Sometimes the treatment for certain disorders can be worse than the original illness. The following is how a true account of how I accidentally became addicted to benzodiazepines and what I’ve learned in the process. My goal is to inform readers to the dangers of reckless use of benzodiazepines. Please be aware that I am not a doctor, and any recommendations I make should be discussed with a medical professional.
Anxiety attacks (also known as panic attacks) is a disorder when the body suddenly feels a fight-or-flight reaction. These usually occur due to stressful stimuli but can also occur at random periods. The sufferer suddenly feels a drowning sensation: unable to breathe or rapid breathing, tightness in the neck, shakiness, and sometimes they mimic the signs of a heart attack.
Unlike a phobia, which is usually an irrational fear of some sort, panic attacks usually surprise the sufferer. The person experiencing these episodes feels an impending sense of doom or that death is about to occur.
Benzodiazepines: A Cure or a Curse?
One form of treatment for this disorder is a class of medication called benzodiazepines. These medications include Xanax, Valium, Klonopin, and Ativan, just to name a few. For the alleviation of panic, they are miracle drugs. Then can either stop an attack from occurring or reduce the severity of it.
But like every medication, there are disadvantages as well. For one, benzodiazepines are known to be “habit forming.” “Habit forming,” to me, is a euphemism for addictive.
I should know. I was once a “benzo” addict.
I went to a psychiatrist [name withheld] for a myriad of reasons, one of them being panic disorder. He prescribed me a low dose of a common benzodiazepine for it.
It all seemed simple enough. Whenever I knew I was about to be in a stressful situation, especially driving, I would take one. When I felt fine, I didn’t. I used them as I felt needed.
Well, when my psychiatrist wrote me prescription after prescription for the medication, I finally told him I didn’t need any refills; I had plenty. He was surprised. He told me that I should take four tablets a day every day, regardless if I felt like I needed them or not. He said it has to build up in my system.
So I followed his instructions – My first big mistake.
The Beginning of Addiction
When I have panic disorder and take a benzo tablet, I felt “normal” – calm but not drowsy. I was alert and functional. But when I took a tablet when I was not experiencing any panic, I felt a sensation of euphoria that I’ve never felt before. It was an incredible feeling. So I took four each and every day.
A fact about benzodiazepines: The human body builds up a tolerance to them quickly. The brain begins to expect the artificial chemical, so the threshold for panic changes. The liver also anticipates the dose of the benzodiazepines and has the proper enzymes ready to metabolize it.
After two or three months, the panic attacks returned even though I was still taking my four-a-day dose. What was the solution?
Simple. He doubled the dose. And now a pattern was set forth.
After several months, I was taking close to 8mg of the common benzodiazepine a day – twice the amount recommended by the manufacture of the medication – and my psychiatrist was about to increase the dosage once again.
Finally, I voiced my concerns. Is there a limit on the dosage one can take? Or will I keep increasing the dosage indefinitely?
He told me not to worry; he wrote prescriptions for himself all time. After discussing the situation with him, I realized he had a benzodiazepine dependency as well. I felt sick to my stomach and felt stupid for not asking questions sooner.
Withdrawals from Benzodiazepines
I began to secretly taper my dosage of the drug – much too rapidly – while my prescriptions were adding up. It was a horrible period. My anxiety came back even worse than before, and I could feel new unpleasant sensations: crawling skin, rapid heartbeats, nervous tics, and I began to become extremely irritable.
Suddenly, my psychiatrist was about to retire, and he was desperate for me to start using a non-benzodiazepine to control my anxiety. I refused, since I was still in the process of withdrawing from benzodiazepines and didn’t want to add yet another chemical to my body’s chemistry. (Later, I did try the medication under a different doctor’s care – It didn’t help me at all).
Within two weeks after my psychiatrist retired, his office caught fire, burning all medical records. I will let the readers draw their own conclusions.
But now I had a new problem. I was still addicted to benzos, both physically and psychologically, and now needed a new doctor to help me with my “habit.” I found myself to be an “accidental addict” and had to do something about it. On top of this, my father had been diagnosed with cancer and diabetes, which only made my depression worse. I began to make some very unwise decisions of which I’m not proud.
Before I go much further with my account, a little more background on how benzodiazepines work:
Mechanisms of Benzodiazepines
Neurotransmitters in the brain suppress anxiety and fear. People suffering from panic disorders are either not producing enough of these neurotransmitters or it is not being processed correctly.
Benzodiazepines help fill this deficiency, thus producing a calming affect. The by-products of the medication are then metabolized in the liver.
When a person first begins taking benzodiazepines, the brain doesn’t expect anticipate this sudden increase of the mild calming chemical. Also, the liver doesn’t have the enzymes readily available to “burn off” the medication. That is why drugs these medications work so well in the beginning.
Here is an excerpt from a comment from a reader of my blog that provides more information:
The “fear” area of the brain is the amygdala, and animals (including people) without amygdala’s show no fear. The neurotransmitters that influence it include GABA (stands for something long), norepinephrine, and serotonin. When the body does not make enough of these chemicals panic or fear is caused. In school we learned about drugs like Xanax and doctors don’t really know how it works other than it appears to enhance GABA uptake which is an inhibitory neurotransmitter – so it inhibits your overreactive fear response. It is very hard to study the effect of just one of those three transmitters, because they all interact and affect each other; so research is still ongoing.
