You know how you can warn a kid not to touch a hot stove, but he’ll do it because he has to learn “hot” for himself? It’s the same with some medications.
Despite numerous warnings about the risks associated with certain long-term prescription drug use, people still use them for months and even years! The misuse and abuse of prescription drugs happens with teenagers, and seniors, and everyone in between, and it’s scary because no matter how judicious we are about warning patients and doctors, the prescriptions keep getting handed out, the pills keep getting swallowed, and the behaviors with these drugs are keep getting riskier.
Benzodiazepine Misuse
The misuse of many popular medications is killing people, especially when combined with alcohol or opiates. I’ve seen happy, otherwise normal people lose their lives, their jobs, their relationships, and their minds due to the use of common, popular drugs that come easily prescribed by well-meaning doctors. These drugs include sedative/hypnotics (sleepers), opiates (like painkillers), antidepressants, benzodiazepines (tranquilizers), and other various muscle relaxants and anxiolytics. Today’s focus is benzodiazepines, or benzos for short.
As a natural pharmacist, I’ve spent my entire career championing the safe use of pharmaceuticals, as well as natural herbs, vitamins, minerals, and nutrients that have few harmful side effects. Benzos are a nightmare to get off of, and the inter-dose withdrawal symptoms can cause major disability. Not only that but getting off these drugs should not be done all by yourself, see your doctor or pharmacist for a personalized withdrawal schedule on how to do this safely because suddenly quitting on your own may lead to hospitalization, no kidding.
Interdose withdrawal is the state of withdrawal that occurs in between your doses.
It is sometimes used interchangeably with another term called “tolerance” withdrawal, but they are not exactly the same. To be precise, tolerance withdrawal is the state of withdrawal that happens if you don’t increase your dosage over time. It’s similar to interdose withdrawal because if you become tolerant to a dose, and fail to increase it, your body will crave it in between the doses. Still tolerance withdrawal has more to do with getting ‘tolerant’ to the dose you’re on, versus “interdose withdrawal” … the state of mild withdrawal that you feel in between each dose. The time frame for this varies depending on the half-life of the drug and how long it takes to clear. This is higly individual. An example of this, is if you take a benzo at night for sleep, and you take the same dose every night for years, then you may notice physical and mental withdrawal symptoms beginning around noon or 2pm every day lasting for hours, until you take your evening dose again.
Only then do you feel better because you’ve fed the monster.
The interdose withdrawal is happening because you are sustaining the same evening dose, which is what many of you do, since you don’t want to keep taking more and more and getting addicted. But you already are addicted. You see once you start a benzo, it’s really not humanly possible to stay at the same low dose you began with. If you try, you’ll be highly uncomfortable, because you’ll go into this terrible state of tolerance withdrawal in between your regular dose. This is really hard to explain in print, but I think you know what I mean.
These dangerous drugs – and they are dangerous in my book – are being routinely overprescribed for this that and the other… and worse, they are being misused and abused as recreational drugs. Many of you start out on a benzo because your physician fails to give you the appropriate warnings (so I’m doing that today), and within weeks you are hooked and on a roller coaster. One of my dear friends called me today and said her physician put her on Xanax due to new onset panic and anxiety. Now this is a very chill girl, she is intelligent, organized and happy-go-lucky. She suddenly is dealing with profound anxiety at 38 and she got prescribed Xanax to offset the emotional problems caused by the antibiotic he gave her last month (a fluoroquinolone drug). So instead of treating the poison that attacked her nervous system and caused this, she is prescribed more … well, you get the picture. It’s something you’ve probably experienced yourself. Layers of drugs needed to treat the side effects of previous drugs. Makes the world go round!
This kind of craziness is exactly what I’m trying to prevent today. Hopefully the benzo mafia won’t come hunt me down for what I’m saying today.
Just don’t start them!
What do I recommend? Just don’t start them. Why start something that is almost impossible to stop, that can cause you long-term harm?! I hope my article will be enlightening and helpful to your future discussions with your practitioners and mental health professionals.
