Why are benzos so vilified and how do I bring this up with a new doctor without sounding like a drug seeker?

[jonghee]

I have an appointment with a new provider. He gave me an initial consult regarding what I was currently taking. He was cool with almost all my regimen except for the klonopin part (.5mgx2/day). I've expressed willingness to try other meds for anxiety, but at the same time, klonopin/benzos are the only thing that work. I actually want to up the dosage to what I was rx'ed by a previous doctor (2mg/day), but fear that I might come off sounding like a drug seeker. Before anybody jumps in with the "benzos are bad" argument, check yourself and read the whole post before passing any judgment. Maybe I am atypical, an exception, but all the alternatives I have tried have been WORSE than all the supposed dangers of benzos. Buspar gave me the worst side effects. Basically every warning in the medication pamphlet I suffered - tremors, tension, tiredness, just to name a few. And withdrawal. In the psych unit I was given Haldol for anxiety. Result: Complete body dystonia, a swollen tongue, seizure like eps where I needed to be stabbed with cogentin to calm my body that was the equivalent of a scene from the exorcism of Emily Rose. Gabapentin caused dizziness, drowsiness and confusion. Inderall is the only anxiety med besides benzos I can think of that didn't cause a bad side effect (although it wasn't particularly effective either, but maybe that was the the dose being low). SSRIs for me have worked for some symptoms of anxiety, particularly social anxiety (ie the feeling of dissociation/detachment) but not for overall general anxiety and panic attacks.

In terms of addiction, withdrawal and dependence, perhaps I am in the minority, but the absolute worst withdrawal I have experienced is from antipsychotics. Benzo withdrawal feels like a mosquito bite compared to the physical pain and feeling of impending death that comes from seroquel or Zyprexa withdrawal, yet we don't hear any hysteria even close to the degree that benzos generate. I laid on the floor for 5 days straight with labored breathing, chills, drastic body temperature fluctuations, just to name a few. I am not here to say that benzos are good or should be rx'ed like candy, but it's extremely unfair to put them in the negative light that they receive. Yes, they can and do cause dependence, and there is a potential for addiction, but why is it any worse than the dependence antipsychotics cause, or why is benzo withdrawal any worse than ssri discontinuation syndrome? Why is it cast in such an evil light when they have been around longer than many other psychotropic drugs? Drugs among which also have long term side effects such as tardiness dykensia, diabetes, neuroleptic malignant syndrome, just to name a few.

I know that many will jump straight to the overdose reasons. By themselves, benzos are EXTREMELY difficult to overdose on. Trust me, I tried. 60mg klonopin in one shot. I didn't even knock out. Conscious the whole time. Mixed with other downers, now that is a different story. Yes, with alcohol or opioids, this is a recipe for disaster. But why blame the benzo? Blame the lack of patient education from doctors. And blame the other substances more so than the benzo. Again, this is my experience. However, the purpose of my post is not to make benzos out to be harmless or a safe wonder drug, but instead to look at the whole picture and end the scapegoating. Having an rx for a higher dose of klonopin causes me to need LESS, because of the comfort in knowing that I'll have enough to be covered. Why should I HAVE to fight through the pain when a pill can prevent it in the first place? Please share your thoughts. This is a topic that needs more discussion.

[Dolphin14]

It's a new relationship with your md. They have their own thoughts about our med list when they meet us and they share their opinion.

This md doesn't know you so shouldn't jump in changing things too much before he/she gets to know you more.

This is all about working together. You both need to hear each other out. Be honest and listen to their side. I hope things work out ok

[clusterfu__d]

I have to agree completely about benzos. Without them, I live on the edge of a panic attack, which is no fun at all. I take a low dose once a day (1mg Lorazepam), twice if things get bad or I feel a panic attack coming on, but always 8-10 hours apart. I have tried so many SSRI/SNRIs, and none of them have worked for me, and the side effects just make life more miserable.

Benzos have been the only thing to work for me, and I don't abuse them or mix them with anything other than Gabapentin and blood pressure meds (no alcohol, no opioids), yet I have been treated like a drug seeker. It's infuriating.

[jonghee in reply to clusterfu__d]

Thank you clusyerfu__d. And your screen name describes it perfectly. I feel like 5-10 years ago it was much easier to ask for them. Now, because of the opioid crisis and irresponsible media hysteria, that has spilled over to us benzo users and had terribly negative effects. It seems like doctors are so cautious and hesitant to rx them more so for fear of their license as opposed to what is best for the patient. All the media reports of overdoses mentioning a toxicology of opioids, alcohol and benzos very irresponsibly paint a broad stroke and characterize benzos as equally lethal as other downers. The irony is that benzos were created to replace barbiturates, which had a therapeutic dose and lethal dose that was too close so as to cause accidental overdose. The ld50 for a benzo alone is essentially a truckload. To get your hands on that amount, you would essentially need a connection to a full blown drug trafficking syndicate. They say that you are more likely to die choking on benzos than to overdose on them. The misinformation out there is infuriating. Just googling benzos leads to search results of rehab and addiction resources. I will be honest - when my benzo doasge was reduced, that is when I started abusing it. However, I don't consider this abuse to any degree, and will not fall for all the rehab and recovery propaganda telling me I need help. The reason I abuse 1mg of klonopin is because I had been prescribed 2mg per day for years. That is what my body is accustomed to. Of course reducing my customary dosage by in half will make my body feel out of balance. I obviously can't say that directly to a doctor, but I am trying to figure out a way to indirectly convey this. Forcing someone to reduce their dosage without a valid medical reason (where most reasons are simply arbitrary) in my opinion amounts to malpractice. It's dangerous and unnecessary. And all of a sudden I am labeled as a drug abuser. I'm not falling for the hysteria. It's illogical. I was rx'ed a certain dosage, my body became adjusted to it, and suddenly the carpet gets yanked from under me. This kind of hysteria led me to abuse seroquel, because I needed to relieve the anxiety in some way, and that was the closest thing to the relief I could get from benzos. Yet doctors have no problem prescribing me the seroquel. Klonopin or xanax? "Drug seeker" alarm rings. Seroquel, zyprexa? "Sure, how many milligrams do you want?" If people can't see the hypocrisy in that, then I really have no idea what to say. I could provide a library of evidence to people of this opinion, yet I don't think facts would do anything to change their mind or even get them to question the status quo. It seems as though people, including professionals, already have their minds made up, regardless of any evidence to the contrary. It's very sad that even the professionals we entrust our health to are susceptible to this kind of simplistic thinking. I welcome anybody to present some counterarguments. I appreciate intelligent debate.

