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Title: Benzodiazepine Blues: Living With (and Without) Minor Tranquilizers
Author: Jim Parker
Publisher: Do It Now Foundation
Publication Date: March 2009
Catalog Number: 134


..Chill Pills

Chill
out.

It’s advice
that’s as old as time — or that dates back at least as long
as people have been around, marking time, wasting time, and generally
worrying about where all the time goes.

Oh, the words
change, but the message remains the same:
Pull yourself together. Get a grip.
Relax.

With all the
pressure and all the advice, it’s no wonder that so few of us
actually do relax. And it’s no less surprising that so many feel
the need for a little chemical help in the process.

That’s why
we’ve put together this pamphlet. In it, we’ll talk about the
actions and effects of the leading family of depressant drugs
in the world today, the benzodiazepines.

Never heard
of ’em?

Well, we’ll
bet you’ve heard of some of them, even if you haven’t heard of
them all. Examples include such common drugs as Valium®,
Librium®, Halcion®,
and Xanax®.

Sound familiar?
If so, stick around. If not, stick even closer.

Because the
problem with chilling out with chemicals as complex as the benzodiazepines
is that problems can heat up awfully fast if you don’t know the
risks involved.

And from the
looks of things, lots of people don’t fully know the risks involved
when they get involved with benzodiazepines.


..What are the benzodiazepines?

The benzodiazepines
(BZD‘s) are a relatively new family
of depressant drugs, discovered in 1957 and introduced throughout
the world in the 1960s and 1970s.

Although the
drugs first found fame for their “anxiolytic” (or anxiety-reducing)
effects, they’re also prescribed as muscle relaxants, anticonvulsants,
and sleeping pills.

In general,
though, the drugs are more alike than different. Their main differences
involve how quickly they go to work and the length of time they
remain active in the body.


..What are some common BZD‘s?

Although Valium
ranked for years as the leading benzodiazepine (and at one time
was the best-selling prescription drug in America), it’s been
slipping lately, a victim of its own success — and its failure
at being trouble- and addiction-free.

But you can’t
keep a good drug family down. As success always seems to do,
Valium’s inspired imitators, as drug makers around the world
scrambled to spin out variations on the basic BZD
theme. The result? A whole clan of chemical cousins joined it
on the pharmaceutical hit parade.

Today, the
top-selling tranquilizer in the United States is Xanax, and another
benzodiazepine, Halcion, is one of the most widely-used prescription
sleeping pills. They’re the two biggest slices in the benzodiazepine
marketing “pie,” which, according to the American Psychiatric
Association, accounts for about 61 million prescriptions a year.

Down but not
out, Valium (and its generic equivalent, diazepam) is still widely
prescribed and still probably the best-known member of the family.
Other common BZD‘s include Klonopin®,
Ativan®, Serax®,
Centrax®, and Tranxene®.


..What are their main effects?

The benzodiazepines’
main therapeutic effects — to reduce anxiety and induce
sleep — are the same as other depressant drugs, with a difference:
BZD‘s target receptors in the limbic
region of the brain (a system involved in emotional regulation
and control) instead of depressing activity throughout the central
nervous system.

This means
that BZD‘s produce their intended effects
without many of the side effects — impaired thinking and
judgment and serious respiratory depression — linked to
other depressants.

Still, that
doesn’t mean they’re harmless.


..You mean they’re not safe?

Not necessarily.
When taken as directed for short periods (no more than two months,
in the case of tranquilizers, and two weeks, for sleeping pills),
most BZD‘s are relatively safe.

Still, they’re
not safe for everyone, all the time.

When taken
for longer periods or at high doses they can be particularly
risky. They can also be dangerous when used with alcohol —
even small amounts of alcohol.

And certain
BZD‘s — particularly Halcion and
Xanax — are being linked to a number of serious side effects,
including depression, hallucinations, amnesia, and violence.

In fact, one
study by the U.S. Food and Drug Administration ranked Halcion
and Xanax first and second in episodes of violence traced to
329 different prescription drugs.

Experts are
unsure why the drugs cause such problems. But they are sure that
they do — or, at least, can. They say that more research
is needed to find out why.

 


..Are other risks linked to BZD‘s?

As a matter
of fact, there are. Probably the most obvious — and most
likely, for most users — is the risk of dependence that
comes with the drugs.

Dependence
is a risk factor so often because the drugs block the experience
of anxiety so well that many users forget they can (and should)
try to live without their daily ration of Valium or Xanax or
Tranxene.

And they should
try for the simple reason that benzodiazepines are addictive,
and putting your life back together after a bout with BZD
dependence can be an agonizing experience.


..What makes getting off so tricky?

For one thing,
users often don’t realize they’re getting hooked until they are
hooked.

They just know
they have to have a hit of Valium or Tranxene or something every
few hours to hold things together — not even to get high,
since most BZD users don’t take the
drugs to get high, but merely to cope.

It’s only when
the drug stops working, when tolerance builds and they have to
step up the dosage just to avoid freaking out (often in the most
mundane situations), that most people begin to suspect they have
a problem.

Unfortunately,
most suspect their problem is anxiety or insomnia or whatever
they started taking tranquilizers to deal with in the first place
— not benzodiazepine dependency.


..Is addiction serious?

