It’s stunning what a quarter milligram of a benzodiazepine can do to the body. Even less than that, I’ve found, can send the body spinning into the deep dark unmentionable. I’ve been detoxing off a high dose of benzodiazepines since September of 2011. The first few months were a failure. I didn’t know about the salve of exercise, didn’t know that shifting from the slam your head benzo to the slow trolling benzo was crucial for mitigation of withdrawals. But this past May, I found my expert and thought I had the formula. I was systematic, dropping my dosage weekly, walking fast even when my legs felt like lead and reminding myself to look up. Look: sky, birds, sun. Things were going well for detoxing off a substance many deem more addictive that heroin. That is, I realized, until they weren’t.
This is how it goes when you’re riding through relatively uncharted medical territory. I felt bad last week. I’ve been attending a women’s support group facilitated by a social worker. Nothing huge – just talk, just no-nonsense support. After last week’s group, the social worker pulled me aside. She was concerned at my claims of nausea, malaise, muscle spasms and existential abyss. I spoke with a friend who specializes in addictions, she whispered, and she told me that there’s no way detoxing should take more than a month. We’re afraid that your doctor is taking you for a ride. I stared at her, the benzo dogs of fury frothing. I wanted to rip her apart verbally. I wanted to have her cowering in the corner in the face of what I could unleash. I told the benzo dogs to get down. Down, dogs, down! I spoke as calmly as I could. There’s no duct tape for benzo withdrawal, I said. Those week long detox centers? They’re M*A*S*H units that titrate people and send them into the world held together with chicken wire and bubble gum. When the Librium (one of the first, longest acting benzos) gets out of their system, they’re out of their minds. I think it would help if you read a bit of the Ashton Manual. Or Robert Whitaker’s Anatomy of an Epidemic. Check it out. Good bedside reading.
I left the meeting stunned. It was one small example of how the cultural at large, including those who consider themselves mental health practitioners, know little about the brutal animal of benzos. Dumping benzodiazepines into the bowl of “chemical addictions” and thinking that their action on the body is similar is a broken and highly dangerous concept. There is no duct tape for benzo withdrawal. The brain has been hijacked. It takes months of slow, careful withdrawal to convince the brain to come online again. And even in the realm of slow and careful, it’s no cakewalk.
So it was this week that I discovered that I’d hit what can or can’t happen during withdrawal: A plateau. My body said, “NO.” Every system in the body said no, can’t do it, can’t cut back again. For anyone else going through this, the signs can include the following:
1. Nausea and a lack of interest in eating coupled with belly sounds resembling those of a large aquarium.
2. A feeling of oppression, as if the sky was tightening its belt around you, growing dark.
4. Night muscle spasms that rip you out of precious sleep as if a pit bull had sunk its teeth into your neck or stomach or leg muscles.
5. Wildfire under the skin. Acid.
6. Fury that I call the Benzo Dogs. They are Michael Vick’s trained killers and they want blood. (Cognitive Behavioral Therapy is a must here as is walking the Dogs and walking them far if you don’t want to end up punching someone. Like your therapist, for example.)
7. A walk into the Existential Cafe where you sit down and stay. You order a coffee. No cream. You stare at the scratches in the table. You lay down on the floor. You curl into a ball and begin sobbing.
Number seven was the kicker for me. The first thing I did (after sobbing briefly in the bathroom and crushing a wash rag into my face), was to remind myself that my symptoms were the drugs, just the drugs.
I returned to Professor Heather Ashton’s website that details 30 years of research on benzo withdrawal. The woman knows her neurotransmitters. And for the record, I’m detailing all of this because these medications are distributed like candy, like cookies at a PTA meeting. And let me say, they are amazing hammers. When you need a hammer, they are your magic pharmaceutical tool. But the dark side of the pharmaceutical/medical industry is in the laxity of regulation. These little pills are so addictive, so fast to seduce the body, it’s rare for people to take them for the few weeks for which they’re officially recommended. They’re the modern opiate flower and once you’re in, you’re in. And if years pass and then more years, these little hammers will slowly deregulate your body until it cranks to a halt.
Here’s a metaphor to explain their operation in the body. You have receptors in the brain called GABA receptors. GABA receptors are the sweet grandmother neurotransmitters. GABA Grandmas say, Hush to the other neurotransmitters. Hush. Be quiet babies, turn everything down a bit. GABA Grandmas are great and necessary to regulate all systems of the body. When the body needs to quiet down, GABA Grandmas are there to help them. Benzos take the GABA Grandmas and throw them into a closet. They stuff their mouths with rags. Like the Mafia, they then turn the main generator of the body way down.
This is a problem. Long term, it’s a problem. Everything gets dialed down: muscular tension, neural activity, digestive activity, cardiac rhythm, organ systems, you name it. Everything goes Shhhhh. Which, after years of use, can cause some serious problems. Not to mention setting up camp in the Existential Cafe which is just a bummer in general and the coffee sucks.
So, there you have it. The quickie medical description of what happens with long-term (described as 4 months or longer) benzodiazepine use. This is my word of caution because it’s so, so hard to get off. So hard. If you need a hammer, know that you are using a hammer.
So, I’ve plateaued, which is a bummer. But I’ll get there. Persephone does return from the underworld and she’s not carrying pills in her back pocket. Neither will I.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.