[MollyStark]

Doctors in general practice have a low opinion of their patients and consider us all to be idiots I think. They don't accept that a good many people can manage their medication just fine and won't become addicted. Hospital doctors seem to have a different opinion. When I've mentioned I take the occasional low dose diazepam for anxiety, they have laughed saying that dose is too low. Others have said they consider it completely acceptable to take them when needed.

GPs (here in the UK) are governed by certain guidelines which restrict them giving an informed assessment on individual patients, so we all get treated the same.

[jonghee in reply to MollyStark]

Oh wow, in my experience here in NJ, USA, I have found it to be the opposite, with primary care doctors more likely to prescribe benzos (albeit at the lowest doses) and hospital doctors (psych unit specifically) not prescribing them except in the rarest circumstances. However, with the primary care doctors, I had already known them for a while, and others I have heard of receiving from their pcp had an established relationship as well. As for hospital doctors, they seem to treat us all as drug addicts first, psych patients second (I wonder if this is a profiling issue due to being located in an urban area).

However, in 5 trips to the psych unit, only one hospital gave me my regular klonopin (ironically after I had downed a whole bottle in a lame "attempt" to overdose - it was more so a cry for help). Perhaps because it was a university hospital, they were better educated. As for the other hospitals, they completely ignore the subject. Not even a mention of it. Considering the supposed potential for withdrawal, either this is negligence or the withdrawal effects are highly exaggerated in an effort, as I previously stated, to vilify and demonize benzos. I have been in the psych unit with many people prescribed benzos regularly for daily use. We all were left without them for days, weeks, and I have yet to see anybody suffer the terrible withdrawal symptoms described in the media and reports. Sure, it was uncomfortable and certainly sucked, but it wasn't like the horror stories I've read about.

It's funny how the culture can affect these kinds of things. I'm curious as to other cultural differences in psych practice between usa and england/Europe. For example, I know that the opioid epidemic in the US is in stark contrast to Europe, where the use and abuse of opioids is much more controlled.

[MollyStark in reply to jonghee]

It is interesting (also puzzling!) why there is such a stark difference in attitudes towards certain medications in different countries. I think the tide is turning on opioids here in the UK. Last year I was prescribed 100 high strength co-codamol tablets for pain and told to take the maximum dose as long as I need them. As my pain is ongoing, it would mean taking them indefinitely. When I queries this I was told 'you'll be fine if you take the maximum dose'. No mention of pain management or alternative treatment. Yet, when I ask for a prescription of low dose diazepam (which would also help witht he occasional muscle spasms that come with my pain) I was told 'we don't prescribe them for muscle spasms because they're addictive.' I was also told by another GP when I asked for diazepam for occasional use to help my anxiety (we're talking one or two prescriptions a year) that 'we only prescribe them for end of life patients who suffer with anxiety'. I have very little trust in doctors because they really don't consider their patients on an individual basis.

[jonghee in reply to MollyStark]

Wow!! I don't know how to respond. Honestly, I'm at a loss for words. I thought the stigmatization of benzos in the us was bad, but this just takes the cake. I mean, even Wikipedia is more reliable as a medical source than this sort of nonsense. Is it that easy to become a doctor? Psychiatrist specifically? These are basic things that can be disproven in the first 3 results from a Google search. I am seriously considering applying for residence in psychiatry at this point. End of life patients? People who go to suicide clinics are given the barbiturates, which benzos were created to replace due to their exponentially lower risk of fatal overdose. So the drug created to replace an end of life drug is now itself being classified as an end of life drug?!

I am so sorry that you have to deal with this misinformation in the UK, my friend. I thought it was bad here in the US, but goddamn is all I can say. You have now officially given me the confidence to essentially laugh at a doctor during an appointment and turn the tables. If I were to receive that sort of response, I would fire the doctor on the spot and demand a refund. I am seriously thinking of only using credit as payment for psychiatry services so that I can contest the charge with my credit card company for for dissatisfaction with services rendered in the event I receive that level of ineptitude. You've inspired an idea in me MollyStark. Thank you. And good luck in your journey. I wish you all the best.

[Vvalerie]

Hi sorry to hear your having problems with Gabapentin I have found it to be very good for me , it really helps my pain no side effects: been on it for a good few years , I can only say in your shoes I would be back to see your go ASAP. Hope this helps good luck .

[Jimmyluke55]

Totally agree with you love xxx

[mixedgrill]

I am sorry to hear of your problems with your medications i have been taking gabapentin for some while along with olanzapine and diazepam i have to say I have tried many antipsychotics and have found as I have that they in themselves are very toxic in more ways than one now gabapentin in the UK has now become a controlled drug because of miss use and addiction and also dependence issues there are occasions where I have been without them mainly due to peacetime issues (being delayed or misdirected to the wrong chemist at these times the effects from not having them were terrible shakes body chills drops in temp and sweats i have been prescribed them for around five years now for spinal pain i hope this is of some help to you