 years of their lives de-toxing. I can't wait that long. And it would be fine, I guess if they were alright, but they're not. They are suffering terribly. God, what a horrible mess this is.
Thanks for the reply. It is much appreciated.


Victory

One more thing. Aren't all these drugs so very toxic to your liver? I worry about that all the time. I know benzos go trough your liver to your brain then back through your liver again...making our liver work extra hard. Scares the heck out of me.

[windysan]

Benzo Island does well at scaring the crap out of people. If the benzo problem was as HUGE as they make it out to be then you'd certainly read about it in the papers and see it on tv (benzo islanders will tell you it is a pharmaceutical industry conspiracty blah blah blan).

Print the Ashton Manual, bring it to your doctor(one with benzo experience), and let him help you get through it.

I had to just quit everything using detox/rehab(benzo islanders call it DIEtox). I was too weak to taper. I had destroyed myself with opiates so I was an old man in a 39-year-old body and I did okay.

From what I have gathered you'll need to get your doc to look at the valium equivalency and see if that is a non-toxic dose. Then go slow with your taper plan. Blood pressure patches help but you need to be careful around machinery.

Here are the charts...

http://www.benzo.org.uk/manual/bzcha01.htm#24

http://www.benzo.org.uk/manual/bzsched.htm#s1

It looks like your xanax dose will have to be tapered down before you can start the valium b/c I doubt that any doctor will prescribe that much valium (that was one of my problems b/c I was taking a lot of xanax).

It is difficult but it has been done by MANY MANY people. Don't let the benzo islanders scare you with their protracted withdrawal mombo-jombo. You can do it. Just remember that xanax is dangerous(it should have NEVER been prescribed to you for 20 friggin years !!!). Find a doctor with experience and let him guide you through.

The only people I know who have had the 5-6 year run on protracted benzo withdrawal are benzo islanders. Seems they've cornered the market on suffering.

You'll be okay. Just go find a GOOD doctor (NOT THE ONE WHO PRESCRIBED YOU THAT CRAP FOR 20 YEARS).

Plenty of level-headed people here to talk to.

Good luck with it and I'll be around.

[VictoryLee]

Thank you so much, Windysan. You have made me feel so much better. I think that maybe I will even get a little sleep tonight!!!!
Hope all is well with you.



Have a good evening,
Victory

[woops]

Hi Victory
Ashton is the only method which seems to make any sense. YOu cannot c/t benzos - very dangerous. You can read all about that online. Read and read - inform yourself. "Benzo island" and "benzo buddies" are great sites for support in recovery. Many people have recovered from benzo dependency - and you can too. Join a benzo forum and ask for help - you will get all you need.
RUNVS is the current expert in here on benzos.................he's around all the time ............ so just shout!
Good luck

[VictoryLee]

Thanks, Whoops. I have seen Runvs on other sites. He sure knows his stuff.
I was wondering if anyone here has read the book "The Road Back"?. It says something in there about using some kind of cherry syrup or pills to help with w/d. It also recommends some kind of barley supplement for people in protracted w/d. Does anyone here know anything about these things? Could they possibly work? Was just wondering, as this tapering business totally sucks. Anything that would help, I would gladly try. I know on BI they say to not even take a vitamin pill, so maybe this book isn't right. Just don't know anymore.
I guess I will just have to see my doctor again and try and get some valium. Although I just visited a yahoo group and there are so many people suffering there, too. I wonder how many people come off of these pills without having a protracted w/d??
Thanks again for listening.


Victory

[VictoryLee]

I have been on BI and find them very cold..not the members, the mods. It is sort of a forum with a cultish...made up that word....agenda. You can't even voice your opinion. Can't tell you how many people have been booted or had posts deleted for saying something "wrong".
Anyway, my doctor said he would give me 40mgs.of valium a day. That is only 2 pills. Is this something that is doable? Can I just start to taper with this small amount? Any suggestions would be most welcome.


Victory

[Kahlia]

Originally Posted by Buzz Kilowatt

There are good uses for any medication and each patient's use must be evaluated in terms of risk / benefit.

This forum is for people who are struggling with their drug and medication usage -- situations where meds have made their life worse, not better as you claim.

I tend to take a "libertarian" view of many things and if Xanax is working for you well great, it's no one else's business.

But I've got to wonder, if you are content or even enthusiatic about your own drug use, why would you be compelled to join an addiction forum?