In my 25 years as a licensed pharmacist, I have seen how matching the right prescription to the right patient can translate to improved health. But I’ve also seen disasters. And one thing I do know more than anything else – if you don’t need a drug and you take it anyway, then it’s all downhill from there.
We all know that less is more, and we know that sometimes the benefits of a medication will not always outweigh its side effects, particularly when there are many non-prescription alternatives that offer nearly the same benefit with fewer, if any, side effects.
Seniors take a lot, and often fall down…
Benzodiazepine drugs are at the top of my list of pharmaceuticals that are best avoided because you can become so dependent on them and because they can cause so many brain problems with long-term use. What’s scary is that benzodiazepines are among the most prescribed drugs for the elderly. Their use is associated with side effects such as dizziness and drowsiness, and of course, the natural consequence to that… falling! Hip fractures, TBI (traumatic brain injury), chronic and intractable pain and early death can be caused by senior falls.
Another sad but true fact is that recreational benzo abuse is favored by both men and women. Why it became so popular is beyond me. If people knew how damaging the misuse and abuse of these drugs can be to your one and only brain, they would think twice about playing around with them.
A SAMHSA study discovered that, in the United States, benzodiazepines account for 35% of drug-related visits to hospital emergency rooms and urgent care clinics. Men and women of all ages are now routinely taking (and more likely abusing) benzodiazepines just for the fun of it. The article I read reveals that at least a half dozen popular benzos are being used as recreational drugs. The number of emergency room visits due to benzodiazepine misuse and abuse increased by 36% in just two years, between 2004 and 2006.
The drug companies that manufacture these drugs only recommend that they be used short-term, generally up to only a few weeks, yet many of you have taken them for years. You can quickly do an online search for “benzos” and see the well-known brand names they are sold under, there are about 30 of them. While not every single person who takes a benzo long-term suffers, I suspect the majority do, they just don’t know it because their tolerance withdrawal symptoms get diagnosed as a brand new disease, and subsequently medicated. Chronic benzo use might also cause long-term neurological damage that is so difficult to diagnose that it’s possible to be accidentally diagnosed with atypical forms of common neurological disorders, such as ALS, Parkinson’s, MS, and Alzheimer’s. I’ll come back to that in a minute. This churns millions, probably billions, for the sick-care system in America.
Benzos are now very affordable drugs because they have been used to tranquilize people for decades. Although benzos are deliberately misprescribed for pretty much everything these days, they should only be considered for serious anxiety, severe insomnia, and seizures, for which they may be effective until the root cause is determined.
Sometimes benzos are prescribed for social anxiety, which I’m very much not in agreement with. My feeling is that benzos might be okay for some individuals, and for short-term use only (a week or two), like if there is sudden grief or shock, or PTSD… but let it be reiterated that I believe the constant use of these drugs can have serious adverse impacts on an otherwise normal brain, due to the widespread cellular damage to the neurons.
Signs of Benzodiazepine Abuse and Dependence
When benzos are being used for a long period of time, there are some signals that should cue others into the fact that a person is “on something” that is altering their brain and body. Some of these symptoms include those that mimic being drunk:
Slurred speech or impaired coordination
Depression
Drowsiness
Dizziness or vertigo
Memory loss
Hostility or rage
Fatigue
Low libido
Panic attacks
Sound and light sensitivity
Twitching
Suicidal ideation
Reclusiveness
A more comprehensive list may be found here: https://www.benzoinfo.com/about-benzodiazepines
How Benzos Work
Benzos work by impacting the receptors of gamma-aminobutyric acid (GABA-a) in the brain. GABA relaxes you. GABA hormone is at its highest when you are sound asleep. That doesn’t sound like such a bad deal, does it? I mean, who wouldn’t like to feel more relaxed? The problem is that benzodiazepine drugs can be highly addictive when they’re not used correctly or if they are used long-term. In fact, both alcohol and benzos impact similar brain receptors and brain chemicals.
