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Posted: May 2, 2006, 11:05 AM
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. 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. -------------------- Get That Giant "Ativan" out of My Life 3.0mg was my highest per day. 13 weeks on ativan and 4 years of heavy drinking. alcohol free 16 months , tapering 1/8th every week. Currently at 0.00mg Ativan (as of July 23, 2005) 13 months Ativan free | ||
Posted: May 2, 2006, 11:07 AM
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. -------------------- Get That Giant "Ativan" out of My Life 3.0mg was my highest per day. 13 weeks on ativan and 4 years of heavy drinking. alcohol free 16 months , tapering 1/8th every week. Currently at 0.00mg Ativan (as of July 23, 2005) 13 months Ativan free | ||
Posted: May 2, 2006, 11:07 AM
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. -------------------- Get That Giant "Ativan" out of My Life 3.0mg was my highest per day. 13 weeks on ativan and 4 years of heavy drinking. alcohol free 16 months , tapering 1/8th every week. Currently at 0.00mg Ativan (as of July 23, 2005) 13 months Ativan free | ||
Posted: May 2, 2006, 11:08 AM
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. -------------------- Get That Giant "Ativan" out of My Life 3.0mg was my highest per day. 13 weeks on ativan and 4 years of heavy drinking. alcohol free 16 months , tapering 1/8th every week. Currently at 0.00mg Ativan (as of July 23, 2005) 13 months Ativan free | ||
Posted: May 2, 2006, 11:09 AM
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. -------------------- Get That Giant "Ativan" out of My Life 3.0mg was my highest per day. 13 weeks on ativan and 4 years of heavy drinking. alcohol free 16 months , tapering 1/8th every week. Currently at 0.00mg Ativan (as of July 23, 2005) 13 months Ativan free | ||
Posted: May 7, 2006, 6:16 PM
bump
-------------------- Get That Giant "Ativan" out of My Life 3.0mg was my highest per day. 13 weeks on ativan and 4 years of heavy drinking. alcohol free 16 months , tapering 1/8th every week. Currently at 0.00mg Ativan (as of July 23, 2005) 13 months Ativan free | ||
Posted: June 2, 2006, 1:55 PM
They talk about benzos on the Radio Great stuff to listen to. -------------------- Get That Giant "Ativan" out of My Life 3.0mg was my highest per day. 13 weeks on ativan and 4 years of heavy drinking. alcohol free 16 months , tapering 1/8th every week. Currently at 0.00mg Ativan (as of July 23, 2005) 13 months Ativan free | ||
Posted: June 12, 2006, 12:28 AM
bump
-------------------- Get That Giant "Ativan" out of My Life 3.0mg was my highest per day. 13 weeks on ativan and 4 years of heavy drinking. alcohol free 16 months , tapering 1/8th every week. Currently at 0.00mg Ativan (as of July 23, 2005) 13 months Ativan free | ||
Posted: July 4, 2006, 9:33 AM
:)
-------------------- Get That Giant "Ativan" out of My Life 3.0mg was my highest per day. 13 weeks on ativan and 4 years of heavy drinking. alcohol free 16 months , tapering 1/8th every week. Currently at 0.00mg Ativan (as of July 23, 2005) 13 months Ativan free | ||
Posted: July 8, 2006, 4:12 AM
A visual animation on how benzos work with gaba receptors -------------------- Get That Giant "Ativan" out of My Life 3.0mg was my highest per day. 13 weeks on ativan and 4 years of heavy drinking. alcohol free 16 months , tapering 1/8th every week. Currently at 0.00mg Ativan (as of July 23, 2005) 13 months Ativan free | ||
Posted: August 29, 2006, 10:36 AM
great info
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Posted: September 23, 2006, 1:08 AM
I'm 14 months off of ativan and still feel very disabled. This benzo stuff is very serious and can make you very sick for a long time.
Please Remember This Warning Now if you read this thread you can't say you didn't know. | ||
Posted: February 28, 2007, 7:08 AM
Some more good info here about benzos -------------------- Get That Giant "Ativan" out of My Life 3.0mg was my highest per day. 13 weeks on ativan and 4 years of heavy drinking. alcohol free 16 months , tapering 1/8th every week. Currently at 0.00mg Ativan (as of July 23, 2005) 13 months Ativan free | ||
Posted: March 11, 2007, 4:56 PM
Thats a lot of cutting and pasting...whew...good info though I suppose.
Thank god that I never became addicted to anything but pain pills...I hated pills until I got addicted to perc and oxy's. I detest pills to this day...all of them. I have ativan prescribed to me for withdrawal and noticed how uneasy I felt only after about a 10 day run! As long as there is breath in my body I will never mess with drugs again! I hate hate hate them. -------------------- LIVE....LAUGH...LOVE...LIKE THERE IS NO TOMORROW!!!! | ||
Posted: May 24, 2017, 12:14 PM
After 55 months off and still unable to walk from crippling muscle tension,today I was hit with the most intense symptoms yet,including severe convulsions ! Anyone else have anything like that happen and if so how long did it last ,plus did you find anything to help ?
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Posted: June 6, 2017, 11:27 AM
If you want help getting off benzo or sleep med like Ambien or Lunesta - you can get a lot of help at benzobuddies.org DO NOT COLD TURKEY OFF A BENZO!
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Posted: February 16, 2022, 1:36 AM
I love this
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