Best regards,

Buzz

BUZZ?????...............As A RN with a Master's degree, and a person who herself is taking Klonopin for a personal reason, I choose not to share with you, I take 2mg in the AM, 1MG at 2pm and 2mg at night. I think I can understand why he would want to SHARE as you call it with the forum, it is an OPEN forum, HE is expressing HIS opinion...I have followed this WHOLE thread...WHY...I have to say that I am not a judgmental person, NORMALLY but to RAMBLE on and on about the same thing for almost 6 pages is rididculous...OK, the point is made..we all know about the drugs being addictive, I am also under an addiction specialist.....I am also under a psychiatrist....THEY BOTH agreed that I need the klonopin...CALL them crazy, if you will. I was about to go crazy until they put me on the Klonopin...who is to say who needs what and who are YOU to ask why anybody needs anything. even an aspirin? I can get very angry with this subject, you may be very liberitarian , I am just dowright sick of this damn subject....yes, I am going to hear your opinion...FREEDOM of speech....AHHH...I am waiting...it will not deter my point. Some people here are just as allowed to state an opinion as anybody else, would you not say? You do. and HAVE....nothing can make a person more judgemental than hanging on EVERY other word....think about it....just a thought.......PEACE and I hope you can try and see the other side.....Kahlia

[Kahlia]

Originally Posted by RUNVS

This thread is to inform others that benzos can lead to problems and there is hope.

Just make sure you do not let your prescription run out. Because cold turkey on 9 years of klonipin use could be real tough. Even the manufactors of klonopin do not recommend taking benzos for more then 4 weeks at most. Remeber this is a sober recovery board and not a board for the promotion of drugs.

BENZODIAZEPINE WITHDRAWAL SYMPTOMS

PSYCHOLOGICAL SYMPTOMS
Excitability (jumpiness, restlessness)
Insomnia, nightmares, other sleep disturbances
Increased anxiety, panic attacks
Agoraphobia, social phobia
Perceptual distortions
Depersonalisation, derealisation
Hallucinations, misperceptions
Depression
Obsessions
Paranoid thoughts
Rage, aggression, irritability
Poor memory and concentration
Intrusive memories
Craving

PHYSICAL SYMPTOMS
Headache
Pain/stiffness - (limbs, back, neck, teeth, jaw)
Tingling, numbness, altered sensation - (limbs, face, trunk)
Weakness ("jelly-legs")
Fatigue, influenza-like symptoms
Muscle twitches, jerks, tics, "electric shocks"
Tremor
Dizziness, light-headedness, poor balance
Blurred/double vision, sore or dry eyes
Tinnitus
Hypersensitivity - (light, sound, touch, taste, smell)
Gastrointestinal symptoms - (nausea, vomiting, diarrhoea,
constipation, pain, distension, difficulty swallowing)
Appetite/weight change
Dry mouth, metallic taste, unusual smell
Flushing/sweating/palpitations
Overbreathing
Urinary difficulties/menstrual difficulties
Skin rashes, itching
Fits, convulsions




Different strokes for different folks. I choose now to be completely drug and alcohol free.

Take good care
RUNVS

RUNVS

I an glad for YOU that you choose to be free of whatever benzo you were taking -all people in recovery including myself,I am under two Dr's care including an addiction specialist. I am also an RN with a Master's Degree. I am wondering why you feel the need to keep listing all the side effects, which can be found in any PDR (Phycisians Desk Reference)-they have them in the library, you seem to be fixated on this benzo-type thing? I have read all your posts and just for the record they are NOT all accurate...there are many that you may think are because you were addicted, you have some wrong information...Your list does not include some side effects that some people have beyond the Normal realm of the drug....my addiction specialist told me yesterday......

1. A feeling of "speeding"
2. Irritability, even though taking the correct dose.
3. loss of sleep, dreaming-nightmares.
4. A slow" reactive" test for pain reflex

Just to name a few.

I am only telling you this because I am begining to think you have researched the drug and think you are an "expert. I , do believe that you are trying very hard to help people and that is always a very good thing. For that I am glad BUT enough already....Why this specific drug....I have been "clean" for 6 years and I am quite sure you will say that I am not because of the Klonopin...UH-OH. I could start a thread about Dilaudid...NOW that is a REAL drug..I went cold turkey off that 6 years ago...OH and Morphine Contin(long-lasting-12 hr. period). PLEASE, no more of the pharmacutical jargon, enough, already....we understand, if it HAS to be, please put it in a PM etc...I think everybody has it all down.....PEACE....Many Blessings for all your work.....kahlia.