Yes —
and unpleasant, too. But how serious and how unpleasant depends
on the drug involved and other factors.

With the short-acting
benzodiazepines (take our friend Xanax again, for example, or
Halcion), withdrawal symptoms appear almost immediately and are
difficult from the start. With longer-acting drugs (like Valium
or Centrax), symptoms build gradually and may not reach a peak
for several days.

Still, no matter
how long they take to arrive, benzodiazepine withdrawal symptoms
are similar, regardless of the drug involved. Main symptoms include
high (even intense) levels of anxiety, insomnia, tension, tremors,
and fatigue.

The main factor
that determines the course of withdrawal is the pattern of use
involved.

Dependency
resulting from short-term, high-dose use follows much the same
course as withdrawal from other downer drugs. Symptoms start
and peak fast, usually within one to four days, and begin to
wind down within two to three weeks.

Long-term,
low-dose use is more typical for more users, though, and presents
a different situation altogether. Symptoms may not be as immediately
intense, for example, but may hang around a whole lot longer.


..Is withdrawal really that bad?

Not if you
do it right — and get professional help. But it can miserable,
if you do it wrong.

The fact is
that benzodiazepine withdrawal can be a soul-wrenching experience
simply because it unmasks so many emotional and psychological
symptoms.

What’s worse
is that many users don’t recognize withdrawal symptoms for what
they are — signs of chemical dependency — but see them
instead as personal inadequacy or a recurrence of the original
problem that gave rise to the dependency.

One frequent
result is that they think of themselves as defective and use
that belief as a reason to stay addicted.

On top of that,
potentially serious physical problems — particularly seizures
— can also develop during withdrawal, especially following
a long-term period of high-dose use.

That’s why
it’s usually wise to seek professional help during withdrawal.
Doctors can help reduce the risk of convulsions and the severity
of other symptoms by gradually reducing dosage or switching from
a fast-acting drug to a slow-acting one, then reducing dosage.

But with help
or without, getting off benzodiazepines takes a lot longer than
getting on them does.


..How long does it take to get off?

Long enough.

Typically,
the full range of withdrawal symptoms last about six weeks and
run a two-phased course. This means that symptoms may seem to
ease during the second week, only to get worse again during the
third week of withdrawal.

In addition,
different symptoms can emerge at different times: Physical symptoms
usually occur during the first phase of withdrawal, while psychological
symptoms can hang on for weeks or months.

But regardless
of which problems occur (and when they kick in), withdrawal from
BZD‘s is a difficult process and one
that some recovering addicts say can take months to complete.

In fact, some
long-term ex-users report not feeling completely on top of their
dependence — and fully in charge of their lives again —
for up to a year after they stop using.


..Alternative: Action

One of the
biggest dangers of the benzodiazepines is their ability to reinforce
what psychologists call “learned helplessness” —
the tendency on the part of stressed-out people to throw up their
hands and simply do nothing, believing that nothing they do will
make much of a difference, anyway.

The problem
with that thinking is that we all need to learn the exact opposite
— to be powerful to the degree that we can be to take charge
of the events and circumstances of our lives.

In fact, the
ultimate lesson that an anxious person, whether a BZD
user or not, can learn is the ancient prayer: “God, grant
me the serenity to accept the things I cannot change, the courage
to change the things I can, and the wisdom to know the difference.”

Those are the
key ingredients, simple as they sound, to beating anxiety and
overcoming addiction: resisting it and learning to change the
areas of our lives that contribute to it.

It may sound
easy, but it isn’t. But, come to think of it, it’s a lot easier
than living life as a nervous wreck — or as a Valium or Xanax
addict.

Give it a try
some time. We’re betting you’ll like it a lot better than the
alternative.

Because the alternative is really
no alternative at all.


..Sidebar | Unhooking
Up: First Things First

Hooked on a tranquilizer and
want to get off the hook-and your life back on track? Great start:
Recognizing a problem is the first step in any plan for getting
past it. That’s true with simple stuff, like getting an overdue
book back to the library, and it’s even more true when it comes
to issues as complex as chemical dependency.

Still, you may be less clear
about your next move. If so, you might want to consider three
more steps for getting past some common pitfalls in BZD recovery:

  • Get medical
    help.
    BZD withdrawal
    is a potentially-serious medical emergency. Treat it that way.
  • Get support. Anxiety and depression can really rear
    their ugly heads now. Talking about funky feelings with someone
    who understands can help. A friendly ear is as near as a Narcotics
    Anonymous or Pills Anonymous meeting. Check your phone book for
    a group in your area.
  • Get busy!
    Need to manage anxiety?
    Learn to meditate or start jogging. Can’t sleep? Keep a pile
    of self-improvement books next to your bed. (If you’re like most
    of us, they’ll put you to sleep instantly.) Just handle whatever
    it is that you need to handle to fully reverse the addiction
    dynamic in your life.

The truth is that getting past
BZD’s can be tough, but it can be done. Thousands of ex-Valium/Xanax
“junkies” can tell you that. They’ll also tell you
it’s worth whatever it costs-jangled nerves, hassles, lost sleep-to
get free.

But you’ll have to find that
out for yourself.


This is one in a series of publications
on drugs, behavior, and health by Do It Now Foundation.
Please call or write for a complete list of available titles,
or check us out online at
www.doitnow.org.


 

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