If you enjoy alcoholic beverages and have tried to stop drinking, you know how difficult it can be to resist the urge for “just a half a glass.” When you think of benzo drugs, think of alcohol, they work in similar ways by impacting GABA receptors. And, likewise, their abuse works in similar ways.
Benzos don’t create more GABA, their ability to relax you is contingent on how much GABA is already being manufactured in the body. These drugs aren’t making more GABA, they are just making better use of the GABA already produced in your body, making it hang around longer in your brain, and thus relaxing you more. GABA offsets glutamate, an excitory chemical that we need a little bit of (but not too much). GABA and glutamate sit on a see-saw.
Brain Shrinkage
The problem with the misuse and abuse of benzos is that the brain’s precious GABA receptors begin to atrophy. Simply put, the doors on the cell (the cell receptors) literally begin to wilt and die through a change in conformation and structure. It’s called “down-regulation” and it can take as little as one month to begin to occur. And once it does begin to happen, a person needs more and more GABA to feel relaxed, which means it becomes harder and harder to stop taking a benzo. This is how tolerance withdrawal takes its hold on a person, and why I said no one can escape it. Not one of us is a super hero, not one person can stop the process of down-regulation with benzos, antidepressants or other mood altering drugs. It’s destiny. It’s why I said, “Just don’t start them.”
Weaning Slooooooly
This is a good time to tell you, you should never ever just stop them, because you have to wean, you can’t suddenly stop, it could produce horrific withdrawal symptoms that require an Emergency Room and hospitalization. So I’m not telling anyone to suddenly stop. People who decide to stop have a plan, and support, and practitioners or addiction specialists, some require medications or stays at the rehab clinic. It’s very individual, it depends on YOU, and what you’ve taken, the duration of your benzo treatment, and dosage and much more. Genes also come into play, as does baseline nutrition. The main point is to warn you that weaning is done slowly, and I mean slooooooly.
The process of weaning off benzos too quickly can spark a seizure – due to the sudden decrease in GABA chemicals – which can take months (or even years) to completely recover. If you withdraw GABA, there is a perceived higher amount of glutamate, and this can produce massive anxiety, panic, insomnia, tremors, unnatural fear, mild seizures paranoia, auditory, visual and phantosmia (smell) hallucinations. And more!
Once you are off, the drug may be out of your system within a month, but the protracted withdrawal symptoms can last months, or as long as several years. Weaning off benzo use must be done extremely, extremely, extremely slowly! Like, over the course of months. Because some of you are reading my article and you’re nervous about your benzo medication, I need to make this very clear.
You do not want to suddenly stop long-term benzo use if the cell receptors have been down-regulated and there is very little GABA remaining. In this case, a sudden stop could become a life-threatening situation. See now, why I told you it’s best to totally avoid them.
New Benzo Research
If a benzo prescription is written and handed to you, here’s another reason to say “No thanks doc, Suzy said not to start this!”
A recent study published in the journal, International Clinical Pyschopharmacology, by researchers in Finland has provided another compelling reason to pause before continuing to refill a benzo prescription. Scientists there followed 45,000 older adults (mean age of 80) who had recently been diagnosed with Alzheimer’s disease, and found that among the 22% of study participants who had used either benzodiazepines or a benzodiazepine-like drug, there was a 20% increase in risk of stroke.
This is a significant increase, and it was surprising because benzos had not been linked to an increased risk of stroke before, although these researchers had found in a previous 2016 study that benzos were associated with a 43% increased risk of hip fractures in Alzheimer’s patients.
Perhaps you know, or take care of someone who has been diagnosed with Alzheimer’s disease. Even if you are thinking that dementia and Alzheimer’s aren’t conditions that are on your radar, consider a second study about this. In 2014 another study found that long-term use of benzos (which is defined as three months or longer) is associated with up to a 51% increased risk of developing dementia or Alzheimer’s.