Building a Tolerance
However, the human body is very adaptable, which can be a curse at times. Eventually, the brain realizes that this calming chemical will be present, so it begins to produce less of its naturally occurring substance. At the same time, the liver has now created a sufficient amount of enzymes to quickly metabolize the drug. This is known as “tolerance.”
By increasing the dose of the benzodiazepine, the brain and liver are once again unprepared for the higher amounts of the calming agent. But in time, they adapt, and once again the medication is rendered useless.
The really dangerous part is how the brain reacts. Since it keeps receiving this synthetic chemical, it starts to lower the production of it naturally occurring neurotransmitters. If a person suddenly quits the benzodiazepine medication, the brain is left depleted of its own “calming chemistry.” This produces “rebound anxiety,” which is many times worse than what the patient originally experienced. If a large enough dosage is discontinued, convulsions, seizures, and even heart arrhythmia can occur.
When Addiction Occurs
At this stage, a person is now physically dependent on the drug. This is known as “physical addiction.” There is also the psychological aspect to the addiction, because of the euphoria the medication can produce.
A long time heroin addict uses heroin not to become “high” but to stave off the sickness of withdrawals. The same holds true with benzodiazepines. The only difference is, few people die from withdrawing from heroin, despite the ill effects they experiences. Not true with benzodiazepines. More people die from quitting these medications – some brands more than others – too rapidly than from overdosing.
If I knew this information earlier, I would never have started taking a benzodiazepine. As always, hindsight is 20/20.
The following is definitely a “do as I say, not as I have done” account. Consider this a disclaimer.
After my psychiatrist quickly retired, it was hard to find a doctor to fulfill my prescription. The stack I had from the psychiatrist was out-dated and couldn’t be used.
Desperate situations sometimes make people not think clearly. I was one of those people.
Before benzos, I never did any illicit or illegal drugs. I rarely ever drank, except for an occasional glass of wine at dinner or a social beer. I didn’t smoke, and I even kept my caffeine intake to a minimum; caffeine is the last thing an anxiety-ridden person needs.
But I felt I needed more benzodiazepine than was prescribed by my new doctor. I had tapered off slowly but not slowly enough, and the withdrawals were getting severe and started to interfere with my work and social life.
I actually considered buying the medication online from some of the shady pharmacies located overseas. But fortunately I at least had the good sense to squelch that idea early on.
So I improvised. Alcohol is a depressant and when mixed with benzos, the effects are greatly increased. So I added alcohol to my chemistry, along with the antidepressants and benzodiazepines.
Another trick, which worked on workdays, was to take benzos with grapefruit juice. Grapefruit can cause benzodiazepines to metabolize slower.
Mixing any prescription medication either with alcohol or grapefruit could cause serious side-effects, including poor judgment, “risk-taking” behaviors, and lack of coordination, just to name a few. In some rare cases, it could possibly be fatal.
The withdrawal symptoms lessened considerably. But now my depression increased due to the alcohol (I’m bipolar, which is another factor that did not help my situation). I learned later that this process is common to addicts: switch from one addiction to another. Luckily, I never became an alcoholic, but it was still very unwise to mix benzodiazepines with alcohol. That said, it made tapering off the the drug easier.
So my depression was getting worse just as my family life was falling apart with father’s illness. Instead of coping with it, I began to use alcohol more and more.
Another common factor with addiction is the idea of a “gateway” drug. This idea is that a potential addict starts off with one drug and then proceeds to another, stronger one, until the addict finally “kicks” the habit all together or dies. Marijuana is often considered the most common gateway drug. In my case, it was my brand of benzodiazepine.
Addiction Can Happen to Anyone
If you told me back in the early 1990s, when I was playing frequently tennis and taking great care of my body, that I would have addiction problems a decade later, I would have laughed. All through my teens and 20s I’ve never tried marijuana, smoked tobacco, or used alcohol that often. Addiction, I sadly discovered, is a creeping illness. It lies in wait for the right time to strike, when one is most vulnerable and blinded by a “it could never happen to me” attitude.
Some Final Thoughts
I hope I haven’t demonized benzodiazepines too much. They have legitimate uses when used properly, when needed. I wouldn’t have been able to drive without them due to anxiety attacks behind the wheel.
The main point I want to stress is to be aware of new medications, and question your doctors thoroughly, even if it annoys them. After all, they are human and are bound to make mistakes like the rest of us. Do your own research before blindly adding a new substance to your body. Just because it’s a prescribed medication, as opposed to an illegal one, does not mean it doesn’t carry any risks.
Currently, I have found two excellent doctors who have put me on a reduction plan (I reduce my dosage by .5mg every two months). I still take benzos to this day but at much smaller doses and only when I really need them. I am still physically and psychologically addicted to it, but not nearly as much as I once was. It will take some time to finally be off the medication all together.
To help my anxiety issues while reducing my benzodiazepine intake, I have been prescribed gabapentin (an anti-seizure medication) and hydroxyzine (an antihistamine). Both medications have anti-anxiety properties and have been extremely helpful to reduce panic attacks. And they are much safer than benzodiazepines.
Also, do not suddenly quit a medication until you know about it withdrawal effects. Some you can discontinue immediately; others you will need to taper off slowly.
And never assume you are not a risk for addiction. Everyone is potentially at risk. I found out the hard way.