[Buzz Kilowatt]

Originally Posted by Kahlia

BUZZ?????...............As A RN with a Master's degree, and a person who herself is taking Klonopin for a personal reason, I choose not to share with you, I take 2mg in the AM, 1MG at 2pm and 2mg at night. I think I can understand why he would want to SHARE as you call it with the forum, it is an OPEN forum, HE is expressing HIS opinion...I have followed this WHOLE thread...WHY...I have to say that I am not a judgmental person, NORMALLY but to RAMBLE on and on about the same thing for almost 6 pages is rididculous...OK, the point is made..we all know about the drugs being addictive, I am also under an addiction specialist.....I am also under a psychiatrist....THEY BOTH agreed that I need the klonopin...CALL them crazy, if you will. I was about to go crazy until they put me on the Klonopin...who is to say who needs what and who are YOU to ask why anybody needs anything. even an aspirin? I can get very angry with this subject, you may be very liberitarian , I am just dowright sick of this damn subject....yes, I am going to hear your opinion...FREEDOM of speech....AHHH...I am waiting...it will not deter my point. Some people here are just as allowed to state an opinion as anybody else, would you not say? You do. and HAVE....nothing can make a person more judgemental than hanging on EVERY other word....think about it....just a thought.......PEACE and I hope you can try and see the other side.....Kahlia

Kahlia,

Sorry, I don't understand exactly what you are trying to say and why you are angry with me. Perhaps the message I intended to convey was not delivered or received.

Maybe if I rephrase it, you can point out what I said that troubles you:

1. Addictive medications have their (good) uses.

2. If you are a prescribing MD or RN you should always take into account the downside risks and possible complications of any medication, addictive or not.

3. If Klonopin helps you, WONDERFUL! I'll be the LAST to suggest you stop using any medication that is helpful to you, addictive or not. IT'S REALLY NONE OF MY BUSINESS!

4. I agree that Arpeggioh is entitled to his opinion. Great if his meds are working for him, too.

5. Arpeggioh is (apparently / obviously) happy with the meds he is taking. I'm simply curious why someone who doesn't feel they have any medication problem --- indeed the opposite --- would surf the net and join an addiction and recovery forum (you have to join before you can post). I thought it was a fair question -- apparently you did not.

6. The title of this forum is Sober Recovery. Most of the posters here are having trouble with some aspect of control over the medications they are using. A lot of people are in real distress. If I was happy with my Ford it would probably never occur to me to find out who on the Chevy forum doesn't like Fords and why . . .

7. I tend to see irony where others don't. Consider it a character flaw. Or blame it on overzealous English professors. Sorry if I offended you - that's not my intent.

- Buzz

[Live]

Damn, I do sort of understand. Both sides. Because, yes, I am prescribed a benzo. (#1) and (#2) because what I read about it here got me very scared and (#3) mental patients are notorious for not wanting to take their medications, and I am one of them and therefore (#4) I decided based on this thread and the "experts" quoted that I would decide better than my p-doc and took a month off work to detox. and then (#5) found that my original diagnosis was still correct and I was just making my self sicker by being stubbornly self-determined and too vulnerable to others' opinions and (#6) went back on a reduced dosage of benzo and (#7) am not listening anymore to any one who does not know my full history and health issues. and oops (#8) taking the medications, 3 of them, that improve my health and well being are not sobriety issues.

[Arura]

well put ((Live)) as i also am on benzos...so i like to read and understand, as much as possiable about there affect on me, as this is not just an elasterplast, on my life it stops me from hurting myself,..! yes actually cutting myself, to stop it i need a combination of the drugs i need to take, n LOTS of coping stratrgies...LOL...hummm.!

I like the info, on here its an eye opener...as the Drs never tell you ...!

In most med books it says dont perscibe for over 3 weeks,..! So many contradictions there...???

I personally know that what has happened to me in my life is not just going to go away with a pill,...but with time medication, and dedication...! I will get to a stable place...!
People take there meds for many resons,...and some are VALID resons to jump off the roof, let alone try to stop that...happening.

As for me at times with out valium i would have no face left...Littrally, so dont be so hasty to judge why others need there meds...!

sorry my sp is really bad.! it is late...! here now...!