I wish that physicians were not so quick to prescribe these drugs, but there’s nothing I can do about it. I can only educate you. So think about the gravity of what we’re learning about benzos for a moment:
If the research is correct, and we can extrapolate the data big picture, then it sounds like the chronic use of benzos can hinder your ability to walk, your bone strength, your brain power, and your blood flow. Taken together, the adverse effects impact of long-term benzo use – to say nothing of their misuse and abuse – can have a horrific impact on your mind and body as a whole.
La La Land
The long-term use of benzos is not just making you sleep in la la land, it could be negatively impacting you for years to come while you catch those Zzz’s. And for the record, delta brain waves are not achieved very well, you’re “sleeping” but you’re not really sleeping.
Statistics show the use of benzodiazepine drugs and other mood-altering drugs like antidepressants, sleepers and nootropes are mis-prescribed like candy from a vending machine, and worse, the risks are not relayed to the patients.
You cannot suddenly stop, it’s dangerous so do not stop your medication. But if you are at the place where a doctor wants you to begin the medication, I beg you to say no. Don’t believe this “Yeah, there’s absolutely no harm in taking this, don’t worry so much.”
Or another one, “This is safe because it’s been on the market for decades, plus psychiatrists prescribe it every day for people, don’t worry.”
If you’ve been told this, my opinion is you’re either dealing with an ignorant practitioner, or it’s a flat-out lie. A quickle google search reveals benzodiazepine risks. My concern is once you begin benzodiazepines, there will be no choice but to keep raising your dosage or face tolerance withdrawal, or worse… suffer the consequences that slowly claim your brain. If you’re trying to get off, please see an addiction specialist, do not suddenly stop.
In the past 20 years, research has found that prescriptions for benzodiazepines have more than tripled and fatal overdoses – particularly from misuse and abuse – have more than quadrupled. And when the dosage is raised again and again to maintain its effectiveness, the horrific symptoms of tolerance withdrawal can be disabling. And my fear is that once you begin benzodiazepine use, there is no choice but to keep upping the dosage and face the disabling neurological symptoms that claim your brain. Acute use turns into chronic long-term use because it feels so good when you take these pills, it makes you not care about your current reality, and that is what locks most people into decades of misuse, and abuse. See what I mean – it’s better to never even start.
Relaxing Alternatives
If someone is looking for ways to relieve anxiety or insomnia, a subject that I have written about extensively over the years, please use my search box and put in key terms. As a brief summary, I’ve listed a few natural remedies below. These may be able to take the place of a legitimately prescribed benzo for short-term use but I want you to talk to someone ‘in the know.’ These might be useful for mild anxiety whether or not you are on a prescribed benzo. And remember my warning, do not stop taking a benzo suddenly, weaning off one should take months, and in some cases even longer because it’s such an individual situation. Find an addiction and withdrawal specialist to help you with your personal case. In the meantime, I’d like to share these natural options (sorry, I have to say this out loud) talk to your doctor about what’s right for you:
Passionflower
Make a nice strong cup of passionflower tea, which will be a lovely, deep shade of pink (making it appealing even to young children). A study of people with “generalized anxiety disorder” found that passionflower was as effective as a common generic benzodiazepine in reducing anxiety-like symptoms.
Lavender
Inhale this essential oil deeply right before bed, and rub it behind your ears and on your hands and feet. You can also put a drop of lavender essential into some chamomile tea.
Magnesium
A deficiency of magnesium is known to cause insomnia, as well as a higher risk of migraines. Formulas that contain “magnesium threonate” might be better than other salts of magnesium because it’s proven to go into the brain.
Melatonin
Although our pineal gland makes this chemical naturally, as we age we might need a little more, so you might consider supplementing with 0.3 mg to 3 mg an hour before bedtime. But ask your doctor if this is okay for you because even though it’s a nutritional supplement, melatonin can have far-reaching effects in the body. It may also prove useful for some autoimmune conditions.
Magnolia bark
I’ve written a good article on magnolia bark – you can find it by CLICKING HERE.
In addition, a study published in the Journal of Pharmacology showed that honokiol, an extract from magnolia can induces a specific stress-relieving effect and is less likely to cause “motor dysfunction” as well as sedation as compared to prescription drugs. Magnolia is relaxing and natural, and more than that it doesn’t cause brain fog like many prescription sedatives.
Want more help?
You can also find other natural remedies in my previous article, 8 Ways to Calm Down Quickly. One of the few times I recommend taking a benzodiazepine-type drug is to help a person calm down who is prone to panic attacks. This is an extreme situation of course, so for someone who is prone to a panic attack associated with a single event, such as dental surgery or a plane flight (where you think you might faint), a benzo can be indicated. I’m saying in these extreme cases – but not at all for general anxiety – just in cases of literally extreme terror. Another valid situation would be if a person has just been informed about a loved one’s unexpected death or witnessed a tragic accident.
So to be clear, please don’t send me hate mail if you are pro-benzo, I’m just calling it as my professional career has seen it.
To summarize, I am NOT for benzo use unless there’s a very clear legitimate short-term need, and only then there’s a time and place for them, like if you think you are going to swoon after receiving tragic news. If a benzo is being used to control seizures, sure, then that would be considered a medical necessity. Sometimes these drugs are used for panic or anxiety associated with surgery. But that is not what’s happening today in the United States.
Unfortunately, our medication-crazy society is such that benzos are offered for everything under the sun as if they were innocuous. To children too, in order to control behavior, to nursing home residents to keep them quiet. To regular people for minimal problems. I know one woman who was given a benzo for her knee pain. Really! Now 8 years later, she has 6 different diagnoses, she’s on 28 pills a day (including her original benzo) and she’s disabeld. Benzos aren’t for knee pain! How would her life be if she wasn’t given that drug for “knee pain?”
To their credit, the FDA came out with a warning in 2016 about the concomitant use of benzos with opiate drugs like oxycodone, hydrocodone, morphine, and codeine.
The drugging-up of America is disturbing, and the indiscriminate prescribing of benzos can wreck an otherwise perfectly wonderful life. For some people, getting off benzos is way harder than getting off acohol, opiates and even heroin. If your doctor tells you not to worry about starting your benzodiazepine drug, or that these drugs are “easy to withdraw from over a week” then your doctor is not only critically uninformed, he or she is playing games with your life. It is truly unfortunate how often I hear this dangerous opinion being told to many patients today. I so want to protect you and wish you well.
For those of you interested in more information or virtual help, visit these sites:
Don Killian has a personal fascinating story. He tells it, and offers encouraging help for those in withdrawal through his videos. He has taken the time to record over 160 videos, all free to watch.
Benzo Buddies: An online community forum to help you get through (and celebrate) being free of benzodiazepines.
Benzodiazepine Information Coalition: This website has information and supportive articles and videos to help you understand the dangers of benzodiazepines. They are a non-profit organization that raises awareness of the risks of benzodiazepines, particularly tolerance and severe and protracted withdrawal which really appears to be withdrawal triggered illness, sometimes it is termed PAWS.
https://www.benzoinfo.com/
Dr. Heather Ashton: This is “the manual” that helps many people withdraw properly, written by a professor from the United Kingdom. https://www.benzo.org.uk/manual/
References
Hip fracture study: https://www.sciencedaily.com/releases/2016/11/161123090702.htmLong-term benzo use and Alzheimer’s risk: https://www.sciencedaily.com/releases/2014/09/140909192042.htm
Benzo, stroke and Alzheimer study: https://www.ncbi.nlm.nih.gov/pubmed/28072593
Mechanisms Involved in Benzo Tolerance: https://pdfs.semanticscholar.org/461d/d16eaba1c67aac51c8d8a45b9175422fc794.pdf
Suzy Cohen, has been a licensed pharmacist for over 30 years and believes the best approach to chronic illness is a combination of natural medicine and conventional. She founded her own dietary supplement company specializing in custom-formulas, some of which have patents. With a special focus on functional medicine, thyroid health and drug nutrient depletion, Suzy is the author of several related books including Thyroid Healthy, Drug Muggers, Diabetes Without Drugs, and a nationally syndicated column.
